By Robert Mignone, DO
Obstructive sleep apnea is a common sleep disorder that, according to the American Academy of Sleep Medicine, affects 30 million adults in the United States.
Sleep apnea can leave you feeling tired all the time, and it can increase your risk for serious health complications.
Fortunately, there are several effective treatments for sleep apnea, including a minimally invasive surgical procedure that can help keep your airway open at night and promote regular breathing.
The Sleep Center at Penn Medicine Princeton Medical Center (PMC) provides comprehensive care — from diagnosis to treatment — for sleep apnea and a range of other sleep disorders.
Understanding Sleep Apnea
Sleep apnea is a disorder in which a person stops breathing for brief periods (10 seconds or more) during sleep.
The most common form of sleep apnea, called obstructive sleep apnea, occurs when muscles in the back of the throat relax during sleep and tissue blocks the airway. When this happens, it can cause you to briefly wake up or to come out of a deep sleep to re-establish breathing.
These episodes can occur a few times or as many as several hundred times each night, causing poor quality sleep that leaves you feeling tired and often irritable the next day.
In addition, when a person stops breathing, oxygen levels in the blood drop. Over time, this can affect the brain and heart. As a result, sleep apnea has been linked to serious health conditions such as:
• High blood pressure.
• Heart disease.
• Stroke.
• Type 2 diabetes.
• Erectile dysfunction.
• Depression.
Though sleep apnea can occur in men and women who are a healthy weight, the most common risk factor is being overweight or obese. Middle-aged and older men as well as post-menopausal women are also at greater risk, as are people with larger neck sizes (a man with a neck size of 17 inches or more or a woman with a neck size of 16 inches or more). Additionally, people with a family history of sleep apnea are also more likely to develop the condition.
Snoring a Common Symptom
Snoring is the most common symptom of sleep apnea, especially snoring that is followed by silent pauses in breathing and choking, snorting, or gasping sounds. It is important to note, however, that not everyone who snores has sleep apnea.
Other symptoms of sleep apnea include:
• Daytime sleepiness or fatigue.
• Unrefreshing sleep.
• Insomnia.
• Morning headaches.
• Waking during the night to go to the bathroom.
• Difficulty concentrating.
• Memory loss.
• Decreased sexual desire.
• Irritability.
If you experience signs of sleep apnea, talk to your doctor. He or she will likely refer you to a sleep specialist for a correct diagnosis and appropriate treatment.
Diagnosing and Treating
The first step in treating obstructive sleep apnea is diagnosis through a sleep study that charts vital signs such as brain waves, heartbeat and breathing. Today, most sleep studies can be performed at home with a small monitor that collects data as you sleep.
If you are diagnosed with sleep apnea, there are a range of treatment options, depending on its severity.
In cases of mild sleep apnea, losing weight can help improve your breathing during sleep. Changing your sleep position can also help. For some people, sleep apnea only occurs while sleeping on their back. In those instances, side-sleeping and raising the head of the bed may relieve symptoms. Avoiding alcohol and smoking can also help alleviate sleep apnea.
Additionally, oral appliances, similar to sports mouth guards, that you wear at night can help reposition the jaw or hold your tongue in place while you sleep so you can breathe properly.
For people with moderate to severe sleep apnea, continuous positive airway pressure (CPAP) remains the standard treatment and is recommended for most patients, according to the American Academy of Sleep Medicine.
A CPAP machine provides a steady stream of air to gently keep your airway open throughout the night. With CPAP treatment, you sleep with a mask equipped with a hose that is attached to a machine kept at your bedside. CPAP treatment has improved in recent years to be more comfortable, quieter and customizable. Still, many people find the devices uncomfortable and fail to use them as directed.
Minimally Invasive Surgical Procedure
For patients who do not tolerate or receive little benefit from CPAP or other treatment options, a minimally invasive surgical procedure called Inspire therapy may be an effective option. Specifically, the surgery involves implanting a device that clears your airway and enables you to breathe normally and sleep without obstruction.
Put another way, the transmitter and leads function like a pacemaker, but for sleep apnea instead of cardiac issues. It is operated by remote control so you can turn it on before bed and off after waking.
You might be a candidate for the procedure if:
• You have moderate to severe obstructive sleep apnea.
• You are unable to use or get consistent benefit from CPAP.
• You have body mass index (BMI) of 32 or below.
• You are age 18 or above.
This therapy is part of the comprehensive care for sleep disorders available through PMC and its Sleep Center, which is fully accredited by the American Academy of Sleep Medicine.
Left untreated, sleep apnea can cause serious health problems and impact your quality of life. If you experience symptoms of sleep apnea, talk with your doctor or to a sleep specialist about a treatment approach that is right for you.
For more information about the Sleep Center at PMC or to find a physician affiliated with Penn Medicine Princeton Health, call 888-742-7496 or visit princetonhcs.org.
Robert Mignone, DO, is a board-certified otolaryngologist and the medical director of the Sleep Surgical Program at Penn Medicine Princeton Medical Center.