What is sleep apnea?

Sleep apnea is a night time event whereby a person will stop breathing at night and their oxygen saturation will go down, this waking the body and disturbing healthy sleep. There are variations in severity with this issue. Not all patients who snore have sleep apnea. When the patient has sleep apnea, the body is not able to go through a normal sleep cycle. The sleep cycle goes from light stages of sleep to very deep stages of sleep to REM, or dream sleep, and cycles back up and down through these stages of sleep through the night. Interruptions of this cycle can be stressful on the body, not allow the brain to re-energize and re-oxygenate and put undue stress on the heart and the lungs in order for them attain enough oxygen for the vital organs. With sleep apnea the red blood cells crave oxygen and the heart and the lungs have to work harder and pump more to get enough oxygen in the blood stream. This can lead to high blood pressure and an increase in pulmonary pressure.

The airway obstruction during sleep that causes patients to desaturate, or drop oxygen levels, is sleep apnea. Sleep apnea can be mild, mild-moderate, moderate, moderate-severe and severe depending on how many times and how low the oxygen level goes down. Sleep apnea can be a structural blockage, usually at the base of the tongue, based on the person’s anatomy or weight and sometimes both. Sleep apnea can go undiagnosed for many years as the tired person gets used to how they feel and compensates for it on a daily basis. An individual is often sent to the doctor’s office by a family member or a loved one for their snoring and sometimes obvious gasping at night. One way to determine if you are getting a good night sleep is to look at your bed in the morning. If your sheets are everywhere and the blanket is on the floor, you likely are not getting a quality night’s sleep and you may have sleep apnea. To make a diagnosis of sleep apnea a sleep study is done, either at home or in a sleep lab. Depending on the cause and severity of the sleep apnea, many treatment options are available. If the tonsils are grossly enlarged then often removing them will cure the problem. If a patient has narrow tongue base due to a weak chin, retrognathia, then an oral appliance may be the best option. Weight loss is also recommended if weight is an issue. Weight loss can be difficult with sleep apnea as a patient has a slower metabolism with poor sleep. It is often necessary to start managing the apnea making weight loss easier. CPAP is continuous positive airway pressure and is a machine that a person will wear at night to force a breath of air by the airway obstruction, this is usually the best option for a patient with severe sleep apnea. This device will keep the oxygen saturation above 98% and allow the patient to achieve all stages of proper sleep. If you are concerned if you have sleep apnea, go see your ENT for a physical exam and a sleep study.