Sleep apnea is a syndrome where people have trouble breathing at night. It is a common disorder, affecting from 10 to 25% of men, and 5-15% of women. It is more common as we age, but can affect children as well. The most common form is caused by an obstruction of the neck. During sleep, the person with sleep apnea is unable to keep their airway open. During inspiration, the airway collapses and blocks the flow of air. A 10 to 60 second pause will occur while the patient attempts to breathe but can not. Eventually, the need to breathe is strong enough that the person awakens briefly to reopen the airway and breathe. This awakening is usually only a few seconds, which means the person will not remember awakening. The cycle of breathing and obstruction of airflow continues through the night, occurring from 5 to 120 times an hour. This results in fragmentation of sleep. A person with sleep apnea usually will not feel rested in the morning, and often has trouble with daytime sleepiness. They may experience brief bursts of sleep lasting a few seconds off and on during the day, and tend to fall asleep when sitting still. In addition to the burden of excessive daytime sleepiness, the sleep apnea patient often has medical complications of high blood pressure, heart attacks, strokes, or a weak heart.
Diagnosis is by careful history and physical exam, followed by a night time sleep test called a polysomnogram.
Treatment is variable depending on the person’s anatomy and reason for the airflow obstruction. It may include surgery, but most patients are treated by wearing a CPAP mask at night. This is a mask fitting over the nose, which allows a low level of air pressure to be applied to the upper airway, thereby keeping the airway open at all times so the person can breath normally while asleep. It is fully corrective of the sleep disorder, and prevents the health consequences of untreated sleep apnea.
The US National Library of Medicine and the National Institute of Health
Obstructive Sleep Apnea
The American Sleep Apnea Association
AWAKE support group
The American Family Physician
The American Academy of Family Physicians