Sleep Apnea

Sleep apnea is a serious disorder that causes your breathing to stop repeatedly while you sleep. These breathing pauses or “apneas” usually last 10 to 30 seconds and can happen many times throughout the night.

The most common type of sleep apnea is obstructive sleep apnea, which happens when the upper airway gets blocked during sleep. Often, the blockage happens when the soft tissue in the back of the throat collapses and closes during sleep. Relaxed throat muscles, a narrow airway, a large tongue or extra fatty tissue in the throat can also block the airway. Central apnea and mixed apnea are other types of sleep apnea, but are more rare.

Signs and symptoms of sleep apnea

Family members or bed partners often pick up on the signs of sleep apnea first. Many people with sleep apnea don't know they're snoring and gasping for breath at night. If you have any of the following signs, see your doctor:

• daytime sleepiness
• loud snoring followed by silent pauses
• gasping or choking during sleep
• morning headache
• irritability or mood changes
• poor concentration or memory loss
• lowered sex drive
• falling asleep while driving

Snoring by itself doesn't necessarily mean that you have sleep apnea. It is true that loud snoring is common in people with this disorder, but there's a big difference between simple snoring and sleep apnea.

Untreated sleep apnea can cause serious health problems. If it's not treated, sleep apnea can lead to:

• high blood pressure
• stroke
• heart attack
• motor vehicle collisions
• depression
• decreased sexual function
• work-related injuries

Treatment

There are easy and effective treatments for sleep apnea. Your treatment will depend on whether your sleep apnea is mild, moderate or severe. Your doctor can help you choose the best treatment for you. The most common treatment for sleep apnea is CPAP or continuous positive airway pressure. CPAP involves wearing a special mask that keeps the throat open and stops the snoring and pauses in breathing.

The key is to confirm whether you have sleep apnea so you can start treatment. If you have any of the signs and symptoms listed above, see your doctor. Your doctor may send you for overnight testing at a sleep disorder centre where your condition can be studied thoroughly. You may also be required to do some home tests.

Lifestyle changes - like losing weight and exercising - can reduce sleep apnea symptoms and can also help reduce other risk factors for heart disease and stroke. If you have mild sleep apnea, some lifestyle changes may get rid of the symptoms altogether. Here are some of the things you can do:

Lose weight

Being overweight is a risk factor for sleep apnea. If you're overweight, ask your doctor for advice on how to lose weight safely. Weight loss of just 10 per cent - that's equal to 20 lbs for a 200 lb man - can greatly reduce the number of sleep apnea episodes that happen each night.

Exercise isn't just a great way to maintain a healthy body weight, but also contributes to healthy sleep. (Try not to exercise for at least three hours before bedtime. A hard workout right before bed might actually cause trouble sleeping.)

Smoking can make sleep apnea symptoms worse because it can irritate your throat and make you cough at night. Stopping smoking will also give you more energy for everyday physical activities.

Going to bed and waking up at roughly the same times every day helps you to get the right kind of sleep. You need to experience the full cycle of deep- and lighter-stage sleep to feel well rested. A regular sleeping schedule also prevents you from getting overtired, which can make sleep apnea symptoms worse.

If you have trouble sleeping, try a cup of decaffeinated herbal tea or juice instead of unwinding with a glass of wine. Alcohol and certain medications (sleeping pills and some pain medications) can make throat muscles relax more than normal. As a result, airways can get blocked. Alcohol and medications can also make it harder for your brain to "wake up" and register a lack of oxygen in the body. This can cause longer and more serious pauses in breathing. If you find it hard to fall asleep, try reading a book or taking a warm bath.

Sleeping on one side instead of sleeping on your back can help to improve sleep apnea symptoms. Sleeping on your back lets gravity pull on the tissues at the back of your throat and neck. This can cause the upper airway to become narrow or collapse completely. You can "train" yourself to sleep on you side by:

• putting pillows against your back to prop yourself on your side.
• using the 'tennis ball trick'. Sew a pocket onto the back of your pajama top and put a tennis ball in it. If you start to roll to your back during sleep, the pressure from the ball will make you roll back to your side.

Publications

• What is the Impact of Sleep Apnea on Canadians: Fast Facts from the 2009 Canadian Community Health Survey - Rapid Response
•  Sleep Apnea. Life and Breath: Respiratory Disease in Canada

About sleep apnea: what is it? - Canadian Lung Association