There are basically three types of sleep apnea:
- Obstructive Sleep Apnea – OSA – occurs when there is a physical obstruction of the airway during sleep. Because your body tends to relax during sleep, and because your airway consists of walls of soft, collabsible tissue, it’s understandable that your breathing can be physically obstructed while you sleep. Many people suffer mild, occasional sleep apnea during the course of an upper respiratory infection; this is of little consequence. But those who suffer chronic, severe OSA need to seek treatment to prevent or resolve sleep deprivation and other effects.
- Central Sleep Apnea happens when the brain fails to send a signal to the diaphragm that “it’s time to breathe again.” This is a rare form of sleep problem, occurring in fewer than one-half-of-one-percent of those with sleep disorders.
- Mixed (or Complex) Sleep Apnea is an even rarer combination of the first two types.
Most at risk for OSA are those who have poor muscle tone generally and higher-than-usual soft tissue around the airway due to being overweight. Structural features – such as larger tonsils or adenoids, deviated septum, receding chin, or a larger-than-usual neck size – that tend to lead to a narrowed airway also increase the risk.
Men, particularly overweight men above the age of 40, are most likely to have OSA, as are the elderly. Nonetheless, women and even children do suffer from obstructive sleep apnea and should be aware of its symptoms and consequences.
Symptoms of Sleep Apnea
Many times sleep apnea remains undiagnosed. There are no laboratory tests that will reveal it, and your doctor generally cannot determine during a routine office visit that you have difficulty sleeping. Suspicion about and diagnosis of sleep apnea most often occurs because a family member of bed partner notices the symptoms.
Among the things that suggest you might be suffering from sleep apnea are loud snoring, failure to sleep “peacefully,” and sleepiness during the day. If you are frequently drowsy or sleepy during the day, even after having “sufficient” sleep, you should consider whether sleep apnea might be the cause of this drowsiness.
Snoring is nearly universal among those with sleep apnea. But the reverse isn’t true – you don’t necessarily have sleep apnea just because you snore. And the loudness with which you snore – the sound of the air moving through the back of the nose, mouth, and throat – does not indicate the severity (if any) of airway obstructions. What to watch for – or what to have your spouse watch for – is when the snoring stops! If snoring stops, along with breath, while your body keeps trying to breathe, then sleep apnea should be strongly suspected. When you start breathing again you’ll probably issue a deep gasp and then continue snoring.
Tossing and turning is common among those with sleep apnea. But, as it’s also very common among those not suffering from this problem, it’s not necessarily indicative that you have this problem.
A common – and commonly effective – means of dealing with obstructive sleep apnea is the use of a CPAP (continuous positive airway pressure) device. This device maintains a flow of pressurized air into the airway, keeping it open while you sleep.
A dentist who specializes in sleep disorders may prescribe oral appliance therapy (OAT). This is a mouthpiece designed to shift your lower jaw forward, and thus to open your airway. This is, unfortunately, effective only in cases of mild-to-moderate sleep apnea. It is currently used more often in Europe and Canada than in the United States.
Neither CPAP technology or oral appliance therapy is helpful for central sleep apnea or mixed sleep apnea.
Obstructive sleep apnea may also be treated through the use of a pillow designed to promote airflow through keeping your body parts properly aligned.