Sleep apnea is a serious medical condition that demands accurate clinical diagnosis and proper treatment.
Literally speaking, sleep apnea translates to stopping breathing during sleep
The prevalence is about 15% in men, and 5% in women
Risk factors for sleep apnea include: advancing age; obesity (63% men > 30 BMI, 22% women > 30 BMI); gender: men are 3 times more likely than women; smoking; family history; excessive alcohol use (more than 2 drinks per day); sleep medications; congestive heart failure, kidney failure, stroke, under active thyroid, and a personal history for post-traumatic stress disorder.
The cause is collapse of the upper airway, which prevents normal breathing especially during sleep.
Symptoms: choking & gagging during sleep is the most suggestive symptom. Snoring, especially loud snoring, day-time sleepiness, breathing interruptions during sleep, poor concentration, morning headaches, sleep attacks (sudden fall into sleep), irresistible need to sleep, mood changes, fatigue, and non-restorative sleep are all typical for obstructive sleep apnea or OSA.
Signs: the signs of sleep apnea – high blood pressure, mood disorders, depression, cognitive dysfunction, coronary artery disease, stroke, congestive heart failure, sexual dysfunction, cardiac arrhythmias, and dementia – are the consequence of chronic, prolonged reduction in the supply of oxygen to vital organs including the nervous and cardiovascular systems. In other words, OSA is no laughing matter.
Other consequences: motor vehicle crashes, household accidents, diabetes, fatty liver disease, and increased all-cause mortality.
Diagnosis: sleep studies can be performed in a sleep lab or in your home. 15 or more apneic events (interruption in breathing or stopping breathing) per hour constitutes a positive test. Following a positive study, the sleep lab technician will measure the amount of pressure necessary to keep the airway open with CPAP. This is called CPAP titration.
Treatment: it is imperative that sleep apnea be treated to avoid the long-term consequences. The most effective treatment is utilization of continuous positive airway pressure or CPAP devices. While initially CPAP may take some getting used to, over time most patients adjust to it and discover the benefits of restorative sleep and improved daytime energy and cognitive function. Many patients find using a nasal pillow over a mask that covers the nose and mouth preferable.
For obese individuals weight loss is imperative.
In some studies, oral appliances have shown benefit, however, CPAP is the preferred therapy.
One word of caution here, surgical solutions have been disappointing and should be avoided.
Kingman, P., 2018. Overview of obstructive sleep apnea. Up to Date, April 3, 2018.