Interruptions of Breathing During Sleep
If you’ve ever had a stuffed-up nose, you know the feeling of trying to breathe through a very narrow passageway. This is what happens in your throat when you snore. While you sleep, structures in your throat partially block your air passage, making the passage narrow and hard to breathe through. As air from the nose or mouth passes around this blockage, the throat structures vibrate, causing the familiar sound of snoring.
In order to accurately diagnosis a sleep disorder, some patients may benefit from a sleep study, which records brain function and physical activity (breathing, snoring, heart rate, oxygen levels, and movements) during sleep.
Central Sleep Apnea
Central sleep apnea occurs when breathing temporarily stops for 10 seconds or more many times during a night's sleep. This is caused by an abnormality in the brain, which prevents it from regulating oxygen levels and automatically triggering breathing. This diminished oxygen is a condition called hypoxia. It can worsen conditions such as epilepsy, or lead to problems such as chest pain or heart attack in people who have coronary artery disease. Central sleep apnea may also be caused by problems in carbon dioxide regulation.
Obstructive Sleep Apnea
If the entire passage becomes blocked and you can’t breathe at all, you have sleep apnea. Since the lungs aren’t getting fresh air, the brain tells the body to wake up just enough to tighten the muscles and unblock the air passage. With a loud gasp, breathing begins again. This process may be repeated over and over again throughout the night, making your sleep fragmented with a lighter stage of sleep.
Even though you do not remember waking up many times during the night to a lighter sleep, you feel tired the next day. The lack of sleep and fresh air can also strain your lungs, heart, and other organs, leading to problems such as high blood pressure, heart attack, or stroke.
Medicines are generally not effective in the treatment of sleep apnea. Therapy may include the following:
- Oxygen may safely help some people, but does not end sleep apnea or prevent daytime sleepiness.
- Behavioral changes are an important part of a treatment program, and in mild cases of sleep apnea, behavioral therapy may be all that is needed. You may be advised to:
- Avoid the use of alcohol.
- Avoid the use of tobacco.
- Avoid the use of sleeping pills.
- Lose weight if overweight (even a 10% weight loss can reduce the number of apneic events for most people).
- Use pillows and other devices to help sleep in a side position.
- Nasal continuous positive airway pressure (CPAP) is a device that is used nightly in which you wear a mask (nasal pillows, over the nose, or full face) during sleep, and pressure from an air blower forces air through the nasal passages.
- Dental appliances that reposition the lower jaw and the tongue have been helpful to some people with mild sleep apnea, or who snore but do not have apnea.
- Some patients might benefit from a home sleep test which measures your breathing and blood oxygen level in order to diagnose obstructive sleep apnea.
Some people with sleep apnea may need surgery. Examples of these procedures include:
- Surgical procedures to remove adenoids and tonsils, nasal polyps, or other growths or tissue in the airway, or to correct structural deformities may be done.
- Uvulopalatopharyngoplasty (UPPP) is a procedure used to remove excess tissue at the back of the throat (tonsils, uvula, and part of the soft palate).
- Surgical reconstruction for deformities of the lower jaw may benefit some people.
- Surgical procedures to treat obesity are sometimes recommended for a person with sleep apnea who is obese.