Sleep Apnea

Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts while sleeping. If you snore loudly and feel tired even after a full night’s sleep, you might have sleep apnea.

The main types of sleep apnea are:

• Obstructive Sleep Apnea (OSA) –  the more common form that occurs when throat muscles relax.
• Central Sleep Apnea – which occurs when your brain doesn’t send proper signals to the muscles that control breathing.
• Complex Sleep Apnea – also known as treatment-emergent central sleep apnea, which occurs when someone has both Obstructive Sleep Apnea and Central Sleep Apnea.

The signs and symptoms of obstructive and central sleep apneas overlap, sometimes making it difficult to determine which type you have. The most common signs and symptoms of Obstructive and Central Sleep Apneas include:

• Loud snoring (more common in obstructive sleep apnea)
• Having episodes when breathing stops witnessed by another person
• Awakening abruptly with shortness of breath (more common in central sleep apnea)
• Having headaches in the morning
• Having difficulty staying asleep
• Feeling very sleepy during the daytime
• Having attention problems
• Feeling irritable
• Awakening with dry mouth or a sore throat

Causes of Sleep Apnea

Obstructive Sleep Apnea (OSA)

This occurs when the muscles in the back of your throat relax. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate (uvula), the tonsils, the side walls of the throat and the tongue.

When the muscles relax, your airway narrows or closes as you breathe in. You can’t get enough air, which can lower the oxygen level in your blood. Your brain senses your inability to breathe and briefly rouses you from sleep so that you can reopen your airway. This awakening is usually so brief that you don’t remember it.

You might snort, choke or gasp. This pattern can repeat itself five to 30 times or more each hour, all night, impairing your ability to reach the deep, restful phases of sleep.

Central Sleep Apnea

This less common form of sleep apnea occurs when your brain fails to transmit signals to your breathing muscles. This means that you make no effort to breathe for a short period. You might awaken with shortness of breath or have a difficult time getting to sleep or staying asleep.

How is Sleep Apnea diagnosed?

Your primary care doctor will not be able to detect the symptoms of sleep apnea because they occur during sleep. Even you may be unaware of the signs. Most cases are brought to light because of a partner or family member who witnesses the symptoms.

To diagnose the condition, your doctor will ask you questions about your symptoms as well as gain information about your medical history, family history, medications, and lifestyle.

There are two tests are used to diagnose sleep apnea:

• Nocturnal Polysomnography – For this test, you will come to our sleep clinic for overnight monitoring. This test will use equipment to monitor different bodily functions while you sleep.  You will be hooked up to equipment that monitors your heart, lung and brain activity, breathing patterns, arm and leg movements, and blood oxygen levels while you sleep.
• Home Sleep Testing – This is a more simplified tests to be done at home to diagnose sleep apnea. This test usually measures your heart rate, blood oxygen level, airflow and breathing patterns.

If the Physicians at San Tan Sleep Solutions suspect you have sleep apnea, they will order a one of these two Sleep Study tests.

If you have Obstructive Sleep Apnea, your doctor might also refer you to:

• An ear, nose and throat (ENT) doctor to rule out a blockage in your nose or throat.
• A heart doctor (cardiologist) to evaluate if you have associated heart problems.
• A neurologist (a doctor who specializes in the nervous system) might be necessary to look for causes of central sleep apnea.

Sleep Apnea Treatment at San Tan Sleep Solutions

Our board-certified physicians will work with you to develop a personalized treatment plan for sleep apnea.

There are many treatment options to choose from. These may include:

• weight management
• positional therapy in which you are trained to sleep on your side
• lifestyle changes such as avoiding alcohol near bedtime
• a Continuous Positive Airway Pressure machine (CPAP)
• oral appliance therapy

Continuous positive airway pressure (CPAP)

If you have moderate to severe sleep apnea, you might benefit from using a machine that delivers air pressure through a mask while you sleep. With CPAP (SEE-pap), the air pressure is somewhat greater than that of the surrounding air and is just enough to keep your upper airway passages open, preventing apnea and snoring.

Although CPAP is the most common and reliable method of treating sleep apnea, some people find it cumbersome or uncomfortable. Some people give up on the CPAP machine, but with practice, most people learn to adjust the tension of the straps on the mask to obtain a comfortable and secure fit.

You might need to try more than one type of mask to find one that’s comfortable. Don’t stop using the CPAP machine if you have problems. Check with your doctor to see what changes can be made to increase your comfort.

Additionally, contact your doctor if you’re still snoring or begin snoring again despite treatment. If your weight changes, the pressure settings of the CPAP machine might need to be adjusted.

DO NOT adjust the settings without consulting your Physician.

Other airway pressure devices 

If using a CPAP machine continues to be a problem for you, you might be able to use a different type of airway pressure device that automatically adjusts the pressure while you’re sleeping (auto-CPAP).

Units that supply Bi-Level positive airway pressure (BPAP) also are available. These provide more pressure when you inhale and less when you exhale.

Oral Appliances

Another option is wearing an oral appliance designed to keep your throat open. CPAP is more reliably effective than oral appliances, but oral appliances might be easier to use. Some are designed to open your throat by bringing your jaw forward, which can sometimes relieve snoring and mild obstructive sleep apnea.

A number of devices are available from your dentist. You might need to try different devices before finding one that works for you.

Once you find the right fit, you’ll need to follow up with your dentist repeatedly during the first year and then regularly after that to ensure that the fit is still good and to reassess your signs and symptoms.

How do I get started?

Contact San Tan Cardiovascular Center today to make an appointment with one of our healthcare providers.

At this appointment:

• we will review your medical history, discuss your symptoms and perform a non-invasive, diagnostic test to further determine your medical condition,
• any pertinent testing that needs to be done beforehand will also be ordered at this time.

Our billing department will then contact your health insurance company to obtain prior authorization.  Upon receiving insurance authorization, the test will be scheduled.

Sleep Apnea FAQs

Q:  What are the risk factors for Sleep Apnea?

A: Sleep apnea can affect anyone, even children. But certain factors increase your risk.

Obstructive Sleep Apnea (OSA)

• Excess weight.
• Neck circumference
• A narrowed airway (narrow throat, enlarged tonsils or adenoids)
• Men
• Being older
• Family history
• Use of alcohol, sedatives or tranquilizers
• Smoking
• Nasal congestion

Central Sleep Apnea

• Age
• Men
• Heart disorders
• Using narcotic pain medications
• Stroke

Q:  What are some complications from Sleep Apnea?

• Daytime fatigue
• High blood pressure or heart problems
• Type 2 diabetes
• Metabolic syndrome – This disorder, which includes high blood pressure, abnormal cholesterol levels, high blood sugar and an increased waist circumference, is linked to a higher risk of heart disease.
• Liver problems
• Sleep-deprived partners
• Complications with medications and surgery. Obstructive sleep apnea is also a concern with certain medications and general anesthesia. People with sleep apnea might be more likely to have complications after major surgery because they’re prone to breathing problems, especially when sedated and lying on their backs.

Before you have surgery, tell your doctor about your sleep apnea and how it’s being treated.

Q:  When should I see a doctor?

A: Loud snoring can indicate a potentially serious problem, but not everyone who has sleep apnea snores. Talk to your doctor if you have signs or symptoms of sleep apnea. Ask your doctor about any sleep problem that leaves you fatigued, sleepy and irritable.

Q:  How can I prevent Sleep Apnea?

A:  There are things you can do at home to help avoid sleep apnea, such as:

• Lose excess weight. Even a slight weight loss might help relieve constriction of your throat. In some cases, sleep apnea can resolve if you return to a healthy weight, but it can recur if you regain the weight.
• Exercise. Regular exercise can help ease the symptoms of obstructive sleep apnea even without weight loss. Try to get 30 minutes of moderate activity, such as a brisk walk, most days of the week.
• Avoid alcohol and certain medications such as tranquilizers and sleeping pills. These relax the muscles in the back of your throat, interfering with breathing.
• Sleep on your side or abdomen rather than on your back. Sleeping on your back can cause your tongue and soft palate to rest against the back of your throat and block your airway. To keep from rolling onto your back while you sleep, try attaching a tennis ball to the back of your pajama top. There are also commercial devices that vibrate when you roll onto your back in sleep.
• Don’t smoke. If you’re a smoker, look for resources to help you quit.

If you suspect you or a family member may have Sleep Apnea, please call San Tan Sleep Solutions office for a consultation.