Sleep Disorders

HomePatientsLung Disease Week at the ATS2014Sleep Disorders ▶ General Information About Sleep Apnea
General Information About Sleep Apnea

Sleep Disorders Week

What is sleep apnea?

Sleep apnea is the lack of adequate breathing during sleep. It is called obstructive sleep apnea when associated with collapse of the throat and upper airways. It is called central sleep apnea when there is no effort to breathe. Both forms of sleep apnea can leads to low oxygen levels, arousals from sleep, insomnia and sleepiness or fatigue during the day.

Who is at risk?

Obstructive sleep apnea:  Adult men are at highest risk for sleep apnea along with women after menopause. The other major risk factor is obesity, which is a body mass index >30 (BMI Calculator). In children, obesity and enlarged tonsils are the major risk factors.

Central sleep apnea: Patients with congestive heart failure and atrial fibrillation.

What are the consequences?

Obstructive sleep apnea: Daytime sleepiness or fatigue, difficulty at school or work; increased risk of driving accidents; worsened control of diabetes; cardiovascular diseases such as hypertension, heart disease, congestive heart failure and stroke.

Central sleep apnea: Daytime sleepiness or fatigue; decreased physical functioning, increased risk of early death.

What are common symptoms?

Sleep apnea develops slowly and is often missed. It is thought that most people with moderate-to- severe sleep apnea are undiagnosed. See table (below) for the most common symptoms of sleep apnea. You should tell your physician if you have any of these symptoms.

How is the diagnosis made?

A diagnosis is made with an overnight sleep study (polysomnography) usually in a sleep laboratory but sometimes at home. During these studies, airflow, oxygen levels, chest and abdominal movements, heart rate are monitored to determine how many times a person stops breathing (apnea) or has partial reduction in breathing (hypopnea) at night. An apnea-hypopnea index is used to look at how severe the problem is for each person. An apnea-hypopnea index >5/hr is considered abnormal.

How can sleep apnea be prevented?

Prevention of weight gain and obesity can lower the risk of obstructive sleep apnea. Weight loss can reduce the severity of sleep apnea. Identifying and treating nasal obstruction can help some people with this condition. Stopping smoking, and avoiding alcohol and sedative medications can lessen the severity of the problem. For patients with congestive heart failure, aggressive medical therapy of their condition is often sufficient to prevent central sleep apnea.


Treatment can improve how patients feel during the day (specifically, the patient feels more rested and less sleepy) and can improve control of conditions such as diabetes and hypertension. Treatment leads to decreased risk of motor vehicle accidents. For both obstructive and central sleep apnea, the best initial treatment for most people is continuous positive airway pressure (CPAP). This is a machine that delivers air under pressure to the upper airway by a nose or face mask, keeping the airway open during sleep. There are many mask types, covering nose or nose and mouth, with the patient helping choose which type will work best for them. Other treatments for obstructive sleep apnea include dental appliances to splint the airway open and surgery to widen the upper airway. For central sleep apnea, wearing oxygen during sleep is another possible therapy.

Common Symptoms at Night

Common Symptoms during the Day

  • Snoring: usually loud and bothers other people trying to sleep the person. Snoring can come and go through the night.

  • Gasping or choking sounds

  • Breathing pauses observed by someone watching the person sleep.

  • Sudden or jerky body movements

  • Restless tossing and turning

  • Frequent awakenings from sleep

  • Wake up feeling like you have not had enough sleep even after sleeping many hours

  • Morning headache

  • Dry or sore throat in the morning from breathing through your mouth during sleep

  • Sleepiness during the day

  • Fatigue or tiredness through the day

  • Problems with poor memory or unable to concentrate