According to the National Institutes of Health, sleep disorders such as sleep apnea affect about 50-70 million Americans, and one in three adults doesn’t consistently get enough uninterrupted sleep to protect their health. Sleep disorders can increase the risk of cardiovascular issues, type 2 diabetes, dementia, obesity, and even certain cancers.
Laken Turner, MSN, CRNP, is a sleep medicine expert at the UAB St. Vincent’s Chilton Sleep Disorders Center. She answers some common questions about sleep apnea, how it’s treated, and managing the symptoms.
What is sleep apnea?
Sleep apnea is a condition that causes breathing to repeatedly stop and start while sleeping and disrupts the natural progression of sleep cycles. This leads to lower oxygen levels and reduces the benefits that a good night’s sleep normally brings. People with untreated sleep apnea may wake up feeling tired, unrefreshed, or with a morning headache.
Are there different types of sleep apnea?
Sleep apnea generally falls into two categories:
- Obstructive sleep apnea results from obstruction of the airway which results in reduction of airflow and reduced oxygenation levels
- Central sleep apnea – a condition in which there is no airway obstruction but a desynchrony between the brain and respiratory effort
What are the symptoms?
The symptoms of sleep apnea can include:
- Fragmented sleep, meaning an individual wakes up multiple times a night and has a disrupted night’s sleep due to frequent awakenings
- Snoring
- Frequent morning headaches
- Weight gain
- Feeling tired after sleeping and remaining sleepy throughout the day
- Drowsiness when driving
- Mood swings, anxiety, and depression
- Trouble concentrating
- Frequent urination at night
- Waking during the night with a choking sensation
- Patients sometimes come to our sleep center with their spouse or partner, who reports that the patient stops breathing during sleep or gasps for air.
Is snoring always a symptom?
Snoring can be an indicator of sleep apnea, but not everyone who snores has sleep apnea. Snoring is caused by airway resistance that can increase as we relax during sleep, and it isn’t always connected to disruptions in oxygen levels. If your snoring is loud and frequent, this increases the chances that it’s related to sleep apnea. If you’re concerned about your sleep habits or snoring, you should discuss it with your healthcare provider – especially if you have any of the other symptoms listed above.
What happens if I don’t treat my sleep apnea?
Untreated sleep apnea has long-term risks, especially for the cardiovascular system. Research shows a connection to a greater risk for high blood pressure, stroke, arrhythmia (abnormal heart rhythm), and heart attack. It also increases the risk for obesity, type 2 diabetes, dementia, and even certain cancers.
How do you test for and diagnose sleep apnea?
Patients usually are asked to fill out a questionnaire first, which helps assess your overall risk for sleep disorders, especially sleep apnea. Next, a diagnostic test called polysomnography (PSG) is performed, which takes a much closer look at your overnight sleep patterns. This is usually done in a sleep lab, but a home sleep study also may be an option. However, home sleep studies are not as thorough as a PSG that takes place in a formal sleep lab setting. After completing a PSG, patients can expect to discuss the results at a follow-up appointment with their provider and learn about treatment options based on those results.
What should I expect when doing a sleep study?
A sleep study conducted in a sleep lab is a comprehensive look into an individual’s sleep patterns while looking at multiple different metrics. During an overnight PSG in a sleep lab, brain and muscle activity are monitored to help determine what stages of sleep you may be in throughout the night and how often your sleep is disrupted. Oxygen levels, heart rate, and heart rhythm also are monitored, along with how often you snore, grind your teeth, move your legs, and change positions. All of these factors can affect sleep quality and help determine whether you may have sleep apnea or some other sleep-related disorder.
Can I test for sleep apnea at home?
Home sleep studies are an option for some patients, but they aren’t always the best choice depending on the case. Home sleep studies carry a higher risk of producing a false negative result, which can lead to delays in treatment. Home sleep studies are best suited for patients who:
- Are suspected to have moderate to severe sleep apnea
- Don’t have significant heart or lung health issues
- Aren’t suspected of having (or at high risk for) some other sleep-related disorder
Also, home sleep studies are not ideal for diagnosing mild sleep apnea, and they cannot be used to assess other sleep disorders such as periodic limb movement disorder, REM behavior disorder, and narcolepsy. Talk with your healthcare provider about which option for sleep evaluation may be right for you.
Are there alternatives for CPAP machines for sleep apnea?
The first and most effective line of treatment for sleep apnea is a CPAP machine, which stands for Continuous Positive Airway Pressure. This device uses air pressure to help the airway remain open during sleep, which in turn helps maintain good oxygen levels in the body. This improves sleep quality and reduces cardiovascular risk in most cases. Lifestyle changes such as weight loss, improving sleep hygiene habits, and changing positions during sleep also may help manage sleep apnea.
Some people are more likely to experience sleep apnea when sleeping flat on their back, so sleeping on their side can help. Other treatment options include an oral appliance and a surgically implanted nerve stimulator. It’s always important to discuss these options with your healthcare provider.
Can sleep apnea be cured, or is it a lifelong condition?
A permanent cure for sleep apnea is possible for some patients, but this depends on many factors, including your specific anatomy, weight, neurological history, and how well you follow treatment recommendations. Losing weight may clear up sleep apnea for some, but it isn’t a guarantee. However, symptoms of sleep apnea usually get better with treatment with CPAP device and improvements in lifestyle, diet, exercise, and sleep hygiene. These changes usually improve your overall health and well-being, even if you still need ongoing treatment for sleep apnea.
Is a referral required to see a doctor for sleep?
This depends on your insurance coverage. Some plans require a referral from a primary care provider, while others allow self-referrals.
If you have any of the symptoms mentioned above, please consider making an appointment with a healthcare provider to discuss whether a sleep evaluation may be right for you. To reach UAB St. Vincent’s Chilton Sleep Medicine, please call 205-258-4459.