Sleep-disordered breathing (SBD) is a general term for a group of conditions with an abnormal breathing pattern during sleep. This can impact life in many ways, from everyday functioning to health and well-being.
Knowing more about these conditions can help you talk with a doctor about your symptoms and get appropriate treatment.
SBD, or breathing difficulties during sleep, is associated with various health issues and risk factors for health, affecting your quality of life.
Types of SDB include:
- upper airway resistance – difficulty getting air through the the upper airway
- hyponea– shallow breathing
- apnea – pausing of breathing during sleep
- catathrenia – groaning or moaning while exhaling
- heavy snoring
Knowing more about SDBs and getting an accurate diagnosis is essential to finding an effective treatment. Sleep disorders associated with SBD include:
Obstructive sleep apnea
Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that occurs when a person does not get enough air even though they are trying to breathe. It happens when the muscles in the throat and neck relax during sleep, and the soft tissue in the back of the throat collapses, blocking the upper airway. This obstruction causes breathing to reduce or stop during sleep and could last up to 10 seconds.
Central sleep apnea
Central sleep apnea (CSA) is
Upper airway resistance syndrome
Upper airway resistance syndrome (UARS) is similar to OSA in that the throat relaxes and doesn’t allow proper airflow while you sleep, obstructing the airway. However, it’s not severe enough to meet the diagnostic criteria of OSA.
People with SDB can have daytime symptoms as a result of poor sleep quality, including:
- sleepiness, which is sometimes excessive
- depressed mood
- cognitive dysfunction (memory or concentration problems)
Symptoms during the night may include:
- snoring loudly
- reports from your bed partner that you sometimes stop breathing in addition to snoring
- waking up with dry mouth/sore throat/headache
- waking up suddenly, short of breath
- having trouble staying asleep
- groaning or moaning during sleep
- decreased interest in sex
Diagnosis involves various factors, and each person’s diagnostic process will be different depending on your symptoms and the pattern of symptoms. A medical history, physical exam, and sleep studies may all be used to help make a diagnosis. They will also do other tests or exams to rule out other potential disorders causing these symptoms.
Treatment can vary depending on your diagnosis, your overall health, and any other conditions you might have.
Many times the first thing that will be implemented are lifestyle changes. These may include weight loss for those who have obesity, quitting smoking, reducing alcohol consumption, and positional therapy for symptoms while only on their back.
Sometimes, continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) machines can help. These therapies involve wearing a mask while sleeping. The mask is connected to a device that provides constant airflow, and this airflow keeps your airways open.
Although CPAP and BiPAP machines are usually the gold standard, people may avoid using them or use them incorrectly, decreasing their effectiveness.
There are several surgical options for the treatment of sleep-disordered breathing, such as:
- Trans oral robotic surgery (TORS). This involves giving the surgeon an enhanced view and 3-D image that allows them to remove tissue from behind the tongue that may be obstructing your throat. Sometimes the epiglottis is trimmed down, since it can fall into the airway and obstruct it.
- Inspire hypoglossal nerve stimulation. If the tongue has a backward collapse during sleep, this surgery can help. A breathing sensor and stimulation lead are implanted and monitors breathing while you sleep. It mildly stimulates muscles, moving the tongue and muscles away from the airway during sleep.
- Uvulopalatopharyngoplasty or UP3 (UPPP). This procedure removes excess tissue in the throat to make the airway wider. It is commonly combined with tonsillectomy.
- Lateral pharyngoplasty/expansion sphincteroplasty. This is a variation of the UP3 procedure, usually done in those who have narrowing of the throat or webbing of part of the palate. Tonsils are removed, as well as the uvula, and any webbing is modified to extend the back of the throat.
- Lingual tonsillectomy. For individuals with severe OSA, this procedure may be an option, particularly if they have an obstruction at the base of the tongue. The lingual tonsils are removed and sometimes part of the tongue.
- Thyrohyoidopexy. If there is an obstruction behind the tongue, this can help. The hyoid bone is repositioned and tongue and epiglottis are pulled down and forward.
- Tongue reduction surgery. A less invasive surgical option, tongue reduction surgery may help improve airflow during sleep by removing extra tissue from the base of the tongue.
There are various risk factors of developing sleep-disordered breathing, such as:
- family history of the condition or snoring
- being male
- large tonsils
- drinking alcohol at bedtime
- being post-menopausal (for women)
- high levels of growth hormone (acromegaly)
- small lower jaw
Talk with a doctor about other risk factors and which ones may be particularly applicable to you.
Treatments are available to relieve symptoms and help you get a better night’s sleep. Creating a plan with a doctor, specific treatment options, and lifestyle changes, can all help you manage the symptoms and effects of sleep-disordered breathing.
Questions for your doctor
When you see a doctor for your sleep-disordered breathing, it’s a great opportunity to express concerns and ask questions. Here are some questions you may want to ask:
- Other than sleep-disordered breathing, are there any other possible explanations for my symptoms?
- Why do I have this?
- Are there any other tests I need to confirm my diagnosis?
- What treatment do you think is best for me and my symptoms?
- Are there lifestyle changes that I could make that might help?
- Are there other complications I should be aware of or look for?
Some researchers have suggested that OSA may be an independent risk factor for unfavorable COVID-19-related outcomes. However, these outcomes may also be related to other known risk factors such as older age, diabetes, male gender, and body mass index (BMI) that people with OSA may also have.
While there was no significant difference in the risk of developing COVID-19 between those with OSA and those who did not have OSA, the risk of hospitalization was higher in certain studies if you had both COVID-19 and OSA.
Sleep-disordered breathing can have many effects on both your health and your quality of life. There are various treatments available that can help ease your symptoms and improve your health and everyday life.
Talk with a doctor about your specific symptoms and treatment plan, and ask what your options are. Together, you can develop a treatment plan that works best for you.