Sleep Apnea: Just Snoring--or a Serious Medical Issue?

3 Types of Sleep Apnea

Obstructive sleep apnea is the most common type of sleep apnea. It most often happens when your airway has collapsed or is blocked during sleep. This causes shallow breathing, or your breathing pauses. When you try to breathe, you might snore loudly from air that squeezes past the blockage or not be able to breathe at all.

Central sleep apnea happens when the part of your brain that controls breathing doesn't send correct signals. This means you make no effort to breathe for brief periods of time.

Complex sleep apnea is a combination of obstructive and central sleep apnea.

What do the cartoon character Dagwood, corporate executives, truck drivers, and, most likely, a few of your neighbors and friends have in common? Sleep and breathing problems!

Some experts view America's profile as a sleep-deprived nation as an epidemic. Far too many of us are not getting enough sleep or “bad” sleep. It is a public health issue that is linked to a host of chronic diseases, learning disabilities, and psychological effects in individuals. Sleepiness is a major cause of auto accidents—with as many as 1.9 million drivers’ admitting to having had a car crash or a near miss due to drowsiness last year.1

The mechanics of sleep affect everyone’s breathing. When you sleep, your muscles relax, including the ones in the back of your throat. This narrows your airways as you inhale, and breathing can stop for a moment. When the oxygen level in your blood drops from that paused breathing, the part of your brain that controls breathing wakes you up to force you to breathe again. Typically, almost everyone stops breathing once or twice a night. But when that number climbs up to at least five times an hour, the person has the most common sleep disorder—obstructive sleep apnea.

Dagwood’s napping, overeating, loudly snoring character brilliantly personifies the traits that scientists now understand as part of a very serious, common medical condition. Sleep apnea is estimated to affect more than 12 million Americans. The most common type of sleep apnea, obstructive sleep apnea, occurs when the soft tissues at the back of your throat block air as you inhale. Central sleep apnea is caused by a malfunction in the part of your brain that controls breathing. Complex sleep apnea is a combination of the two.

Research into this relatively new disease area has paid off, resulting in new areas of study and connections among other diseases, and effective treatments such as CPAP (continuous positive air pressure). CPAP is the most effective treatment for obstructive sleep apnea. In CPAP, a small portable machine delivers air at a constant pressure through a tubing and mask, which the person wears while sleeping. The pressure keeps the airways open and gives the person an uninterrupted, restful night’s sleep. CPAP machines are small, lightweight, and fairly quiet. The noise that they make is soft and rhythmic.

Scientific study of sleep apnea is evolving, as investigators are finding more variations of sleep-disordered breathing. We now know that sleep apnea is sometimes the first domino in a chain of poor health—hardening of the arteries, plaque buildup in the arteries, heart attack, and stroke. New research suggests a link between sleep apnea and metabolic disorders such as insulin resistance and high cholesterol. Scientists believe the impact of sleep apnea may be greater on individuals who have other cardiovascular risk factors such as high blood pressure or high cholesterol.

Researchers today are working to understand these relationships more deeply. They are studying how sleep apnea may affect a range of chronic diseases, like fibromyalgia, and how controlling sleep apnea can improve heart disease and other serious illnesses. New treatments under study include nasal insufflation, which uses a warm, humid, high-volume flow of air through nasal tubing to increase pressure in the nasal cavity; it is less intrusive than CPAP. An evolving area of research involves the broader category of sleep disorders that are linked to a metabolic syndrome that impacts obesity, high blood pressure, abnormal cholesterol levels, or elevated insulin levels. This disorder is a strong predictor of Type II diabetes. Research is focusing on the connections between these disorders to better diagnose and treat each.

The future of research into sleep apnea is just beginning to emerge into an important public health problem. In the broad scope of medicine, scientific understanding of sleep apnea is in its infancy. The growing spectrum of research promises deeper knowledge of sleep apnea and its relationships with other diseases, with a focus on better treatment and quality of life for patients.

Who Can Get Sleep Apnea?

Anyone can have sleep apnea, even children. But there are certain factors that may put you at risk for the different types of sleep apnea. Things that put you at risk for having obstructive and complex sleep apnea:

  • Being overweight
  • Smoking
  • High blood pressure
  • Family history of sleep apnea
  • Gender—males are more likely to have sleep apnea than females
  • Being older than 65
  • Using alcohol or sedatives before going to sleep
  • Certain endocrine abnormalities
  • Obstruction of the nose and throat; many children have sleep apnea due to enlarged tonsils and adenoids

Things that put you at risk factors for central sleep apnea:

  • Gender—males are more likely to have central sleep apnea than females
  • Heart disease
  • Stroke or brain tumor

1. National Sleep Foundation, 1.9 Million Drivers Have Fatigue-Related Car Crashes or Near Misses Each Year. November 2, 2009 news release.