Sleep Apnea

It’s easy to dismiss snoring as a nighttime nuisance, but sometimes snoring can be a sign of sleep apnea, a serious disorder. Sleep apnea occurs when your breathing is frequently interrupted while you’re sleeping. You may not fully wake up during these breathing disruptions, and they can happen anywhere from a few times a night to more than a hundred times.

There are three kinds of sleep apnea:

• Obstructive sleep apnea, the most common form, occurs when the tongue or tissues in the neck block the airway.
• Central sleep apnea is due to the brain’s inability to effectively control breathing.
• Complex sleep apnea involves aspects of both obstructive and central sleep apnea.

Regardless of the type, sleep apnea can harm your health by causing chronic exhaustion and increasing your risk of heart attack and stroke, if left untreated. MultiCare’s sleep medicine specialists can help determine if you have sleep apnea and form a treatment plan that will help you get the quality rest your body needs.

Sleep apnea can affect both adults and children. The most common signs of sleep apnea include:

• Chronic morning headaches or throat discomfort
• Difficulty concentrating or remembering during waking hours
• Fatigue and daytime sleepiness
• Frequent waking to urinate
• Irritability, depression or other mood problems
• Gasping or choking during sleep
• Loud snoring

Risk factors of sleep apnea

Anyone can develop sleep apnea, but common risk factors include:

• Age. Sleep apnea is more common in older adults, particularly those over 60 years of age. This is because the soft tissues in the mouth and throat tend to sag or become floppier, increasing the likelihood they will obstruct the airway.
• Sex. It’s more common for men to have sleep apnea, but when women reach menopause, they are just as likely to experience it.
• Structural features. Certain anatomical features can increase the likelihood of experiencing sleep apnea. These include large tonsils and adenoids, a small airway, a small lower jaw or a lower jaw that is set far back, a large tongue, or large neck circumference.
• Family history. If you have family members with sleep apnea, you are more likely to develop it.
• Lifestyle factors. Sedatives, alcohol use and smoking can worsen obstructive sleep apnea.
• Excess weight. People who are overweight or have obesity have a higher risk of developing sleep apnea.
• Chronic medical conditions. Certain conditions, such as hypertension, Type 2 diabetes and a history of stroke can increase the risk of sleep apnea.
• Sleep position. Sleeping on your back may increase the likelihood that the tongue and other tissues in the mouth and throat can obstruct the airway.

Diagnosing and treating sleep apnea

If you suspect you have sleep apnea, you may need to undergo a sleep study in one of MultiCare’s state-of-the-art sleep centers. In-home testing is an option for diagnosing moderate-to-severe obstructive sleep apnea. Whether your sleep study takes place at one of our sleep centers or is self-administered at home, our board-certified specialists will review your results and develop a treatment plan to help you get restful sleep.

Treatment varies depending on the cause and severity of sleep apnea as well as your overall health. Common treatment options include:

• Continuous positive airway pressure (CPAP) therapy. A CPAP device comfortably delivers pressurized air through a mask to keep your airway open while sleeping. Masks come in a variety of shapes and sizes so you can find the best fit.
• Hypoglossal nerve stimulation (Inspire®). Implanted inside the body, this small device gently stimulates the throat muscles, allowing the airway to remain open during sleep.
• Mandibular advancement devices (MADs). These oral devices open the airway during sleep by pulling the tongue and jaw forward. MADs must be fitted by a dentist and are similar to a mouth guard worn during sports.
• Weight loss. People who are overweight tend to have excess throat tissue that impedes the airway. Maintaining a healthy weight can lessen the severity of sleep apnea, sometimes eliminating it altogether. MultiCare’s weight loss services offers evidence-based programs to help you reach and maintain a healthy weight.
• Surgery. If you have severe obstructive sleep apnea, or your symptoms are not improving with other forms of treatment, surgery may be an option. Two common procedures include a tonsillectomy or a uvulopalatopharyngoplasty (UPPP), which removes excess tissue in the throat.

Learn more about obstructive sleep apnea treatments such as CPAP machines and hypoglossal nerve stimulation (Inspire®) in this video, featuring MultiCare physicians Christine Puig, MD, and Kimberly Mebust, MD.