What is apnea?
Apnea is the medical term used to describe slowed or stopped breathing. Apnea can affect people of all ages, and the cause depends on the type of apnea you have.
Apnea usually occurs while you’re sleeping. For this reason, it’s often called sleep apnea. Usually, sleep apnea is treatable with medication, nighttime breathing support, and lifestyle changes. Occasionally, surgery is needed.
Untreated apnea can lead to heart and brain problems due to a lack of oxygen.
Types of apnea
Apnea occurs when the airways become blocked or when the brain fails to send a signal to breathe. The cause of your apnea is directly related to the type of apnea you have.
This type of apnea occurs when there is an obstruction in the airways preventing proper breathing. One important cause of obstructive apnea is enlarged tonsils or adenoids (glands on the roof of the mouth).
In central apnea, the area of the brain that facilitates breathing doesn’t function properly. This form of apnea is most commonly seen in immature babies and results from improper development of this area of their brain. Certain brain and nervous system problems can cause this as well.
This form of apnea is a mixture of both obstructive and central apnea. It can occur when you’re asleep or awake.
Sleep apnea has many causes. The most common include:
- overly relaxed throat muscles or tongue
- enlarged tongue
- enlarged tonsils or adenoids
- being overweight
- irregular function of the brain signals that control the throat muscles
- the shape of your head and neck
During an episode of sleep apnea, a person is unable to breathe sufficiently due to a narrowing of the airway, which causes them to snore loudly and take long breaks in between breaths.
Central sleep apnea
There are many types of central sleep apnea. Each type has its own cause:
- Complex sleep apnea develops when a person is being treated for obstructive sleep apnea with continuous positive airway pressure.
- Cheyne-Stokes breathing can be caused by congestive heart failure or stroke.
- Drug-induced apnea is caused by certain prescription medications, including oxycodone (Oxaydo, Roxicodone) and morphine (Kadian, Morphabond).
- High-altitude periodic breathing can occur when a person reaches altitudes of 15,000 feet.
- Idiopathic central sleep apnea is a rare form of sleep apnea with an unknown cause.
- Medical condition-induced central sleep apnea is caused by brainstem damage.
- Apnea of prematurity occurs in premature babies due to an underdeveloped nervous system.
When to see a doctor
Contact your family doctor immediately if you or a loved one develops any of the following symptoms:
- chronic (long-term) snoring
- loud snoring
- choking in your sleep
- gasping for air when sleeping
- daytime fatigue
- headaches in the daytime
- difficulty concentrating
- memory problems
- frequent urination at night
- dry mouth
- sore throat after waking up
- frequent episodes of waking up
Emergency first aid
If you hear someone who is snoring suddenly go quiet, or you notice long pauses in their breathing, check to see if they are breathing. If they aren’t, call 911. Follow the emergency operator’s instructions on how to rouse the person and assist their breathing until the paramedics arrive.
While people with sleep apnea typically begin breathing again on their own, extended periods without oxygen should be cause for alarm.
Treatment options vary widely, depending on what kind of apnea you have and what causes it. Before offering treatment, your doctor will ask questions about:
- your sleep patterns
- what medications you use
- your medical history
- your family history
Sleep testing is often used to diagnose sleep apnea. There are many kinds of sleep studies. Most involve sleeping in a medical facility with monitors reading brain, nerve, and heart signals, as well as oxygen levels. The most common sleep studies include:
- nocturnal polysomnography, a test that measures electronic brain waves, breathing rate, blood pressure, blood oxygen levels, and various other bodily conditions during sleep
- oximetry, a way of measuring the oxygen in your blood
- portable cardiorespiratory testing, which involves testing your breathing and pulse throughout the night away from a hospital setting
Approaches to treating apnea include the following:
Treating medical conditions
Many different medical conditions can cause apnea. Most often, the first line of treatment is to treat these underlying conditions. This often includes losing weight if you’re overweight.
Certain medications can induce apnea. Sometimes changing these medications can help you improve.
Wearing a breathing mask while you sleep
This mask is called a continuous positive airway pressure mask, or CPAP mask. Wearing it supplies you with a flow of constant air that keeps your airway open while you sleep.
Other treatments for apnea can include:
- taking medications that stimulate breathing
- using a ventilator device to regulate your breathing patterns, called adaptive servo-ventilation
- having surgery to remove obstructions from the airways
- using a mouthpiece to keep the airways open
- administering caffeine intravenously in-hospital for apnea of prematurity
Long-term health complications
If you have severe apnea and don’t respond to other treatments, your doctor may recommend a variety of options for surgery that can involve the nose, throat, or tongue. A tracheostomy may be needed in individuals who are severely overweight to create an opening to the throat. This opening, or stoma, is then fitted with a tube to facilitate breathing.
Heart problems may result from sudden drops in your blood pressure and blood oxygen levels that occur with slowed or stopped breathing. Early detection and treatment of apnea is the best way to prevent this complication.