Sleep apnea is a sleep disorder characterized by pauses in breathing during sleep. Each episode is called an apnea and lasts long enough that one or more breaths are missed, and such episodes occur repeatedly throughout sleep. An apneic event includes a minimum 10-second interval between breaths, with either a neurological arousal or a blood oxygen desaturation. Sleep apnea is diagnosed with an overnight sleep test called a polysomnogram, or a “sleep study”.
Clinically significant levels of sleep apnea are defined as five or more episodes per hour of any type of apnea. There are three distinct forms of sleep apnea: central, obstructive, and complex (i.e., a combination of central and obstructive) constituting 0.4%, 84% and 15% of cases respectively. Breathing is interrupted by the lack of respiratory effort in central sleep apnea; in obstructive sleep apnea, breathing is interrupted by a physical block to airflow despite respiratory effort. In complex (or “mixed”) sleep apnea, there is a transition from central to obstructive features during the events themselves.
Regardless of type, the individual with sleep apnea is rarely aware of having difficulty breathing, even upon awakening. Sleep apnea is recognized as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body (sequelae). Symptoms may be present for years (or even decades) without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance.
Obstructive sleep apnea is a treatable disorder and is typically defined in adults as cessation of breath that lasts at least ten seconds while sleeping. This could happen hundreds of times a night. Sleep apnea is a common disorder that affects millions of men, women, and even children.
Sometimes the cause of sleep apnea is unknown. Obesity is a contributing factor although people with a normal body weight may also be affected. An abundance of soft tissue at the rear of the throat may occlude a person’s airway during sleep and cause them to have sleep apnea. Loud snoring is typical but not always present. Untreated sleep apnea may result in high blood pressure and other cardiovascular diseases such as heart attack and stroke. People with sleep apnea may also complain of morning headaches, trouble with memory, feelings of depression, reflux, frequent urination, and impotence. They often will fall asleep at inappropriate times. Untreated sleep apnea may also be responsible for poor job performance and motor vehicle accidents.
Risk factors for sleep apnea include a family history of sleep apnea, obesity, a large neck, a recessed chin, abnormalities in the structure of the upper airway, smoking, and alcohol use. Sleep apnea can affect both males and females of all ages, including children and people of any bodyweight.
The Pulmonary and Sleep Specialists of Northeast Georgia Sleep Diagnostics Center is directed by Dr. Rami Arfoosh, who is not only an ABIM Sleep Board Diplomate but also fellowship-trained in the diagnosis and treatment of various sleep medicine disorders including sleep apnea. Our sleep lab is accredited through the American Academy of Sleep Medicine (AASM) for both in-lab and home sleep studies.
To check your risk for sleep apnea, click on the link above.