Sleep Apnea—Symptoms, Diagnosis, And Treatment

Sleep apnea is a serious sleep disorder. When not detected and treated early, it can lead to severe health problems such as heart complications and hypertension.

When you are suffering from sleep apnea, you experience repeated pauses in breathing while sleeping. It happens several times, which leads to a restless night and makes you feel fatigued in the morning. Sleep apnea is very common in the United States and affects people of all ages and genders.

What are the three types of sleep apnea?

There are three types of this disorder: obstructive sleep apnea, central sleep apnea, and mixed sleep apnea.¹

Obstructive sleep apnea (OSA)

OSA is caused by a physical blockage of the airways at the back of the throat. This physical obstruction leads to temporary lapses in breathing while sleeping.

Central sleep apnea (CSA)

CSA is a result of a disruption to the brain’s mechanisms that control the muscles involved in respiration, resulting in slower and shallower breaths throughout the night.

Mixed sleep apnea

This condition is also known as complex sleep apnea. It comes about when you experience both OSA and CSA at the same time.

How is sleep apnea diagnosed?

When diagnosing sleep apnea, doctors conduct an extensive physical examination and a complete medical history. Important clues during diagnosis are loud snoring and daytime sleepiness.

Your doctor will carry out a physical examination of your head and neck to single out any physical factors linked to sleep apnea. You may also be given a questionnaire to get information about daytime drowsiness, your sleeping habits, and your quality of sleep.

While some patients may be evaluated for OSA at home without needing any assistance from a technician, further diagnostic tests may be required if other sleep disorders are suspected. The following diagnostic tests may also be performed²: 

Polysomnography (PSG)

During this test, you will be required to sleep overnight at a medical facility or sleep center. You will be connected to various medical devices that monitor and record physiologic variables.

As you sleep, the PSG test will measure the activities of various organ systems linked to sleep. These include, but are not limited to, the following:

• Electroencephalogram (EEG), which is used to measure brain waves

• Electrocardiogram (ECG), used to measure the rate and rhythm of the heart

• Pulse oximetry test for measuring blood oxygen levels

• Electrooculogram (EOM), used to measure eye movement

• Electromyography (EMG), used to measure the activity of the muscles.

Home sleep tests

Where it seems fit, your doctor may also just give you simple self-diagnostic tests for sleep apnea that you can conduct at home. With these tests, you will measure your blood oxygen level, heart rate, breathing patterns, and airflow.

Who are the doctors or specialists involved in sleep apnea?

Most people disclose worries about sleep apnea to their personal doctors who will carry out a physical examination and medical history assessment to diagnose the disorder.

Once your doctor (i.e., your general practitioner) gets all the information they need from the assessment, they may refer you to a somnologist, a doctor who specializes in diagnosing and treating sleep disorders.³

Over the years, somnologists have carried out various sleep studies to closely monitor the activities of the brain when someone is asleep. The findings of these studies help in the diagnosis of sleep disorders and determine the underlying causative factors.

How to know if you have sleep apnea

It is worth noting that because the symptoms of central and obstructive sleep apneas are more or less the same, it may not be easy to determine which type you are suffering from. The most common signs of sleep apnea¹ are:

• Very loud snoring

• Episodes in which one stops breathing while asleep

• Bad headaches in the morning

• Insomnia

• Hypersomnia

• Gasping for breath while asleep

• Irritability

• Inattentiveness.

When should you see a doctor for sleep apnea?

While loud snoring can be a sure sign of a potentially serious problem, not everyone dealing with sleep apnea snores. Reach out to your doctor if you show the above signs and symptoms.

Also, seek medical assistance if you experience any sleep problems that leave you feeling fatigued and irritable the next day.

Risk factors of sleep apnea

Sleep apnea can affect anyone. However, the following factors may increase your chances of developing this medical disorder:

• Being overweight

• Having a thicker neck circumference

• Being male. Men are more likely to suffer from sleep apnea than women.

• Being older. Sleep apnea affects a lot of older people.

• Having a narrowed airway that may be caused by enlarged tonsils

• Having a family history of sleep apnea

• Poor lifestyle habits such as drinking and smoking

• Health conditions such as diabetes, Parkinson’s disease, and heart complications, among others.

These risk factors, as well as any signs and symptoms you may be experiencing, will help your doctor arrive at a diagnosis of sleep apnea.

You have been diagnosed with sleep apnea. Now what?

If you have just been diagnosed with sleep apnea, you may be wondering what to do next. The first and best approach is to talk to your doctor about the lifestyle changes you can make and the treatment options that are most effective for you. You may be surprised at the world of difference the right tools may make in your life.

If you suffer from a mild case of sleep apnea, your doctor may simply require you to make simple lifestyle changes. You may be advised to cut weight or quit smoking. If you suffer from nose allergies, you may also just be treated for it.

If these recommendations do not improve your condition or if you have moderate to severe sleep apnea, you may be subjected to several other treatment options⁴, including the following:

1. Therapies for sleep apnea

Continuous positive airway pressure (CPAP)

Continuous positive airway pressure is a common and reliable method of treating sleep apnea. It is a machine that delivers oxygen through a mask while you are sleeping.

CPAP uses air pressure that is greater than the surrounding air to keep your upper airway passages open, preventing pauses in breathing and snoring. While this can be cumbersome and uncomfortable at times, you will get used to it with practice.

Alternative airway pressure devices

If you find it challenging to use the CPAP machine, you can use an alternative airway pressure appliance that adjusts air pressure automatically while you sleep (auto-CPAP).

Oral devices

Your doctor may also recommend you use oral appliances designed to keep your throat open. While CPAP is more effective than these oral devices, oral appliances are easier to use.

Supplemental oxygen

If you suffer from CSA, using supplemental oxygen with devices that deliver oxygen to your lungs may be helpful. 

Adaptive servo-ventilation (ASV)

Adaptive servo-ventilation is a recently approved device that studies your normal breathing pattern and stores this data in a built-in computer. While you are sleeping, this device will use pressure to normalize your breathing, thus preventing sleep apnea.

2. Surgical treatment for sleep apnea

Surgery is usually the last option after all the other treatment approaches have failed. However, this is a great first option for people with jaw structure problems.

Your surgical options may include, but may not be limited to, tissue removal, tissue shrinkage, implants, repositioning of the jaw, stimulation of the nerves, and tracheostomy (coming up with a new air passageway).

Depending on your condition, you may also have to undergo weight-loss surgery or have your enlarged tonsils removed.

3. Home remedies for sleep apnea

Self-care is important when dealing with sleep apnea. You may be asked to do the following in combination with the other treatment options mentioned above.

• Lose weight

• Exercise regularly

• Avoid or cut down on your alcohol intake

• Avoid tranquilizers and sleeping pills

• Sleep on your side or stomach as opposed to your back

• Quit smoking.

The lowdown

If sleep apnea is not diagnosed and treated early, it can lead to a number of complicated health conditions such as cardiomyopathy, stroke, cardiac arrest, diabetes, obesity, hypertension, and arrhythmias. 

There are numerous options for treating sleep apnea. If one is not a good fit for you, your doctor may walk you through other alternatives. You can also use an AASM-accredited sleep center⁵ to find a sleep provider.