Sleep Apnea

What is sleep apnea?
A person with a sleep apnea stops breathing during sleep either due to the airway being blocked or improper signals from the brain being sent to muscles that control breathing. 

What are the main types of sleep apnea?
Obstructive Sleep Apnea
Obstructive sleep apnea occurs when the airway is blocked during sleep prohibiting enough air from reaching the lungs, which results in a short period where the individual stops breathing.  This may result in the individual gasping or choking for air or snoring loudly. At least 25 million people in the United States suffer from obstructive sleep apnea.

Central Sleep Apnea
Central sleep apnea occurs when there is a disconnect between the brain and muscles that control breathing. Central sleep apnea is much less common than obstructive sleep apnea.


What are the steps to getting diagnosed?
Each person's journey to becoming diagnosed with a sleep disorder is different; however, generally, an individual would first need to bring their concerns to their physician or healthcare provider and potentially be referred to a sleep specialist.  Bringing specific information, including detailed information on symptoms as well as concerns, is helpful.

Sleep apnea is generally diagnosed through a thorough evaluation of your complete medical history and completion of a sleep test, which may include polysomnography (PSG), home sleep apnea testing (HSAT), and/or a positive airway pressure (PAP) titration.

Polysomnography is an overnight sleep study performed at a sleep center.  You would go to the sleep center in the evening at your scheduled day and time.  You will meet with the sleep technologist who may talk with you about your sleep history, explain the testing process, and get you set up for the test; this includes putting sensors on your body that monitor your breathing and oxygen levels, heart rate, brain activity, and movements while you sleep. You will then follow your normal bedtime routine until lights out.  You'll sleep through the night at the sleep center; it may be difficult to sleep due to the new environment or sensors, but this shouldn't affect your test results.

Alternatively, your physician may order a home sleep apnea test (HSAT) instead if you have a high pre-test probability for obstructive sleep apnea (OSA).  This means that there is high likelihood that you have OSA based on your symptoms and medical history.  The HSAT is completed at your home and does not require that you spend the night at the sleep center.  Generally, you will be given HSAT equipment either by your physician's office or be mailed the equipment and receive some form of instruction on readying the test and applying the sensors needed for the test.  At bedtime, you will then apply the sensors yourself, hook up the equipment and go to sleep.  After completing the test overnight, you will then return the equipment to your physician, either by dropping it off at the office or through the mail.

Once your test results have been reviewed, your physician will contact you to follow-up on your results.  If you have sleep apnea, your physician may suggest that you be treated using PAP therapy (see below for more information).  This may require that you complete a PAP titration (to ensure the treatment is effective).  This may be completed in conjunction with your PSG (called a split-night study) or at a later date after the completion of your PSG.


How is sleep apnea typically treated?
The main treatment options for sleep apnea typically include PAP therapy, oral appliance or surgery. In certain cases, lifestyle changes (such as losing weight) may also help to address this disorder.

PAP Therapy
PAP therapy is essentially a machine that provides air pressure in your airway via a face mask worn during sleep which stops obstructions in your airway during sleep. Includes a variety of options:
  •  CPAP (Continuous PAP): Provides a continuous stream of pressurized air at a single pressure setting (set by your physician usually after a titration study)
  •  BiPAP (Bilevel PAP): Provides continuous pressure at two pressure settings—one for inhaling, and one for exhaling.  If you are having trouble exhaling when using a CPAP, you may want to talk to your doctor about switching to BiPAP.
  •  APAP (Automatic PAP): Provides continuous pressure that automatically adjusts to meet changing breathing needs through the night

There are also a variety of mask options available for your machine, including a nasal mask or full-face mask; work with your physician's office to choose the best mask for you.

Oral Appliance
A customized, titratable device or mouthpiece that fits in the mouth and either moves the lower jaw forward or depresses the tongue; This is generally considered an option if you are intolerant of PAP therapy and is provided by a qualified dentist in conjunction with your sleep physician.

Surgery
Several different surgery options are available for patients with sleep disorders, including options that address mouth, nose, tongue, or jaw issues. Talk with your medical team about appropriate options for you.


If you feel that you may have a sleep disorder, talk to your primary physician or a sleep specialist regarding your concerns.

*The information above does not constitute medical advice; you should talk with your physician or healthcare provider regarding your medical care, including appropriate treatment options.


Member Only Resource: Sleep Apnea
This informational sheet provides additional information regarding sleep apnea and can be used as a resource for patients or for medical professionals to provide as supplemental information for their patients. AAHS members will have indefinite access to these informational sheets through the file archive on your member account.