What Is Sleep Apnea?
What’s an “apnea?” We learned this in school. Was it a forest-dwelling mammal? Or a small, biting insect?
Apnea (noun): a temporary cessation of breathing, especially during sleep.
No. OK, that sounds awful. Holding your breath is hardly ever a good idea. Usually, it’s reserved for life-threatening situations. And you almost never want something else to suddenly take your breath away without your consent—not like this, anyway. So, you don’t want your own body betraying you and not letting you breathe so you wake up gasping! That’s not in the fun zone.
There are three types of sleep apnea, none of which are fun. In obstructive sleep apnea, the muscles of the throat relax in a way that blocks airflow. In central sleep apnea, the signals from the brain that tell a person to breathe just don’t get through. And complex sleep apnea syndrome is a combination of both.
Since obstructive sleep apnea (OSA) is 80–90% of all cases, this post will mostly focus on OSA.
Sleep Apnea Symptoms and a Handy-Dandy Self-Diagnosis Quiz
So, let’s not go all hypochondriac here. There are clear factors that tell you that you might have sleep apnea or be at risk of it. Any one of them on its own may or may not be enough to diagnose it. But if you have a few overlapping symptoms, it might be time to see your doctor.
If you think you might have it, here are some self-diagnosis questions, A.K.A. how to check yo self before you wreck yo self:
- Do you have any of these symptoms?
- Unusually high drowsiness during the day—even when you’ve slept enough
- Inability to stay asleep
- A feeling of constant tiredness
- Not feeling rested in the morning
- Sore throat and dry mouth when you wake up
- Do you wake up in the night with shortness of breath or a choking sound?
- Has someone else heard or seen you snoring loudly or stopping breathing during sleep?
- Do you have any of these other problems?
- Being easily frustrated, upset, or irritated
- Waking frequently to go to the restroom
- Lost ability to concentrate
- Lost or lowered sex drive
- Increased memory problems
- Headaches in the morning
- Do you have one or more of these attributes?
- Nasal polyposis (polyps)
- Deviated septum
- Overbite or recessed jaw
- Enlarged tonsils or tongue
- A neck circumference of 16–17 inches or more
- Do you have one or more of these related medical issues?
- Irregular heart rate
- Type 2 diabetes
- Heart problems, including past heart attacks, congestive heart failure, or coronary artery disease
- Past strokes
- Psychological problems, such as mood disorders, depression, or bipolar disorder
- High blood pressure
If a few of these sound like you, tell your doctor. She can tell you if you need a sleep study to find out for sure.
A Killer of Adults 40 and Older
You need food every three weeks, water every three days, but air? Three minutes or less. So, sleep apnea is serious stuff. You don’t mess with sleep apnea. It’s life-threatening, and we’re increasingly more at risk of it as we age past 40—as if turning 40 wasn’t bad enough, right?
Complications caused by sleep apnea include:
- Heart and blood pressure problems: The frequent stops in breathing put people’s cardiovascular systems under intense stress, leading to higher risk of heart attacks, high blood pressure, and abnormal heartbeats. But if someone had heart disease already, the oxygen deprivation from repeated apneas can lead to death!
- Type 2 diabetes: This and insulin resistance can result.
- Severe daytime drowsiness: Because people repeatedly fall asleep and wake again—often without remembering—they may then fall asleep during the day while working or driving! They may also be irritable or depressed. And children’s grades may drop.
- Sleep-deprived partners: It can cause loud snoring that disrupts the sleep of a spouse or partner.
- Liver disease: It’s linked to liver function problems and liver scarring.
- Metabolic syndrome: This condition includes high blood pressure and blood sugar, abdominal obesity, and cholesterol problems, which can lead to stroke and heart attack.
- Negative reactions to medication and surgery: It can cause people to react poorly to certain medications and to anesthesia. It can cause complications during recovery from surgery (when you’re lying on your back asleep).
But older adults can’t hog all the fun—younger adults and children can get sleep apnea from nasal congestion, an inherited narrow throat or small neck, or a family history of sleep apnea (thanks, gramps!). And people of all ages are more at risk if they are obese, smokers, users of alcohol, sedatives, or narcotic medications, or survivors of heart disorders or stroke.
Let’s Get a Formal Medical Diagnosis
Okay, enough unpleasantness—at least of that kind. If you want to get a real medical diagnosis of sleep apnea, your doctor will usually give you two options:
- Visit a sleep disorder center: You’ll hang out with a sleep specialist all night long who will give you a super-fun sleep study, using equipment to record your sleeping breathing rates, leg and arm movements, oxygen levels, and brain, heart, and lung activity. This is called polysomnography, which will make you super-popular if you say it at the next party you’re at.
- Simplified home monitoring: Your doctor could send portable monitoring equipment home with you to measure your breathing, oxygen levels, and heart rate. What’s the point? To find out if your sneaky blood oxygen level suddenly drops and then rises again during apneas. In the middle of the night. When no one’s looking.
If you’re lucky (are you?), your doctor might prescribe a treatment just from a home study, but it might not be enough. You might have to go to the sleep disorder center after all. But the in-crowd are all doing it, anyway, and just a single night of monitoring will prove if you have it or not. So, rest easy.
What Can I Do About It, Doc?
So, what sort of purgatorial treatment are you in for? It’s actually not bad! With a positive diagnosis in hand, your doctor can prescribe one or more of the following:
- Weight loss: This can cure sleep apnea outright or improve the outcomes of other treatments.
- Sleep position changes: Devices invented by NASA help people to sleep on their side if they only suffer sleep apnea when on their back. (The NASA part is lies and slander, but didn’t it feel good for a second?)
- Behavioral strategies: This can include quitting alcohol and tobacco or using a nasal decongestant at night. All good stuff.
- Cognitive behavior therapy (CBT): A therapist can help you stop thoughts or actions that are disrupting either your sleep itself or your sleep apnea treatment. Hey, we’ve all been meaning to start therapy some time!
- CPAP: This is a machine that gently keeps a patient’s airway open during the night. It’s just awesome.
- Oral appliance: This is a device that helps people who have milder sleep apnea who don’t like the CPAP machine. It’s fitted by a dentist, so start flossing now.
- Surgery: This actually doesn’t work that well, but it’s a last resort if the CPAP or oral appliance don’t cut it.
Remember, this post is focused mostly on obstructive sleep apnea (OSA)—the most common type. If you have central or complex sleep apnea, your doctor may still treat you for OSA with a CPAP, oral appliance, or something else, which will still improve your sleep, and discuss other options with you.
Sleep Apnea Treatment Covered by Insurance
So, let’s finally talk about it. The snoring elephant in the room. Money. Good news! Most insurance providers, including Medicare, will pay for a sleep study ordered by a doctor—a full test in a sleep lab or a home test. Just call them first to hammer out the deets: let them know the type of test you’re getting, and find out how much you’ll have to pay yourself.
If you get diagnosed with sleep apnea, most insurance will also pay for whatever devices and accessories you need. They’ll ask for:
- The results of your sleep study
- A diagnosis of obstructive sleep apnea (OSA)
- A prescription for the device and accessories
- Your physician’s notes on your case
Sleep apnea is well understood, easy to diagnose, relatively easy to treat, and covered by insurance. Yes, it’s always a drag to find out you have a medical problem. But fortunately, there are so many great doctors and treatments for it now. People just like you have recovered. And just think, pretty soon, you’ll be able to have the restful sleep you’ve been missing—so you can be alert while driving and working, snore less, and wake up every morning feeling refreshed and ready for an hour-long jog. Well, okay, that last part is up to you.