Understanding Sleep Apnea

A Comprehensive Guide to Diagnosis, Treatment, and Management

Family Medicine

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Last updated: Mar 24, 2025

What is Sleep Apnea?

Sleep apnea is a serious sleep disorder where breathing repeatedly stops and starts during sleep. These pauses in breathing can last from a few seconds to minutes and may occur 30 times or more per hour.

Types of Sleep Apnea

  • Obstructive Sleep Apnea (OSA): Most common type, caused by blocked airway
  • Central Sleep Apnea: Brain doesn't send proper signals to breathing muscles
  • Complex Sleep Apnea: Combination of both types

Common Symptoms

  • Loud snoring
  • Episodes of stopped breathing during sleep
  • Gasping for air while sleeping
  • Morning headaches
  • Excessive daytime sleepiness
  • Difficulty concentrating
  • Irritability

Risk Factors

  • Excess weight
  • Neck circumference >17 inches (men) or >16 inches (women)
  • Family history
  • Age (risk increases with age)
  • Male gender
  • Use of alcohol or sedatives
  • Smoking
  • Nasal congestion

Diagnosis

Initial Assessment

  • Medical history review
  • Physical examination
  • Sleep study (polysomnography)

Sleep Study Measurements

  • Brain activity
  • Eye movements
  • Heart rate and blood pressure
  • Blood oxygen levels
  • Breathing patterns

Treatment Options

Lifestyle Changes

  • Weight loss
  • Regular exercise
  • Side-sleeping position
  • Avoiding alcohol and sedatives

Medical Devices

  1. CPAP (Continuous Positive Airway Pressure)

    • Most common treatment
    • Delivers air pressure through mask
    • Keeps upper airway passages open
  2. Other Devices

    • Oral appliances
    • Bilateral hypoglossal nerve stimulation

Surgical Options

  • Tissue removal
  • Jaw repositioning
  • Implants
  • Tracheostomy (rare cases)

Complications if Untreated

  • High blood pressure
  • Heart problems
  • Type 2 diabetes
  • Liver problems
  • Sleep-deprived partners

When to See a Doctor

  • Loud snoring disrupting sleep
  • Waking up gasping for air
  • Observed breathing pauses during sleep
  • Excessive daytime sleepiness

Living with Sleep Apnea

  • Follow treatment plan consistently
  • Maintain regular sleep schedule
  • Keep healthy lifestyle habits
  • Regular medical follow-up
  • Monitor symptoms

Prevention Strategies

  • Maintain healthy weight
  • Regular exercise
  • Avoid smoking and excessive alcohol
  • Establish good sleep hygiene
  • Regular medical check-ups

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