1. What is sleep apnea?
Sleep apnea is a very common disorder that causes pauses in breathing or shallow breathing. It is usually a chronic condition that results in poor sleep quality and tiredness throughout the day. To learn what happens to your airway passages during periods of sleep apnea, visit the National Heart, Lung, and Blood Institute’s website for details and a brief video.
2. How long can these pauses in breathing last?  
Pauses in breathing can last anywhere from a few seconds to a few minutes. In some cases, pauses can occur nearly 30 times in one hour. Breathing will start again naturally, sometimes with a choking or snorting sound. You may sometimes notice yourself waking and gasping for air.
3. What causes sleep apnea?
While awake, the muscles in the throat help keep airways open, allowing air into the lungs. While asleep, these same muscles relax, narrowing the airway. Normally this isn’t enough of a change to keep air from entering the lungs, but with sleep apnea the airway can become blocked. Some reasons for this include:

    • Weight. For those who are overweight, fatty tissue thickens the wall of the trachea (windpipe) causing it to narrow and making it harder to keep open.
    • Age.  The brain typically receives signals telling itto keep your throat muscles stiff while sleeping. As you age, those signals become limited causing the airway to narrow or collapse.
    • Sleeping Habits. For some people, while sleeping, the throat and tongue relax more than normal.
    • Tonsils. Some people have larger than normal tonsils.
    • Airway Size. Airway size varies due to the size and shape of a person’s head.

4. I snore. Does that mean I have sleep apnea?
No, it does not. It does indicate, however, that you are experiencing an obstruction to your breathing while asleep. If you know that you snore, look for other symptoms of sleep apnea such as daytime sleepiness, morning headaches, lack of concentration, waking up frequently at night to urinate, mood swings and dry mouth upon waking. While each of these symptoms alone may be an indication of another type of problem, if you are experiencing more than one, you might consider talking to your doctor about your likelihood for sleep apnea.

5. How is sleep apnea diagnosed?
Because symptoms only occur while sleeping, sleep apnea can be hard to detect and is oftentimes noticed first by someone else living in the home, such as a sleeping partner. They may actually observe you not breathing or notice loud snoring.

Physicians diagnose sleep apnea based on a few factors, but the best way is to send their patients to a sleep specialist, who may then order a sleep study.

6. What can I do if I suspect that I have sleep apnea?
Consider keeping a sleep diary for one or two weeks that documents sleeping patterns and your performance throughout the day. This can be done prior to visiting a doctor as it will give the doctor much needed information to begin the process of diagnosing sleep apnea and whether a sleep study is needed. You can find a sample sleep diary in the National Heart, Lung, and Blood Institute’s “Your Guide to Healthy Sleep.”

7. What are the risks if sleep apnea remains undiagnosed or untreated?
Because there may be periods of time without breathing, oxygen levels will be lower than what the body actually needs. A drop in oxygen levels, along with poor quality of sleep, can trigger the release of stress hormones, which, in turn, raise the heart rate. (The heart has to work harder to make up for the oxygen it is missing when not breathing regularly). An increased heart rate increases the risk of high blood pressure, stroke, heart attack and heart arrhythmias (irregular heartbeat).

Untreated sleep apnea also changes the way the body uses energy, increasing the risk for diabetes and obesity.

8. What is a sleep study?
Sleep studies are tests that measure what is happening to your breathing while sleeping to determine how the body responds. These are the most widely-used and accurate methods for diagnosing sleep apnea.

9. What is involved in a sleep study?
A physician must order the study at a specific facility. Studies are typically available in hospitals and in sleep centers, where your comfort is the main focus. It is important to be relaxed enough to fall asleep, so the technicians will do all they can to create optimal conditions for sleeping.

Studies also typically take place overnight, with a sleep technician monitoring your sleep patterns. Sticky electrodes are placed on the patient’s chest, limbs, finger, head and face and will record heart rate, blood pressure, eye movements, brain activity and oxygen saturation. Elastic belts are placed around the abdomen and chest and will measure chest movements and length of time of inspiration and expiration. Some patients are required to blow air through a mask into his/her nose and/or mouth in order to determine what pressure will best help to keep the airway open while sleeping.

All data is recorded and has to be read by a qualified sleep specialist to determine the results, which will help decide the next course of action. Results are typically presented within a few days.

10. Will my insurance cover a sleep study and treatment, if needed?
It is best to call your insurance company and ask them directly so they can clarify any questions regarding out-of-pocket expenses and deductibles. The sleep center will also do this for you prior to setting up the study. Call Breathe PA at 1-800-220-1990 to inquire about our Patient Assistance Program. We may be able to help with the purchase of equipment if it is not covered by insurance.

11. What treatments are available?
Treatment options include: surgery, mouthpieces, breathing devices (CPAP), and lifestyle changes. The goal of each of these treatments is to relieve symptoms and restore regular breathing during sleep.

Visit the National Heart, Lung, and Blood Institute or the American Sleep Apnea Association for more information on treatments.

For general information regarding sleep apnea, please call Breathe Pennsylvania at 1-800-220-1990. Good luck and sweet dreams!