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What Happens During Sleep Apnea

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Improving Health With Current Research

What happens during obstructive sleep apnea?

Learn about the following ways the NHLBI continues to translate current research into improved health for people with sleep apnea.

  • Sleep Disorders Research Advisory Board . The NHLBI has administered this specialty program advisory panel since 1993. Board members, including medical professionals, federal partners, and members of the public, meet regularly to provide feedback to the NIH on sleep-related research needs and to discuss how to move sleep research forward. Visit the Sleep Disorders Research Advisory Board for more information.
  • National Sleep Research Resource . This resource was established by the NHLBI to provide biomedical researchers a large, well-characterized data collection from NIH-funded sleep research studies. These data can be used in new research studies to advance sleep research. Visit the National Sleep Research Resource for more information.
  • Identification of genes that increase susceptibility to obstructive sleep apnea. The NHLBI Trans-Omics for Precision Medicine program and its Whole-Genome Sequencing project is using WGS data to identify genetic variations that may increase the risk of obstructive sleep apnea. Visit the Cleveland Family Study-WGS Collaboration for more information.

Learn about some of our pioneering research contributions that have improved clinical care.

How Common Is Sleep Apnea

Obstructive sleep apnea is estimated to affect between 2-9% of adults in the United States, but many cases are believed to go undiagnosed, which fits with studies that have found considerably higher rates of OSA. Precise prevalence is hard to determine because studies have used different criteria for diagnosing the condition. A consistent finding, though, is that OSA affects men more than women. It can occur in people of any age but is more common in older adults.

Central sleep apnea has been found to affect around .9% of adults over the age of 40. It is found much more frequently in men than in women.

As this data demonstrates, OSA is much more common than CSA. For this reason, when people talk about sleep apnea, they are generally referring to OSA.

Sleep Lab Studies What To Expect

Sleep studies conducted at specialist labs are more comfortable than many people think. The word lab conjures images of cold indifference people in white coats and unfriendly, clinical surroundings. Most bedrooms in specialist sleep clinics are comfortable and sympathetically decorated, with a real bed as opposed to a hospital trolley some say akin to a three-star hotel.

Before your study

To ensure good sleep and reliable data, there are a few things to do in the lead up to your study:

  • Maintain a normal and healthy sleep routine on the nights leading up to the study.
  • Avoid napping on the day of the study.
  • Limit caffeine consumption and avoid alcohol altogether.
  • You may also need to adjust your medications .

What to bring

  • A change of clothing for the next day
  • Toiletries
  • Something to keep you occupied before going to sleep. There will likely be a period of winding down before the study starts, so a book or puzzle to keep you occupied is a good idea.
  • Any medication you take routinely, both to maintain that routine and to show to the staff, as this can provide some insight into your sleep symptoms.
  • Any necessary documentation

Getting wired up

Different labs will vary, but typically you will have these various attachments on a number of places on your body:

Once all of these attachments are in place, your technician may ask you to blink or make some snoring noises to test the connections.

You are likely to then be given some time to wind down before going to sleep.

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Is It Sleep Apnea Or Just Snoring

Not everyone who snores has sleep apnea, and not everyone who has sleep apnea snores. So how do you tell the difference between normal snoring and a more serious case of sleep apnea?

The biggest telltale sign is how you feel during the day. Normal snoring doesnt interfere with the quality of your sleep as much as sleep apnea does, so youre less likely to suffer from extreme fatigue and sleepiness during the day. The way you sound when youre snoring also provides clues. As mentioned above, if youre gasping, choking, or making other unusual sounds, you should suspect sleep apnea.

Keep in mind that even if you dont have sleep apnea, a snoring problem can get in the way of your bed partners rest and affect your own sleep quality. But there are tips and treatments that can help you stop snoring.

Other Positive Airway Pressure Breathing Devices

What Happens During Sleep Apnea

In addition to CPAP, there are other devices that a sleep specialist may recommend for sleep apnea treatment.

Expiratory positive airway pressure single-use devices fit over the nostrils to help keep the airway open and are smaller, less intrusive than CPAP machines. These may benefit people with mild-to-moderate obstructive sleep apnea.

Bilevel positive airway pressure devices can be used for those who are unable to adapt to using CPAP, or for central sleep apnea sufferers who need assistance for a weak breathing pattern. This device automatically adjusts the pressure while youre sleeping, providing more pressure when you inhale, less when you exhale. Some BiPAP devices also automatically deliver a breath if the mask detects that you havent taken one for a certain number of seconds.

Adaptive servo-ventilation devices can be used for treating central sleep apnea as well as obstructive sleep apnea. The ASV device stores information about your normal breathing pattern and automatically uses airflow pressure to prevent pauses in your breathing while youre asleep.

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Who Reviews Sleep Apnea Test Results

While an in-lab sleep test takes much longer to analyze because of all the extra data they must interpret, home sleep tests have a much faster turnaround time. Once you wear the device during a successful night of sleep, you will mail it back for the data to then be interpreted by a board-certified sleep physician.

It Could Be The Difference Between Life And Death

Take heed of the warning signs of sleep apnea and dont let complications of sleep apnea shorten your life!

DISCLAIMER: THIS WEBSITE DOES NOT PROVIDE MEDICAL ADVICE The information, including but not limited to, text, graphics, images and other material contained on this website are intended to increase awareness and provide information. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment.

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Upper Airway Surgery For Sleep Apnea

If you have exhausted other sleep apnea treatment options, surgery to increase the size of your airway may be a possibility.

The surgeon may remove tonsils, adenoids, or excess tissue at the back of the throat or inside the nose, reconstruct the jaw to enlarge the upper airway, or implant plastic rods into the soft palate. Surgery carries risks of complications and infections, and in some rare cases, symptoms can become worse after surgery.

How To Diagnose Or Get Diagnosed With Sleep Apnea

What Happens During A Sleep Apnea Episode

In order to be diagnosed with sleep apnea you must undergo a sleep study and have the results and diagnosis confirmed by a board-certified sleep physician. Like many disorders that require long-term treatment, a sleep apnea diagnosis qualifies you to receive a variety of sleep apnea treatments like CPAP, AutoPAP, BiPAP, or even surgery and dental appliances.

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Sleep Apnea Test: Stopbang

A “yes” answer to three or more of these questions suggests possible sleep apnea. Ask your doctor if you should have a sleep study.

Neck: Is your neck circumference more than 16 inches or 17 inches ?

Gender: Are you male?

If your husband is worried about spending the night in a sleep laboratory, reassure him that most of the time, that’s not necessary. Instead, a doctor can prescribe a home-based test, using equipment you borrow from a sleep lab. This includes a small, lightweight monitor and several sensors that measure oxygen levels, heart rate, airflow, and body movements during sleep. Today, about 60% to 70% of sleep studies for suspected sleep apnea are done using home-based tests. If his symptoms suggest moderate to severe sleep apnea and he has no other serious medical problems, a home-based test is almost as accurate for detecting apnea as a test done in a sleep lab.

by Deepak L. Bhatt, M.D., M.P.H.Editor in Chief, Harvard Heart Letter

Lifestyle Treatments For Sleep Apnea

For mild cases of sleep apnea, lifestyle changes may be enough to treat the issue. Your doctor will let you know if thats the right starting point. But even if you are prescribed a medical treatment, the following changes can help reduce your sleep apnea episodes and improve your sleep.

Lose weight. If you are overweight, losing weight can have an enormous impact. While it is usually not a total cure, it can reduce the number of breathing episodes you experience, reduce your blood pressure, and decrease daytime sleepiness. Even a small amount of weight loss can open up your throat and improve sleep apnea symptoms.

Exercise. Even when exercise does not lead to weight loss, it can decrease your sleep apnea breathing episodes and improve your alertness and energy during the day. Aerobic exercise, resistance training, and yoga are all good choices for strengthening the muscles in your airways and improving breathing.

Sleep on your side. Lying on your back is the worst position for sleep apnea, as it causes the jaw, tongue, and other soft tissues to drop back toward the throat, narrowing your airway. Sleeping on your stomach isnt much better, since lying face down or twisting your head to the side both obstruct breathing. Lying on your side, on the other hand, helps keep your airway open. If you find side sleeping uncomfortable or you tend to roll on to your back after youre asleep, countered side pillows or body pillows may help.

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How Do I Get A Sleep Study

Medical referral

If you think you might have sleep apnea, first assess your risk with some questionnaires. Scoring high on screening questionnaires such as the STOP-Bang questionnaire and the Epworth Sleepiness Scale can be useful in persuading clinicians that a sleep study is necessary.

You can then see your doctor to request further investigation into your sleep breathing problems.

As well as your screening questionnaire results, SnoreLab can often be very helpful in giving your doctor some evidence of your loud snoring or maybe even some apnea episodes.

If seeing a general practitioner for your initial consultation, you may first be referred to a sleep specialist or an ear, nose and throat clinician before being offered a sleep study.

Requesting a home study online

In some countries, there are online companies that conduct home sleep studies without you ever having to attend a medical consultation. After filling out an online assessment form and paying a fee, these companies will post your study equipment to you with instructions.

What Happens During An Apnea

What Happens During A Sleep Apnea Episode

To understand what is going on in an apnea, it’s helpful to think of this analogy. Imagine trying to drink a milkshake through a paper soda straw. As you suck in, the weak paper straw collapses, and you don’t get any of the milkshake. This collapsing is similar to what happens to people with OSA, but instead of missing out on a milkshake, they don’t get enough air into their lungs. This does not occur with normal breathing during wakefulness because signals from the brain activate the tongue and the muscles surrounding the airway and stiffen the airway. Therefore, air can flow into the lungs uninterrupted. In other words, normal breathing during wakefulness is like drinking the milkshake through a plastic soda straw.

When we sleep, there is an increased risk for the airway behind the tongue to collapse with each breath . For most people this collapse does not occur because activation of the muscles surrounding the airway during sleep is still strong enough to prevent any blockage. However, for someone with OSA, the muscles do not respond adequately. Like the paper straw that collapses, the airway collapses and air does not reach the lungs.

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What Are The Signs & Symptoms Of Obstructive Sleep Apnea

When breathing stops, oxygen levels in the body drop and carbon dioxide levels rise. This usually triggers the brain to wake us up to breathe. Most of the time, this happens quickly and we go right back to sleep without knowing we woke up.

This pattern can repeat itself all night in obstructive sleep apnea. So people who have it don’t reach a deeper, more restful level of sleep.

Signs of obstructive sleep apnea in kids include:

  • snoring, often with pauses, snorts, or gasps
  • heavy breathing while sleeping

Because it’s hard for them to get a good night’s sleep, kids might:

  • have a hard time waking up in the morning
  • be tired or fall asleep during the day
  • have trouble paying attention or be hyperactive

As a result, obstructive sleep apnea can hurt school performance. Teachers and others may think a child has ADHD or learning problems.

How Can Treating Sleep Apnea Lower Your Risk Of Dementia

Dementia is a general medical term to describe the decline of cognitive abilities, including memory, language skills, problem-solving, and thinking that are severe enough to impact your daily life. Alzheimers Disease is one of the leading causes of Dementia.

New research from the University of Michigan Health Lab reveals that a particular form of Obstructive sleep apnea treatment could minimize the risk of developing Dementia. The treatment is called Positive Airway Pressure Therapy.

For the study, researchers analyzed people 65 and older with OSA. They discovered that the patients who used Positive Airway Pressure Therapy were less likely to be diagnosed with Dementia over the course of three years compared to those who did not use the therapy treatment. The experts say these findings further solidify just how vital good sleep is to cognitive health.

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Symptoms Of Sleep Apnea

Because some of the symptoms of sleep apnea occur while youre sleeping, your bed partner may notice them first. You, or that person, may notice heavy snoring or long pauses in your breathing during sleep.

Even if you dont remember waking up during the night, you may notice daytime sleepiness , irritability, or fatigue. You may also experience morning headaches, forgetfulness, mood changes, and a decreased interest in sex.

Research For Your Health

What to Expect During a Sleep Apnea Study

The NHLBI is part of the U.S. Department of Health and Human Services National Institutes of Health the Nations biomedical research agency that makes important scientific discovery to improve health and save lives. We are committed to advancing science and translating discoveries into clinical practice to promote the prevention and treatment of heart, lung, blood, and sleep disorders, including sleep apnea. Learn about the current and future NHLBI efforts to improve health through research and scientific discovery.

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Sleep Apnea Cardiovascular Risk And Metabolism

Several studies have shown an association between sleep apnea and problems like type 2 diabetes , strokes , heart attacks and even a shortened lifespan, says Jun. Why this connection? For one thing, obesity is common in sleep apnea patients, and obesity greatly increases risks of diabetes, stroke and heart attack, he says. In most cases, obesity is the main culprit behind both conditions, Jun explains.

Still, its important to note that not everyone with sleep apnea is obese. Furthermore, evidence suggests an independent link between sleep apnea and diabetes. Our lab and others have shown that sleep apnea is associated with higher risks of diabetes, independent of obesity, and that sleep apnea can increase blood sugar levels, says Jun.

For people who are overweight or obese, weight loss is key for treating or avoiding sleep apnea. People who accumulate fat in the neck, tongue and upper belly are especially vulnerable to getting sleep apnea. This weight reduces the diameter of the throat and pushes against the lungs, contributing to airway collapse during sleep.

Women in particular should be careful as they age. While premenopausal women tend to put on weight in the hips and in the lower body instead of the belly, this shifts with time. Weight begins to accumulate in traditionally male areas like the tummy, and this leads to a greater chance of sleep apnea.

What Are The Health Risks Of Sleep Apnea

Sleep apnea can lead to sleep deprivation from constant nightly interruptions and shallower overall sleep. Lack of sleep is associated with far-reaching health consequences that affect a person physically, mentally, and emotionally, and as a result, it comes as no surprise that sleep apnea has been tied to diverse health problems.

Because of how it affects oxygen balance in the body, untreated sleep apnea raises dangers for various types of cardiovascular issues including high blood pressure, heart attack, heart disease, and stroke.

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Can Sleep Apnea Kill You

If you happen to be a firsthand witness, it can be a little scary to realize someone has stopped breathing during sleep. While several things can make your breathing stop while you’re asleep, a common cause is sleep apnea. People often ask, “Can sleep apnea kill you?” The answer is that it can have numerous short-term and long-term health consequences and yes, some of them can be life-threatening.

Does Medicare And/or Insurance Cover Sleep Apnea Testing

What to Expect During Your Sleep Apnea Study: Larry R ...

Home sleep testing is often covered by most insurance companies if the patient exhibits likely symptoms for sleep apnea and qualifies for medical necessity. Sleep apnea testing is covered by Medicare as well as insurance companies like Blue Cross/Blue Shield, Aetna, and Cigna. Be sure to check with your insurance provider before ordering your sleep test.

While insurance does typically cover testing and, occasionally, treatments, ApneaMed does not work with insurances directly. This is actually beneficial to the patient because it means you can receive your testing sooner and, oftentimes, for cheaper.

Paying ApneaMed out-of-pocket does not mean your insurance wont reimburse you. However, you will have to do some research to see if your insurance has processes in place for out-of-pocket medical purchases. Check out our blog post for more information on billing your insurance directly.

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