Dear Doctors: One of those sleep apps that record you at night said I have "unstable breathing" that could be sleep apnea. It turns out the "unstable" reading was because the app was also recording my two dogs. But now I want to know what sleep apnea is and how to know if you have it.
Dear Reader: Sleep apnea is a disorder in which someone's breathing repeatedly stops or becomes shallow while they are asleep. These interruptions in airflow often lower blood oxygen levels, sometimes hundreds of times per night. In order to compensate for that deficit, the heart begins to work harder. Over time, this can lead to high blood pressure, a thickening of the walls of the heart and arrhythmias. Without treatment, sleep apnea puts the person at increased risk of cardiovascular disease, heart attack and stroke.
The most common form of this condition is obstructive sleep apnea, or OSA. In some people, the muscles that keep the airway open relax during sleep, which leads to a partial or complete collapse of the upper airway. This can also allow the tongue to fall backward, creating a blockage. Other risk factors include being overweight or obese, having large tonsils or a large tongue and certain hormonal disorders. The condition occurs more often in men than in women, and, due to age-related changes, it also becomes more common in older adults.
Symptoms of OSA include breathing during sleep that repeatedly stops and restarts, sudden gasping breaths and frequent or loud snoring. People living with the condition can be prone to waking up with a headache that fades within a few hours without medication. Dry mouth and chapped lips are also common. Due to repeated drops in oxygen and chronic poor-quality sleep, OSA often causes fatigue and daytime drowsiness. If you suspect you have it, please talk to your healthcare provider. They will assess your symptoms and, if needed, recommend an overnight sleep study. These may be done in a hospital, a specialized facility or at home with portable monitoring devices.
The goal of treatment for OSA is to keep the sleeper's airway open. For some people, lifestyle changes such as losing weight, changing sleep position and doing exercises to strengthen the muscles that control the tongue, throat and mouth may be helpful. Others need a physical intervention. The most common are devices known as positive airway pressure (PAP) machines. There are several different types, but each uses air pressure to keep the airway open. When a PAP machine is not an option, oral devices that keep the jaw or tongue in an optimal position may be used. In severe cases, certain surgical procedures can address airway issues.
The story about your sleep app recording your dogs is pretty funny. However, it highlights an important caveat: Apps can be useful for flagging nighttime snoring, but as your own experience shows, they can't distinguish sounds coming from multiple sleepers. Apps can tell you if you snore, but they are not meant to diagnose sleep apnea.
(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
