About Sleep Apnea

• 18 – 20 million Americans suffer from Obstructive Sleep Apnea (OSA). (National Sleep Foundation)
• People who have sleep apnea stop breathing repeatedly during sleep. It is caused by a blocking of the upper airway. The collapse of the airway may be due to such factors as large tongue, extra tissue or decreased muscle tone holding the airway open.
• Each breathing cessation can last from a few seconds to minutes and may occur 5 to 30 times or more each hour. It puts a strain on the heart and can lead to a number of serious health conditions. (U.S. Dept. of Health & Human Services, NIH, 2009)  

Signs/Symptoms 

• Loud, disruptive snoring
• Gasping or choking during sleep
• Excessive daytime sleepiness
• Others signs of sleep apnea may include:
  - Morning headaches
  - Memory or learning problems
  - Feeling irritable
  - Not being able to concentrate on your work
  - Mood swings or personality changes; perhaps feeling depressed
  - Dry throat when you wake up
  - Frequent urination at night
  - Obesity
  - Large neck (greater than 16.5 inches in men and 15.5 inches in women) or crowding of the airway
• Left untreated, sleep apnea may increase the risk for high blood pressure, heart attack, stroke, obesity, and diabetes, increase the risk for or worsen heart failure, make irregular heartbeats more likely, and increase the chance of having work-related or driving accidents. (U.S. Dept. of Health & Human Services, NIH, 2009)  

Effects

• Sleep deprivation and sleep disorders are estimated to cost Americans over $100 billion annually in lost productivity, medical expenses, sick leave, and property and environmental damage. (National Sleep Foundation)
• In sleep apnea, the combination of the intermittent oxygen drops and reduced sleep quality triggers the release of stress hormones. These hormones in turn raise your blood pressure and heart rate and boost the risk of heart attack, stroke, irregular heart beats, and congestive heart failure. (U.S. Dept. of Health & Human Services, NIH,  2005)
• Untreated sleep apnea can lead to altered energy metabolism that increases the risk for developing obesity and diabetes. (U.S. Dept. of Health & Human Services, NIH,  2009)
  The brief drops in blood-oxygen levels can be associated with morning headaches and decreased ability to concentrate, think properly, learn, and remember. (U.S. Dept. of Health & Human Services, NIH,  2005)
• Sleepiness can lead to mood and behavior problems, including depression, and such sleepiness more than triples the risk of being in a traffic or work-related accident.  (U.S. Dept. of Health & Human Services, NIH,  2005)
• The National Highway Traffic Safety Administration estimates that 100,000 police-reported crashes are caused by drowsy drivers each year. These crashes result in more than 1,500 fatalities and 71,000 injuries and result in an estimated $12.5 billion in diminished productivity and property loss. (Knipling and Wang, 1996) 

Who is at risk

• Anyone can have sleep apnea. OSA can occur in men, women and children of all ages.
• People who have sleep apnea generally are not aware that their breathing stops in the night.
  - More than one-half of all people who have sleep apnea are not diagnosed. (U.S. Dept. of Health & Human Services, NIH,  2005)
  It is estimated that more than 12 million American adults have sleep apnea, making it as common as asthma. (U.S. Dept. of Health & Human Services, NIH,  2009)
  - More than one-half of the people who have sleep apnea are overweight.
  - More common in men.
  - More than 1 in 25 middle-aged men and 1 in 50 middle-aged women have sleep apnea
  - About 3 percent of children and 10 percent or more of people over age 65
  - Occurs more frequently in African Americans, Asians, Native Americans, and Hispanics than in Caucasians.  

Diagnosis

• Discuss sleep complaints and symptoms with your doctor. If a sleep order is suspected, your doctor will refer you to a sleep specialist for evaluation. 
• An overnight diagnostic sleep study, known as a polysomnogram, or PSG, is used to determine the type and severity of the sleep disorder and appropriate treatment. If you have sleep apnea, the study will reveal pauses in breathing, frequent sleep arousals, and intermittent drops in levels of oxygen in the blood.  

Treatment

• Positive Airway Pressure (PAP)
  - The therapy provides a gentle flow of air pressure through your nose using a mask.
  - The air pressure prevents airway collapse, allowing you to breathe freely during sleep.
  - This noninvasive therapy can alleviate the symptoms of OSA when used as prescribed.
  • Continuous Positive Airway Pressure (CPAP) is the most commonly used PAP therapy and the treatment of choice for OSA.
  • Bi-level Positive Airway Pressure provides two levels of pressure: a higher pressure on inhalation, and a lower pressure on exhalation. This treatment may be prescribed for patients who cannot tolerate CPAP
  • Auto-CPAP: this mode of PAP therapy automatically adjusts the pressure level to provide the most appropriate pressure required by the patient
• Alternative treatments include:
  - Surgery
  - Body position modification
  - Oral appliances
  - Lifestyle/behavior changes  

Benefits of effective treatment 

• Minimize the impact of OSA
• Additional benefits of effective treatment of OSA may include:
  - Increased energy and attentiveness during the day
  - Lower blood pressure
  - Decreased risk of strokes and heart attacks
  - Increased effectiveness at home or at work
  - Improved overall quality of life  

For more information: 

American Sleep Apnea Association:
http://www.sleepapnea.org

National Center on Sleep Disorders Research:
http://www.nhlbi.nih.gov/about/ncsdr/index.htm

National Institutes of Health (U.S. Department of Health and Human Resources):
http://www.nhlbi.nih.gov/health/dci/Diseases/SleepApnea/SleepApnea_WhatIs.html

National Sleep Foundation:
http://www.sleepfoundation.org