Sleep Apnea

Signs & symptoms

Common symptoms of sleep apnea include:

• Restless sleep
• Loud, heavy snoring often interrupted by silence and gasps
• Drowsiness or fatigue, caused by the lack of sleep
• Headaches in the morning
• Irritability, forgetfulness, mood or behavior changes
• Anxiety or depression

If sleep apnea isn't treated, it can lead to serious health problems such as:

• Hypertension or high blood pressure
• Heart disease, heart attack and stroke
• Psychiatric symptoms such as depression
• Impotence and lack of interest in sex
• Memory loss or other problems with mental processing, also called cognitive dysfunction

Diagnosis

If you think you might have sleep apnea, your doctor may be able to make a diagnosis based on the description of your symptoms. In addition, an overnight evaluation with a sleep study may be performed to assess the severity and cause of your sleep problems.

During an overnight sleep study at your home or in a sleep laboratory, your breathing and other body functions are monitored while you sleep.

In a sleep laboratory such as the UCSF Sleep Testing Laboratory, tests, called polysomnograms, monitor your heart, lung, brain activity and eye movement as well as your breathing patterns, blood oxygen levels and body movements as you sleep.

At home, a portable monitor can measure the amount of oxygen in your blood, volume of air flowing through your nose when you breathe, your heart rate and chest movements that could indicate effort exerted when breathing.

Treatments

Sleep apnea rarely goes away without treatment. Treatments include lifestyle changes and behavior modification, such as losing weight, sleeping on your side or stomach and not on your back, and avoiding alcohol two to three hours before going to bed.

If those efforts fail, the most effective treatment is continuous positive airway pressure (CPAP). A mask covers your nose and mouth and is attached to a device that pumps a continuous flow of air while you sleep. Air flowing into your nostrils helps keep airways open.

Many patients find the mask uncomfortable and give up on treatment, but with practice, you can learn how to adjust the mask and adapt to the air pressure. You may need to try more than one type of mask before you find the one that works best for you.

New devices also are being developed to improve comfort:

• Humidifier. Air pumped by the CPAP device may cause dryness in the nasal passages and throat, sore tongue and nose bleeds. A CPAP humidifier helps alleviate the side effects.
• Nasal pillow. The CPAP nasal pillow is smaller than the conventional mask and plugs into the nostrils, making breathing more comfortable.
• Pressure relief. Exhaling against air pressure can be uncomfortable. A device, called CPAP pressure relief, automatically adjusts the air presssure when you inhale and exhale. The device flexes down air pressure when you start to exhale, then flexes up to treatment level when you inhale for better comfort.

Other treatments are:

• Dental devices to open the throat by forcing the lower jaw forward.
• Surgery by an otolaryngologist or head and neck surgeon to open breathing passages by repositioning or removing tissue of the nose, throat and jaw.
• Oral and maxillofacial surgeons can surgically reposition your jaw to open your throat.