February 20th, 2011
Sleep apnea is very common, and most people who have the occasional case would probably never know the difference if not for the testimony of frightened bed mates. Sleep apnea is an extended period of time (10 seconds or more) between breaths when you are sleeping. If someone is lying next to you, counting the minutes until dawn, it may seem to them that you have died. With any luck, this is not the case, and you take that next, rattling breath. Those extended periods without air can add up to a loss of oxygen in your blood, often cause you to wake gasping for air, and can make your waking life drowsy (read: drowsiness).
Sleep apnea is most often caused by an obstruction in the airway, and often coincides with incidents of severe snoring. The obstruction usually involves that flap in the back of the roof of your mouth (the uvula), the same one that vibrates so noisily when we snore. There are other types of sleep apnea that involve your lungs not performing well, or it could be a combination of the two. This article deals with the most common variety, which can be affected by home treatments. In all cases, I recommend visiting a physician who specializes in sleep disorders.
Ending Sleep Apnea
Weight and other lifestyle choices. Extra weight around the midsection, specifically the neck, almost ensures that you will have sleep apnea problems. Sleep apnea caused by excessive weight is called obesity hypoventilation syndrome (see: fat loss). People who carry around some extra pounds are already putting strain on their hearts. Add a lack of oxygen when they sleep, and it can become a life threatening situation. There are therapies and devices that can help mitigate this problem, but any treatment should start with weight loss.
Adjusting the way you sleep can help to reduce problems. My personal experience has shown that I have fewer episodes of snoring and apnea when I am positioned laterally (on my side). I also like to prop up my head a bit and place a pillow between my knees. Everyone has their own preference, of course. Studies show that sleeping on your side or with your upper body inclined 30 degrees will greatly reduce snoring and apnea (read: how to get rid of snoring). It's an effective and free option that is definitely worth a try!
A sleep study will confirm if you have a problem. If lifestyle changes and adjustments to your sleeping style are not yielding results, then it's time to visit a doctor. Your family doctor might be able to treat or evaluate your condition on their own, but it is quite likely that you will be referred to a specialist. Using monitoring devices and sensors, doctors will be able to keep track of what happens inside of you as you sleep (read: how to get rid of insomnia). Based on this information, they can decide which course of action is necessary for your condition.
Airway pressure masks are one solution. Continuous pressure airway masks (CPAP) are the most commonly prescribed treatment for sleep apnea. They work by sealing around the nose, and an attached hose delivers just enough airflow to prevent the airway from collapsing while you sleep. There are variations on this design, some of which are intended to make the mask less awkward to wear as you sleep. After a few days or nights of restful, undisturbed sleep, you will learn to adapt.
Oral appliance therapy can also help. These devices are a good option for those who can't handle the obtrusive nature of a CPAP mask. They look like a cross between a dental retainer and an athletic mouth guard. They have to be specially made for your mouth by a dentist, and fitted to sit tightly on your teeth, without causing discomfort. Different designs work in different ways, but most involve bringing your lower jaw forward to open up your airway, and keeping the tongue from becoming an obstruction.
If lifestyle changes, CPAP mask, and OAT haven't fixed the problem, it might be time to talk to your doctor about surgical options.
- Uvulopalatopharyngoplasty. This involves the removal of tissue in the back of the throat and soft palette. It requires general anesthesia, and a possible hospital stay.
- Tonsilectomy/Adenoidectomy. Tonsils and adenoids are prone to enlargement and illness, and may be the culprits in many snoring problems. Removal might require general anesthesia, but are generally an outpatient ordeal.
- Maxillomandibular advancement. This complicated bit of oral surgery moves the jaw forward from the face to open up some space in the throat (much like the OAT). This one will definitely require anesthesia and some recovery time.
- Tracheostomy. This is only for serious, life threatening cases of sleep apnea. It involves installing a breathing hole in your trachea through which you can respirate. Not something most of us would want to consider.
- Lasers and implants. There are newer treatments available that are generally minor, and don't require hospital stays. However, they haven't been shown to be as effective as traditional treatments.