Breathing-related Sleep Disorders

Reviewed Jan 19, 2017

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Summary

  •  There are 2 main types of sleep apnea.
  • Being overweight or obese is among the biggest risk factors for sleep apnea.
  • Treating sleep apnea can lower blood pressure in those with severe cases.

Sleep apnea causes breathing to stop or get very shallow while asleep. These pauses can last from a few seconds to minutes. They can happen 30 times or more an hour. Sleep apnea is a common disorder, often spotted by a bed partner. This abnormal breathing can be serious, leading to high blood pressure and heart problems. There are two main types of sleep apnea: obstructive sleep apnea (OSA) and central sleep apnea (CSA).

Obstructive sleep apnea

The most common type of sleep apnea is OSA. Around 4 percent of men and 2 percent of women have it. OSA causes your airway to collapse or become blocked during sleep. The upper airway can be either completely or partially closed. When normal breathing starts again after a pause, there is a snort or choking sound.

OSA can cause fatigue, impaired thinking, and accidents on the job and behind the wheel. Research shows it can also cause high blood pressure. This makes it very important to look out for these signs that you or your partner may have apnea:

  • Extreme tiredness during the day
  • Gasping or choking during sleep that you feel or a partner notices
  • Snoring

Although people who have sleep apnea often snore loudly, not everyone who snores has sleep apnea.
People who are obese or overweight are at greater risk for OSA. So are men, adults older than 60 and people who drink alcohol or smoke. Other markers or red flags that may prompt a doctor to test patients for apnea include:

  • Needing bariatric surgery
  • Certain heart problems
  • Having had a stroke
  • Type 2 diabetes

Central sleep apnea

Central sleep apnea (CSA) is a bit different than OSA. CSA causes total lapses or pauses in breathing, or breath is so shallow that not enough oxygen is taken in. OSA is a structural problem, but with CSA, the brain is not sending the signal to the body to inhale. Many people with CSA also find out they have OSA. And sometimes people with OSA develop CSA. This turns into what’s known as complex sleep apnea.

The symptoms of CSA are generally the same as OSA, except snoring is less likely with CSA. CSA can be caused by heart, kidney and other diseases. If it is caused by another disease, other signs may be trouble swallowing, changes in voice and feeling numb or weak. Using certain opioids (drugs) can also cause CSA. There may also be no known cause. Doctors may advise the same types of treatment for CSA as used with OSA. Certain medicines may also be an option for some people with CSA.

Understanding hypoventilation

Hypoventilation is breathing that is too shallow or slow while sleeping. As a result, the carbon dioxide level can rise and there is not enough oxygen in the blood to meet the body’s needs. This breathing disorder affects some people who are obese, separate from apnea. Yet these processes are alike. And there is much overlap in these weight-related breathing problems.

Treatment

If you have signs of apnea, talk to your doctor. You may need to have a sleep study called a polysomnography. This test looks at brain activity, heart rate and other signs to help find out if you have a sleep disorder. If you have apnea, treatment options can include:

  • Weight loss. Around 70 percent of people with OSA are overweight or obese. Losing weight can be very beneficial in treating apnea and snoring.
  • C-PAP machine. C-PAP stands for continuous positive airway pressure. A C-PAP machine uses air pressure like a splint to keep the airway open. It is the most effective treatment for apnea. The C-PAP can lower blood pressure in people with OSA, especially if it is severe. Using the C-PAP and other breathing machines can be hard to get used to and are often not an easy fix. Many people complain that it is uncomfortable to wear the mask the whole night. People also dislike the air pressure coming into the nose. Surgery may be an option for some if the mask is not working.
  • Positional therapy. This is simply side sleeping instead of back sleeping. It can work in mild cases. In more severe cases, the airway collapses no matter which position you sleep in.
  • Surgery. For adults who snore, surgery can work well. But it is less effective in treating OSA. There are different types of surgery depending on the source of the problem. Yet it can be hard to find the right spot or spots that are collapsing in the airway. For instance, it can be hard to know if the problem is with the nose or the base of the tongue.
  • Oral appliances. This tool forces the jaw into position to allow for proper air flow.

Avoiding alcohol, which relaxes the muscles in the throat, can also help with apnea.

If you or your bed partner spot signs of apnea or feel too sleepy during the day, see a doctor. There are ways you can improve your sleep and feel better when the morning comes. More importantly, treating sleep apnea can protect your heart.

Resources

National Sleep Foundation
www.sleepfoundation.org

American Sleep Apnea Association
http://www.sleepapnea.org/

By Sarah Stone
Source: Ramar, M.D. Kannan and Olson, M.D., Eric. J. (2013) "Management of Common Sleep Disorders." American Family Physician, Volume 88(4);231-238; American Sleep Apnea Association, http://sleepapnea.org/treat/treatment-options.html, www.sleepapnea.org/learn/sleep-apnea/central-sleep-apnea.html and www.sleepapnea.org/treat/treatment-options/surgery.html; National Heart, Lung and Blood Institute, www.nhlbi.nih.gov/health/health-topics/topics/ohs/ and www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea/; Mayo Clinic, www.mayoclinic.org/diseases-conditions/central-sleep-apnea/basics/causes/con-20030485 and www.mayoclinic.org/diseases-conditions/sleep-apnea/basics/risk-factors/con-20020286
Reviewed by Gary R. Proctor, MD, Associate Chief Medical Officer, Beacon Health Options

Summary

  •  There are 2 main types of sleep apnea.
  • Being overweight or obese is among the biggest risk factors for sleep apnea.
  • Treating sleep apnea can lower blood pressure in those with severe cases.

Sleep apnea causes breathing to stop or get very shallow while asleep. These pauses can last from a few seconds to minutes. They can happen 30 times or more an hour. Sleep apnea is a common disorder, often spotted by a bed partner. This abnormal breathing can be serious, leading to high blood pressure and heart problems. There are two main types of sleep apnea: obstructive sleep apnea (OSA) and central sleep apnea (CSA).

Obstructive sleep apnea

The most common type of sleep apnea is OSA. Around 4 percent of men and 2 percent of women have it. OSA causes your airway to collapse or become blocked during sleep. The upper airway can be either completely or partially closed. When normal breathing starts again after a pause, there is a snort or choking sound.

OSA can cause fatigue, impaired thinking, and accidents on the job and behind the wheel. Research shows it can also cause high blood pressure. This makes it very important to look out for these signs that you or your partner may have apnea:

  • Extreme tiredness during the day
  • Gasping or choking during sleep that you feel or a partner notices
  • Snoring

Although people who have sleep apnea often snore loudly, not everyone who snores has sleep apnea.
People who are obese or overweight are at greater risk for OSA. So are men, adults older than 60 and people who drink alcohol or smoke. Other markers or red flags that may prompt a doctor to test patients for apnea include:

  • Needing bariatric surgery
  • Certain heart problems
  • Having had a stroke
  • Type 2 diabetes

Central sleep apnea

Central sleep apnea (CSA) is a bit different than OSA. CSA causes total lapses or pauses in breathing, or breath is so shallow that not enough oxygen is taken in. OSA is a structural problem, but with CSA, the brain is not sending the signal to the body to inhale. Many people with CSA also find out they have OSA. And sometimes people with OSA develop CSA. This turns into what’s known as complex sleep apnea.

The symptoms of CSA are generally the same as OSA, except snoring is less likely with CSA. CSA can be caused by heart, kidney and other diseases. If it is caused by another disease, other signs may be trouble swallowing, changes in voice and feeling numb or weak. Using certain opioids (drugs) can also cause CSA. There may also be no known cause. Doctors may advise the same types of treatment for CSA as used with OSA. Certain medicines may also be an option for some people with CSA.

Understanding hypoventilation

Hypoventilation is breathing that is too shallow or slow while sleeping. As a result, the carbon dioxide level can rise and there is not enough oxygen in the blood to meet the body’s needs. This breathing disorder affects some people who are obese, separate from apnea. Yet these processes are alike. And there is much overlap in these weight-related breathing problems.

Treatment

If you have signs of apnea, talk to your doctor. You may need to have a sleep study called a polysomnography. This test looks at brain activity, heart rate and other signs to help find out if you have a sleep disorder. If you have apnea, treatment options can include:

  • Weight loss. Around 70 percent of people with OSA are overweight or obese. Losing weight can be very beneficial in treating apnea and snoring.
  • C-PAP machine. C-PAP stands for continuous positive airway pressure. A C-PAP machine uses air pressure like a splint to keep the airway open. It is the most effective treatment for apnea. The C-PAP can lower blood pressure in people with OSA, especially if it is severe. Using the C-PAP and other breathing machines can be hard to get used to and are often not an easy fix. Many people complain that it is uncomfortable to wear the mask the whole night. People also dislike the air pressure coming into the nose. Surgery may be an option for some if the mask is not working.
  • Positional therapy. This is simply side sleeping instead of back sleeping. It can work in mild cases. In more severe cases, the airway collapses no matter which position you sleep in.
  • Surgery. For adults who snore, surgery can work well. But it is less effective in treating OSA. There are different types of surgery depending on the source of the problem. Yet it can be hard to find the right spot or spots that are collapsing in the airway. For instance, it can be hard to know if the problem is with the nose or the base of the tongue.
  • Oral appliances. This tool forces the jaw into position to allow for proper air flow.

Avoiding alcohol, which relaxes the muscles in the throat, can also help with apnea.

If you or your bed partner spot signs of apnea or feel too sleepy during the day, see a doctor. There are ways you can improve your sleep and feel better when the morning comes. More importantly, treating sleep apnea can protect your heart.

Resources

National Sleep Foundation
www.sleepfoundation.org

American Sleep Apnea Association
http://www.sleepapnea.org/

By Sarah Stone
Source: Ramar, M.D. Kannan and Olson, M.D., Eric. J. (2013) "Management of Common Sleep Disorders." American Family Physician, Volume 88(4);231-238; American Sleep Apnea Association, http://sleepapnea.org/treat/treatment-options.html, www.sleepapnea.org/learn/sleep-apnea/central-sleep-apnea.html and www.sleepapnea.org/treat/treatment-options/surgery.html; National Heart, Lung and Blood Institute, www.nhlbi.nih.gov/health/health-topics/topics/ohs/ and www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea/; Mayo Clinic, www.mayoclinic.org/diseases-conditions/central-sleep-apnea/basics/causes/con-20030485 and www.mayoclinic.org/diseases-conditions/sleep-apnea/basics/risk-factors/con-20020286
Reviewed by Gary R. Proctor, MD, Associate Chief Medical Officer, Beacon Health Options

Summary

  •  There are 2 main types of sleep apnea.
  • Being overweight or obese is among the biggest risk factors for sleep apnea.
  • Treating sleep apnea can lower blood pressure in those with severe cases.

Sleep apnea causes breathing to stop or get very shallow while asleep. These pauses can last from a few seconds to minutes. They can happen 30 times or more an hour. Sleep apnea is a common disorder, often spotted by a bed partner. This abnormal breathing can be serious, leading to high blood pressure and heart problems. There are two main types of sleep apnea: obstructive sleep apnea (OSA) and central sleep apnea (CSA).

Obstructive sleep apnea

The most common type of sleep apnea is OSA. Around 4 percent of men and 2 percent of women have it. OSA causes your airway to collapse or become blocked during sleep. The upper airway can be either completely or partially closed. When normal breathing starts again after a pause, there is a snort or choking sound.

OSA can cause fatigue, impaired thinking, and accidents on the job and behind the wheel. Research shows it can also cause high blood pressure. This makes it very important to look out for these signs that you or your partner may have apnea:

  • Extreme tiredness during the day
  • Gasping or choking during sleep that you feel or a partner notices
  • Snoring

Although people who have sleep apnea often snore loudly, not everyone who snores has sleep apnea.
People who are obese or overweight are at greater risk for OSA. So are men, adults older than 60 and people who drink alcohol or smoke. Other markers or red flags that may prompt a doctor to test patients for apnea include:

  • Needing bariatric surgery
  • Certain heart problems
  • Having had a stroke
  • Type 2 diabetes

Central sleep apnea

Central sleep apnea (CSA) is a bit different than OSA. CSA causes total lapses or pauses in breathing, or breath is so shallow that not enough oxygen is taken in. OSA is a structural problem, but with CSA, the brain is not sending the signal to the body to inhale. Many people with CSA also find out they have OSA. And sometimes people with OSA develop CSA. This turns into what’s known as complex sleep apnea.

The symptoms of CSA are generally the same as OSA, except snoring is less likely with CSA. CSA can be caused by heart, kidney and other diseases. If it is caused by another disease, other signs may be trouble swallowing, changes in voice and feeling numb or weak. Using certain opioids (drugs) can also cause CSA. There may also be no known cause. Doctors may advise the same types of treatment for CSA as used with OSA. Certain medicines may also be an option for some people with CSA.

Understanding hypoventilation

Hypoventilation is breathing that is too shallow or slow while sleeping. As a result, the carbon dioxide level can rise and there is not enough oxygen in the blood to meet the body’s needs. This breathing disorder affects some people who are obese, separate from apnea. Yet these processes are alike. And there is much overlap in these weight-related breathing problems.

Treatment

If you have signs of apnea, talk to your doctor. You may need to have a sleep study called a polysomnography. This test looks at brain activity, heart rate and other signs to help find out if you have a sleep disorder. If you have apnea, treatment options can include:

  • Weight loss. Around 70 percent of people with OSA are overweight or obese. Losing weight can be very beneficial in treating apnea and snoring.
  • C-PAP machine. C-PAP stands for continuous positive airway pressure. A C-PAP machine uses air pressure like a splint to keep the airway open. It is the most effective treatment for apnea. The C-PAP can lower blood pressure in people with OSA, especially if it is severe. Using the C-PAP and other breathing machines can be hard to get used to and are often not an easy fix. Many people complain that it is uncomfortable to wear the mask the whole night. People also dislike the air pressure coming into the nose. Surgery may be an option for some if the mask is not working.
  • Positional therapy. This is simply side sleeping instead of back sleeping. It can work in mild cases. In more severe cases, the airway collapses no matter which position you sleep in.
  • Surgery. For adults who snore, surgery can work well. But it is less effective in treating OSA. There are different types of surgery depending on the source of the problem. Yet it can be hard to find the right spot or spots that are collapsing in the airway. For instance, it can be hard to know if the problem is with the nose or the base of the tongue.
  • Oral appliances. This tool forces the jaw into position to allow for proper air flow.

Avoiding alcohol, which relaxes the muscles in the throat, can also help with apnea.

If you or your bed partner spot signs of apnea or feel too sleepy during the day, see a doctor. There are ways you can improve your sleep and feel better when the morning comes. More importantly, treating sleep apnea can protect your heart.

Resources

National Sleep Foundation
www.sleepfoundation.org

American Sleep Apnea Association
http://www.sleepapnea.org/

By Sarah Stone
Source: Ramar, M.D. Kannan and Olson, M.D., Eric. J. (2013) "Management of Common Sleep Disorders." American Family Physician, Volume 88(4);231-238; American Sleep Apnea Association, http://sleepapnea.org/treat/treatment-options.html, www.sleepapnea.org/learn/sleep-apnea/central-sleep-apnea.html and www.sleepapnea.org/treat/treatment-options/surgery.html; National Heart, Lung and Blood Institute, www.nhlbi.nih.gov/health/health-topics/topics/ohs/ and www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea/; Mayo Clinic, www.mayoclinic.org/diseases-conditions/central-sleep-apnea/basics/causes/con-20030485 and www.mayoclinic.org/diseases-conditions/sleep-apnea/basics/risk-factors/con-20020286
Reviewed by Gary R. Proctor, MD, Associate Chief Medical Officer, Beacon Health Options

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