Locations Main Campus: Chesterfield, MO 63017   |   Locations
314-434-1500 314-434-1500   |   Contact Us

Multimedia Encyclopedia

BACK
TO
TOP
 
E-mail Form
Email Results

 
 
Print-Friendly
Bookmarks
bookmarks-menu

Obstructive sleep apnea - adults

Sleep apnea - obstructive - adults; Apnea - obstructive sleep apnea syndrome - adults; Sleep-disordered breathing - adults; OSA - adults

 

Obstructive sleep apnea (OSA) is a problem in which your breathing pauses during sleep. This occurs because of narrowed or blocked airways.

Causes

 

When you sleep, all of the muscles in your body become more relaxed. This includes the muscles that help keep your throat open so air can flow into your lungs.

Normally, your throat remains open enough during sleep to let air pass by. Some people have a narrow throat. When the muscles in their upper throat relax during sleep, the tissues close in and block the airway. This stop in breathing is called apnea.

Loud snoring is a telltale symptom of OSA. Snoring is caused by air squeezing through the narrowed or blocked airway. Not everyone who snores has sleep apnea though.

Other factors also may increase your risk:

  • A lower jaw that is short compared to your upper jaw
  • Certain shapes of the roof of your mouth (palate) or airway that cause it to collapse more easily
  • Large neck or collar size, 17 inches (43 centimeters) or more in men and 16 inches (41 centimeters) or more in women
  • Large tongue, which may fall back and block the airway
  • Obesity
  • Large tonsils and adenoids that can block the airway

Sleeping on your back can also cause your airway to become blocked or narrowed.

Central sleep apnea is another sleep disorder during which breathing can stop. It occurs when the brain temporarily stops sending signals to the muscles that control breathing.

 

Symptoms

 

If you have OSA, you usually begin snoring heavily soon after falling asleep.

  • The snoring often becomes very loud.
  • Snoring is interrupted by a long silent period while your breathing stops.
  • The silence is followed by a loud snort and gasp, as you attempt to breathe.
  • This pattern repeats throughout the night.

Most people with OSA do not know their breathing starts and stops during the night. Usually, a sleep partner or other family members hear the loud snoring, gasping, and snorting. Snoring can be loud enough to hear through walls.

People with sleep apnea may:

  • Wake up unrefreshed in the morning
  • Feel sleepy or drowsy throughout the day
  • Act grumpy, impatient, or irritable
  • Be forgetful
  • Fall asleep while working, reading, or watching TV
  • Feel sleepy while driving or even fall asleep while driving
  • Have hard-to-treat headaches

Other problems that may occur include:

  • Depression
  • Hyperactive behavior, especially in children
  • Difficult to treat high blood pressure
  • Leg swelling (if apnea is severe)

 

Exams and Tests

 

Your health care provider will take your medical history and do a physical exam.

  • Your provider will check your mouth, neck, and throat.
  • You may be asked about daytime sleepiness, how well you sleep, and bedtime habits.

You will need to have a sleep study to confirm OSA.

Other tests that may be performed include:

  • Arterial blood gases
  • Electrocardiogram (ECG)
  • Echocardiogram
  • Thyroid function studies

 

Treatment

 

Treatment helps keep your airway open while you sleep so your breathing does not stop.

Lifestyle changes may help relieve symptoms in people with mild sleep apnea, such as:

  • Avoid alcohol or medicines that make you sleepy before bedtime. They can make symptoms worse.
  • Avoid sleeping on your back.
  • Lose excess weight.

Continuous positive airway pressure ( CPAP ) devices work best to treat obstructive sleep apnea in most people.

  • You wear a mask over your nose while you sleep.
  • The mask is connected by a hose to a small machine that sits at the side of your bed.
  • The machine pumps air under pressure through the hose and mask and into your airway while you sleep. This helps keep your airway open.

It can take some time to get used to sleeping with CPAP therapy. Good follow-up and support from a sleep center can help you overcome any problems using CPAP.

Dental devices may help some people. You wear them in your mouth while you sleep to keep your jaw forward and the airway open.

Other treatments may be available, but there is less evidence that they work. It is best to talk with a doctor who specializes in sleep problems before trying them.

Surgery may be an option for some people. It is often a last resort if other treatments did not work and you have severe symptoms. Surgery may be used to:

  • Remove extra tissue at the back of the throat.
  • Correct problems with the structures in the face.
  • Create an opening in the windpipe to bypass the blocked airway if there are physical problems.
  • Remove the tonsils and adenoids .

Surgery may not completely cure obstructive sleep apnea and may have long-term side effects.

 

Outlook (Prognosis)

 

If not treated, sleep apnea may cause:

  • Anxiety and depression
  • Loss of interest in sex
  • Poor performance at work or school

Daytime sleepiness because of sleep apnea can increase the risk of:

  • Motor vehicle accidents from driving while sleepy
  • Industrial accidents from falling asleep on the job

In most cases, treatment completely relieves symptoms and problems from sleep apnea.

 

Possible Complications

 

Untreated obstructive sleep apnea may lead to or worsen heart disease, including:

  • Heart arrhythmias
  • Heart failure
  • Heart attack
  • High blood pressure
  • Stroke

 

When to Contact a Medical Professional

 

Call your provider if:

  • You feel very tired and sleepy during the day
  • You or your family notice symptoms of obstructive sleep apnea
  • Symptoms do not improve with treatment, or new symptoms develop

 

 

Open References

References

Basner RC. Obstructive sleep apnea. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 100.

Kimoff RJ. Obstructive sleep apnea. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 88.

Qaseem A, Holty JE, Owens DK, Dallas P, Starkey M, Shekelle P; for the Clinical Guidelines Committee of the American College of Physicians. Management of obstructive sleep apnea in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med . 2013;159(7):471-483. PMID: 24061345  www.ncbi.nlm.nih.gov/pubmed/24061345 .

Somers VK. Sleep apnea and cardiovascular disease. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 75.

Wakefield TL, Lam DJ, Ishman SL. Sleep apnea and sleep disorders. In: Flint PW, Haughey BH, Lund VJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 18.

 
  • Obstructive sleep apnea

    Obstructive sleep apnea

    Animation

    •  

    Obstructive sleep apnea - Animation

    Does your significant other complain that your snoring wakes them up during the night or keeps them from getting to sleep in the first place? Do they poke you, waking you up because sometimes they're afraid you stopped breathing? If so, you may have a condition called obstructive sleep apnea. When you have sleep apnea, the flow of air to your lungs pauses or decreases while you sleep. This happens because your airway has become narrow or blocked. While you sleep, all of the muscles in your body become more relaxed, including the muscles that help keep your airway open, allowing air to flow freely to your lungs. Normally, your upper throat still remains open enough during sleep to let air easily pass by. Some people, however, have a narrowing throat area. When the muscles in their upper throat relax during sleep, their breathing can stop, often for more than 10 seconds. When breathing stops, it's called apnea. Often you're not aware that you stopped breathing during sleep. But you may wake up not-refreshed, and feel drowsy and tired during the day. If you have this condition, your doctor will perform a physical exam, carefully checking your mouth, neck, and throat. You may take a survey that asks a series of questions about daytime sleepiness, sleep quality, and bedtime habits. If your doctor suspects you do have sleep apnea, you make take a polysomnogram, a sleep study that monitors you while you sleep. Once your doctor diagnoses sleep apnea, treatment will focus on keeping your airway open so that you breathe better while you sleep. Lifestyle steps can help. You can avoid alcohol or sedatives, and not just at bedtime, avoid sleeping on your back, and try to lose weight if you need to. And, exercise can help, even in the absence of weight loss. Your doctor can also prescribe a positive airway pressure using a machine, with a tight-fitting face mask, that pumps slightly pressurized air into your mouth during your breathing cycle. This keeps your windpipe open and prevents apnea episodes. Some people need to wear dental devices that keep their jaw forward during sleep. If lifestyle changes and devices don't help, surgery may be an option. Untreated sleep apnea, however, may lead to or worsen heart disease. Most people with sleep apnea who get treatment have less anxiety and depression than they did before. They often perform better at work or school, too. Naturally, having less daytime sleepiness can lower your risk for accidents at work, while you drive and give you more energy throughout the day.

  • Obstructive sleep apnea

    Obstructive sleep apnea - illustration

    Massively enlarged tonsils can cause episodes of cessation of breathing known as obstructive sleep apnea. Cessation of breathing can last 10 seconds or longer, causing extremely low levels of oxygen in the blood.

    Obstructive sleep apnea

    illustration

  • Obstructive sleep apnea

    Animation

    •  

    Obstructive sleep apnea - Animation

    Does your significant other complain that your snoring wakes them up during the night or keeps them from getting to sleep in the first place? Do they poke you, waking you up because sometimes they're afraid you stopped breathing? If so, you may have a condition called obstructive sleep apnea. When you have sleep apnea, the flow of air to your lungs pauses or decreases while you sleep. This happens because your airway has become narrow or blocked. While you sleep, all of the muscles in your body become more relaxed, including the muscles that help keep your airway open, allowing air to flow freely to your lungs. Normally, your upper throat still remains open enough during sleep to let air easily pass by. Some people, however, have a narrowing throat area. When the muscles in their upper throat relax during sleep, their breathing can stop, often for more than 10 seconds. When breathing stops, it's called apnea. Often you're not aware that you stopped breathing during sleep. But you may wake up not-refreshed, and feel drowsy and tired during the day. If you have this condition, your doctor will perform a physical exam, carefully checking your mouth, neck, and throat. You may take a survey that asks a series of questions about daytime sleepiness, sleep quality, and bedtime habits. If your doctor suspects you do have sleep apnea, you make take a polysomnogram, a sleep study that monitors you while you sleep. Once your doctor diagnoses sleep apnea, treatment will focus on keeping your airway open so that you breathe better while you sleep. Lifestyle steps can help. You can avoid alcohol or sedatives, and not just at bedtime, avoid sleeping on your back, and try to lose weight if you need to. And, exercise can help, even in the absence of weight loss. Your doctor can also prescribe a positive airway pressure using a machine, with a tight-fitting face mask, that pumps slightly pressurized air into your mouth during your breathing cycle. This keeps your windpipe open and prevents apnea episodes. Some people need to wear dental devices that keep their jaw forward during sleep. If lifestyle changes and devices don't help, surgery may be an option. Untreated sleep apnea, however, may lead to or worsen heart disease. Most people with sleep apnea who get treatment have less anxiety and depression than they did before. They often perform better at work or school, too. Naturally, having less daytime sleepiness can lower your risk for accidents at work, while you drive and give you more energy throughout the day.

  • Obstructive sleep apnea

    Obstructive sleep apnea - illustration

    Massively enlarged tonsils can cause episodes of cessation of breathing known as obstructive sleep apnea. Cessation of breathing can last 10 seconds or longer, causing extremely low levels of oxygen in the blood.

    Obstructive sleep apnea

    illustration

A Closer Look

 

Talking to your MD

 

    Self Care

     

    Tests for Obstructive sleep apnea - adults

     
     

    Review Date: 1/27/2016

    Reviewed By: Allen J. Blaivas, DO, Division of Pulmonary, Critical Care, and Sleep Medicine, VA New Jersey Health Care System, Clinical Assistant Professor, Rutger's New Jersey Medical School, East Orange, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

    The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

     
     
     

     

     

    A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.



    Content is best viewed in IE9 or above, Firefox and Google Chrome browser.