What is sleep apnea? Sleep apnea is a common—and potentially serious—sleep and breathing disorder in which breathing stops or becomes shallow during sleep. Health data indicates about 1 out of 10 U.S. adults has obstructive sleep apnea (OSA), the type of sleep apnea in which something in the upper airway physically blocks air flow. Sleep apnea facts: Breathing may be interrupted as many as 20 to 30 or more times per hour, and each pause can last 10 seconds or longer. Pauses in breathing prevent fresh air and oxygen from reaching the lungs, which ultimately starves the body—including the brain and heart—of oxygen. Symptoms of sleep apnea can include loud snoring and snorting, choking, or gasping for air as normal breathing resumes. Daytime sleepiness is common because nighttime sleep is disrupted. Treatment may help prevent sleep apnea complications, such as irregular heartbeat, high blood pressure, coronary artery disease, diabetes, stroke, and dementia. As obesity is a strong risk factor for sleep apnea, steps to prevent or treat obesity can help prevent sleep apnea. What are the different types of sleep apnea? There are two types of sleep apnea: Obstructive sleep apnea is the most common type and happens when air cannot flow into or out of your nose or mouth. Central sleep apnea is when your brain fails to send the right signals to your muscles to start breathing. It is possible to have both obstructive and central sleep apnea, or mixed apnea. Who gets sleep apnea? Obstructive sleep apnea is by far the most common type of sleep apnea, also known as sleep-disordered breathing. Nearly 30 million adults (about 12% of the U.S. adult population at the time of study) have OSA, according to the American Academy of Sleep Medicine. Statistics on obstructive sleep apnea include these other facts: 27% of adults in the 30- to 70-year-old age group are estimated to have OSA. 80% of people with sleep apnea are undiagnosed. Twice as many men than women have sleep apnea. People of all ages can develop sleep apnea, but the risk increases with age. Can you die from sleep apnea? Sleep apnea causes a momentary pause in breathing, but breathing does not stop long enough to cause death. The brain senses the drop in oxygen in the blood and triggers breathing to resume. However, sleep apnea raises the risk of several life-threatening medical conditions, including coronary artery disease and heart attack, stroke, and arrhythmia. It also increases the risk of sudden cardiac death (SCD). In a study of 10,701 patients, obstructive sleep apnea was found to be an independent risk factor for SCD; people with the lowest nighttime blood oxygen levels had an 81% increase in risk of SCD. Abnormal heart rhythms triggered by apnea are thought to be the primary cause of SCD. What are some conditions related to sleep apnea? Breathing-related sleep problems include: Snoring, which is the sound of vibrating tissues in the throat as air passes over them, usually upon inhale. It tends to run in families and is associated with sleep apnea. Child sleep apnea, considered a subtype of obstructive sleep apnea, oftentimes due to large tonsils and adenoids relative to throat size. Infant sleep apnea, which tends to be either mixed (in small premature infants) or central sleep apnea (in larger premature infants and full-term babies). Most cases resolve in less than a year. How does sleep apnea affect quality of life? Severe obstructive sleep apnea can have a negative impact on quality of life, mood, attentiveness, and functional ability, based on standard and sleep-specific quality of life questionnaires completed by patients. In one study, the impact on quality of life was greatest among females who reported daytime sleepiness. Some studies have shown limited differences regardless of sleep apnea severity, but other studies clearly show reduced quality of life even for patients with mild apnea. These differences may be due to patient age, coexisting conditions, and the questionnaires used in the studies. What causes sleep apnea? In obstructive sleep apnea, shallow breathing or a pause in breathing happens because certain tissues or structures narrow or block part of the airway, which includes the nose, mouth, throat and windpipe. The tongue, tonsils, relaxed throat muscles, or extra fat around the windpipe can contribute to obstructive sleep apnea. People most likely to have or develop OSA include those who: Snore loudly Are overweight or obese Have high blood pressure Have physical abnormalities or birth defects in the nose, throat, or other parts of the upper airway Causes of central sleep apnea include: Heart failure Stroke Very high altitude Kidney failure Opioids How are you diagnosed with sleep apnea? Most people with sleep apnea do not know they have a problem. A family member may be the first to point out the signs, such as snoring and gasping for air when transitioning out of apnea. An accurate diagnosis of sleep apnea requires a sleep study. One part of the test is polysomnography. It records the patient’s body functions during sleep, including pauses in breathing, brain electrical activity, and blood oxygen levels. The other part of a sleep study is the multiple sleep latency test, which simply measures how fast the patient falls asleep. The sleep study records the number of sleep apnea events to generate an AHI, or apnea-hypoapnea index. The AHI includes complete pauses and shallow breathing (hypoapnea). The categories of sleep apnea are: Fewer than 5 AHIs: no sleep apnea 5 to 15 AHIs: mild sleep apnea 15 to 30 AHIs: moderate sleep apnea More than 30 AHIs: severe sleep apnea The patient’s symptoms are part of a sleep apnea diagnosis. Daytime sleepiness, fatigue, concentration and memory lapses, headaches upon waking, and sexual dysfunction are just some of the symptoms to consider. In children, symptoms of sleep apnea may include bedwetting, hyperactivity, and learning or academic problems. What are the different treatments for sleep apnea? Therapy for sleep apnea is specifically designed for each patient. Sleep apnea treatment options include: Lifestyle changes including weight loss (for overweight or obese patients), no alcohol before sleeping, no tobacco or sleeping pills, and using pillows and other devices designed for side sleeping CPAP machine, a therapy in which the patient wears a mask that forces fresh air into the nasal passages Oral appliances, custom-fit devices that reposition the lower jaw and tongue to more fully open the airway during sleep Implant placement including an implant that stimulates airway muscles and a nerve stimulator implant. An implant may help manage central sleep apnea. Surgery including placement of implants and tonsillectomy and other operations to enlarge the airway for obstructive sleep apnea Orofacial therapy, exercises to improve tongue position and strengthen oral muscles Additional sleep apnea facts A recent analysis estimated the cost of undiagnosed sleep apnea at nearly $150 billion, including lost productivity and accidents from fatigue, according to the American Academy of Sleep Medicine. The projected cost of treating complications of sleep apnea is an additional $30 billion. Sleep Apnea Awareness week is in March. Learn more at the National Sleep Foundation.