What You Need to Know About Sleep Apnea Treatments

Sleep apnea is one of about 80 different types of sleep disorders. Sleep apnea is a common condition in the US, with the American Sleep Apnea Association¹ estimating it affects approximately 22 million people, nearly 26% of adults between the ages of 30 to 70. Despite how common it is, almost 80% of cases are left undiagnosed and untreated.

What is sleep apnea?

Sleep apnea is a sleep disorder where your breathing is interrupted while you sleep, causing you to stop and start breathing repeatedly. The frequency of these nighttime sleep interruptions varies from person to person, but they can occur up to several hundred times in a night.

Left untreated, sleep apnea can have serious health consequences, leading to severe health conditions such as high blood pressure, diabetes, stroke, heart attack, and heart failure.

There are three types of sleep apnea:

Obstructive sleep apnea

The most common type of sleep apnea occurs when the muscles in the throat relax and block the upper airway. When the throat muscles repeatedly relax, airflow is severely restricted or stopped.

Here's what else you need to know about obstructive sleep apnea.

Central sleep apnea

A condition caused by your brain miscommunicating signals to your muscles that control breathing.

Complex sleep apnea syndrome

A condition where you are diagnosed with both obstructive sleep apnea and central sleep apnea.

Symptoms

Determining the type of sleep apnea you have can be challenging because obstructive and central sleep apnea shares many signs and symptoms. The most common signs of sleep apnea include frequent loud snoring or apnea events during sleep, such as gasping for air and decreased or stopped breathing.

Sleep apnea’s interference with normal sleep patterns results in several symptoms. One of the most common symptoms is sleepiness during the day caused by the lack of restful sleep at night. The fatigue can often be severe enough that it is noticeable to teachers, co-workers, and others during your daily interactions. The sleepiness associated with sleep apnea can interfere with your concentration, alertness, awareness, and motor skills.

Other common symptoms of sleep apnea include:

• Frequent urination at night

• Headaches and dry mouth on waking

• Decreased libido or sexual dysfunction

The signs and symptoms also vary among men, women, and children. For example, women tend to report higher rates of headaches, fatigue, depression, anxiety, insomnia, and sleep disruptions than men. Children with sleep apnea commonly experience bedwetting, asthma attacks, hyperactivity, and issues with their performance at school.

Diagnosis

As it occurs while you are asleep, many people with sleep apnea don’t realize they have it. As a result, it often goes undiagnosed and untreated. You may not realize there is an issue until a bed partner, roommate, or family member notices that you sometimes stop breathing in your sleep and tells you.

If you have been told that you snore loudly or stop breathing when sleeping, or if you feel excessively tired during the day, contact your doctor. They may recommend you undergo a sleep apnea evaluation. Your doctor will assess several factors, including your sleep history, signs and symptoms, and observations by members of your household.

If your doctors suspect that you have sleep apnea, they will refer you to a sleep disorder center, where a sleep specialist can assess your condition and determine whether further testing is required.

Often, an evaluation will include an overnight sleep study in a sleep disorder center, where you will be monitored while you sleep. During this sleep study, your physical movements, heart rate, breathing, brain waves, and other vital signs will be monitored and recorded.

For some patients, home sleep testing is a tool that your doctor may use to diagnose your sleep apnea. Home sleep tests typically monitor your blood oxygen level, heart rate, airflow, and breathing patterns.

Your doctor may be able to make a diagnosis and prescribe treatment based on the result of a home sleep test. Depending on the result, they may refer you to a sleep disorder center to undergo a sleep study to ensure you are correctly diagnosed. The sleep specialist can then provide you with the right treatment plan.

If you are diagnosed with obstructive sleep apnea, your doctor may refer you to an ear, nose, and throat (ENT) specialist who is extensively trained in conditions involving the head and neck. They may be able to determine the cause of your breathing issues and recommend appropriate treatment options.

A diagnosis of central sleep apnea may also require an evaluation by a cardiologist or neurologist to determine the underlying cause.

Treatment

The treatment for sleep apnea varies depending on the severity of your condition. For milder conditions, your doctor may recommend lifestyle changes, such as losing weight, quitting smoking, and reducing alcohol consumption.

Sleep apnea machines

For moderate to severe cases, many patients find that a sleep apnea machine is an effective solution. The most common device used to improve sleep apnea is the continuous positive airway pressure (CPAP).

The CPAP delivers constant air pressure through a mask that you wear while sleeping. The positive air pressure is strong enough to keep your airway passages open, preventing snoring and breathing interruptions.

CPAP machines are considered the most reliable treatment for sleep apnea. However, some people find them uncomfortable and struggle to keep the mask on at night. It may take some adjusting to and trying different masks before you find a comfortable fit.

Many patients report that the CPAP machine has dramatically improved their sleep and quality of life.

Clinical trials

Another treatment option for some patients is participation in a clinical trial. During a clinical trial, patients undergo experimental therapies and treatments in order to provide medical researchers with insight into the effectiveness of potential treatments and possible adverse effects.

Search for sleep apnea clinical trials you may be eligible for here.

Surgery

In severe cases of obstructive sleep apnea, when other non-invasive treatment options have remained unsuccessful for at least several months, surgery may be an option.

Types of surgeries for sleep apnea include:

Tissue removal

Removing tissue from the back of your mouth and top of your throat, along with your tonsils and adenoids. This type of procedure can eliminate snoring but is less effective and reliable than CPAP. 

Tissue shrinkage

This uses radiofrequency ablation to shrink tissue at the back of your mouth and top of your throat. This procedure is used to treat mild to moderate sleep apnea and has been found to produce results similar to tissue removal with less surgical risk.

Jaw repositioning

A procedure in which the jaw is moved forward, reducing the likelihood of airway obstruction by enlarging the space behind the tongue and soft palate.

Nerve stimulation

Using a surgically implanted device to stimulate the nerve that controls your tongue which holds it in position so that it doesn't obstruct your airway.

Tracheostomy

A procedure that is used in cases of severe or life-threatening sleep apnea when all other treatment options have failed. An opening is made in your neck into which a plastic or metal tube is inserted to create a new airway. The opening is covered when you are awake, but it is uncovered at night which allows you to bypass the blocked airway by drawing air in and out of your lungs through the new opening.

Doctors and specialists

Your first contact will typically be your doctor, who can assess your condition and refer you to a sleep specialist for diagnosis and treatment. Sleep specialists come from a wide range of medical disciplines. Alongside your doctor, you could work with a:

• Pulmonologist

• Otolaryngologists

• Neurologists

• Dentist (some dentists have specialized training in the treatment of sleep disorders, including sleep apnea)

• Other medical professionals

When should you see a doctor for sleep apnea?

You should contact your doctor about sleep apnea as soon as you become aware of the following symptoms:

• Complaints of loud snoring from a bed partner or member of your household

• Someone has witnessed you stop breathing while you were asleep

• Waking up gasping for air or making choking sounds

• Having difficulty falling or staying asleep

• Excessive daytime sleepiness

• Frequent headaches or sore throat in the morning

The lowdown

While it's not unusual for you to not sleep well from time to time, sleep apnea is a common sleep disorder in the US that can significantly affect your quality of sleep. If left untreated, it can have serious, even fatal, consequences.

While sleep apnea is a serious medical condition, there are effective treatments available so it is important to get diagnosed and start a treatment plan as soon as you become aware of symptoms.