Patient Resources

Sleep Apnea is a medical condition where sleep is repeatedly interrupted by apnea episodes.  Apnea literally means “without breath” and is clinically defined as a period of at least ten seconds when you stop breathing (most apneas last between ten and thirty seconds).  There are four main types of Sleep Apnea:

• Obstructive-occurs when muscles and other soft tissues in the airway collapse blocking the airflow
• Central-occurs due to a malfunction in the brain or heart.  The brain stops communicating to the muscles that control breathing, so even though the airway is open, there is no airflow.
• Mixed-is a combination of Obstructive and Central Sleep Apnea
• Complex-occurs when Central Apneas develop because of the introduction of positive airway pressure for the treatment of Obstructive Sleep Apnea

Apneas cause your body to unconsciously “wake-up” in order to fix the problem.  The more severe the Sleep Apnea, the more times your body is roused during sleep.  This disrupts continuous sleep and prevents you from reaching the deep stages of sleep, like rapid eye movement (REM).  Our bodies need this deep sleep in order to rest and replenish their strength.  Despite getting the same amount of “time asleep” as other individuals, people with untreated Sleep Apnea do not get the same amount of “quality sleep”.  They are incredibly sleep deprived because of their fragmented sleep. 

Apneas also cause a decrease in the amount of oxygen and an increase in the amount of carbon dioxide in your blood.  This puts a tremendous amount of stress on your heart and other organs.  If left untreated, Sleep Apnea has devastating effects on your body and general health.  Depending on the degree of severity, Sleep Apnea is a potentially life-threatening condition.  Untreated Sleep Apnea causes:

• 37%-55% Increased risk of congestive heart failure
• 25%-45% Increased risk of high blood pressure
• 30%-60% Increased risk of stroke
• 3-7 times more likely to be involved in a motor vehicle accident

Sleep Apnea is a difficult disorder to diagnose because most people do not remember waking up during the night and it is not detectable during routine doctor’s visits.  According to the National Institute of Health, nearly 20 million Americans have Sleep Apnea.  However, of those, 17 million are undiagnosed.  Several key indicators of Sleep Apnea are:

• Fatigue
• Daytime Sleepiness/Tiredness
• Loud Snoring
• Breathing Cessation or Irregular Breathing During Sleep
• Morning Headaches or Dry Throat
• Irritability
• Difficulty Concentrating
• Restless Sleep

Important factors that put people at risk for Obstructive Sleep Apnea:

• Age greater than 40
• Smoking and alcohol use
• A recessed chin, small jaw, or large overbite
• Having a large neck size (17” for men, 16” for women)
• Having a small upper airway (or large tongue, tonsils, or uvula)
• Being overweight (a BMI over 25)---Calculate your BMI
• Gender (men are twice as likely as women to have OSA)

Sleep Apnea, unfortunately, is not cured without attention.  The most effective and noninvasive form of treatment is known as CPAP (Continuous Positive Airway Pressure).  CPAP creates a continuous “air splint” that keeps your airway open while you are relaxed and sleeping.  Air is gently pushed from the CPAP unit through a mask over your nose (and sometimes mouth depending on the type of mask).    The CPAP must be worn every night in order to achieve maximum benefit. 

Because it is medical equipment, you must have a prescription from your doctor to be treated with CPAP.  Typically, your prescription (the pressure you need to keep your airway open) is determined during your sleep study.  In addition to CPAP, there are two other devices used in a similar fashion to treat Sleep Apnea: AutoPAP and BiPAP

By measuring the amount of resistance in the patient's breathing, AutoPAP automatically adjusts to the minimum amount of pressure required to keep your airway open.  For example, when you are in light sleep, you may only need +6 cwp (centimeters of water pressure) but once you reach a deep sleep you may need +10 cwp to keep your airways open.  Also, sleeping on your back, instead of your side, can also cause a need for a higher pressure.  An AutoPap will detect this in your breathing and change accordingly.  Bi-PAP, has two different pressures, one stronger pressure for when the patient inhales, and one weaker pressure for when the patient exhales.  This helps people that may have trouble breathing against the pressure of regular CPAP, or need assistance in taking larger breaths..

Some people feel the effects of treatment after the first night or two of treatment.  However, you must remember that it took years of disruptive sleep to develop your sleep debt, and it will take time to replenish.  Generally, treatment can make you feel like a new person—refreshed and revitalized.