1) What is sleep apnea?
Sleep apnea is a chronic problem with breathing in your sleep. There are two fundamental types of sleep apnea, obstructive and central. By far, obstructive sleep apnea (OSA) is more common. OSA is when your upper airway (the back of your throat) repetitively collapses during sleep. Most but not all people with OSA snore loudly and/or regularly. Central sleep apnea (CSA) is caused by your brain failing to give sufficient effort for your body to breathe resulting in repetitive episodes of breath-holding or shallow breathing.
2) What are the most common sleep apnea effects?
The most common effects of sleep apnea are:
- excessive daytime sleepiness or fatigue
- non-restorative (unrefreshing) sleep, i.e., no matter how much sleep you get you never feel rested
- nocturia (waking during the night to urinate)
- night sweats
- trouble staying asleep (sleep maintenance insomnia)
- waking up in the morning with headaches
- acid reflux (GERD) - both at night and during the day
- impaired attention and memory
- depressed mood
- increased risk of motor vehicle accidents
- secondary medical problems, e.g. high blood pressure, heart attack etc. (see above)
3) I stop breathing while sleeping. Does this mean that I have sleep apnea?
Reporting "witnessed apneas" (someone hears you stop breathing in your sleep) has an 80% positive predictive value for a diagnosis of sleep apnea.
4) What insomnia are symptoms indicative of sleep apnea?
Most of us have periods of life upheaval that result in short-term sleep difficulties. But when insomnia becomes chronic it is often indicative of an underlying medical cause. Sleep apnea tends to manifest as certain insomnia patterns. If you regularly wake up at about the same time (or times) every night, for example, 3-3:30 a.m. and 5-5:30 a.m., this raises the possibility that sleep apnea is at the root cause of your insomnia.
5) I have chronic insomnia. Can this be related to sleep apnea?
Yes, sleep apnea commonly causes sleep maintenance insomnia (trouble staying asleep) and may also result in early morning awakenings (EMAs) in people who are particularly susceptible to sleep apnea during REM sleep. In severe cases, sleep apnea may also lead to trouble falling asleep.
6) I've been reading about narcolepsy symptoms. How do I know whether I have narcolepsy or sleep apnea?
Narcolepsy is very rare - only 0.5% of the population has this problem It results in excessive daytime sleepiness. It can also be associated with disrupted nighttime sleep and a phenomenon known as "cataplexy," where people lose muscle tone in certain situations. OSA, on the other hand, is very common. Perhaps as many as 26% of American adults have this problem. If you're tired during the day, you're statistically much more likely to have OSA as the cause as opposed to narcolepsy.
7) I suffer from daytime sleepiness. Does this mean that I have OSA?
There are many potential medical causes of excessive daytime sleepiness but OSA is certainly a common one. If you have other risk factors like regular snoring, being overweight or obese, or concerning breathing sounds (gasping, choking, pausing), speak with your doctor about having a sleep apnea test.
8) Is sleep apnea hereditary?
Yes, research shows that up to 35% of your risk for sleep apnea is hereditary. Sleep apnea tends to run in families - if you have sleep apnea, it is very likely that you have a family member who also has sleep apnea.
There is clearly a genetic component to sleep apnea. Genes can account for up to 35% of your risk for sleep apnea. Sleep apnea is more common in the following ethnic groups:
- people of East Asian descent
9) What is the sleep apnea weight gain connection?
Being overweight with (body mass index (BMI) 25-30) or obese (BMI >30) is one of the strongest risk factors for the development of obstructive sleep apnea. Weight gain leads to deposition of fat in the tongue, neck, and other tissues that line the upper airway causing an increased likelihood of the upper airway to collapse on itself (obstruction). Weight loss can definitely help sleep apnea.
10) What are the most common risks of untreated sleep apnea?
Untreated sleep apnea is associated with the following medical disorders. The most common medical co-morbidities associated with sleep apnea:
- high blood pressure (hypertension)
- type 2 diabetes
- high cholesterol (dyslipidemia or hyperlipidemia)
- heart failure (congestive heart failure or CHF)
- heart attack (myocardial infarction)
- irregular heart rhythms (cardiac arrhythmias or dysrhythmias) NOTE: there is a particularly tight association with atrial fibrillation or "a fib"
- transient ischemic attack (TIA) and stroke (cerebrovascular accident or stroke)
See our comprehensive sleep apnea risks list for further information.
11) How does sleep health tie into overall health?
Sleep health is integral to your overall health. If you're not sleeping well you may experience a host of quality of life and health issues. Chronic sleep deprivation of six hours or less has been associated with type 2 diabetes and increased cardiovascular disease. Sleep apnea can lead to a number of health care problems, as described above.
12) Are there any sleep apnea screening questionnaires?
Yes, the Stop-BANG is widely used. Please see the bottom of this page if you'd like to register to take the Stop-BANG online.
13) How do I find a place to have a sleep apnea test near me?
Many hospitals have sleep labs that are located in the hospital or in an associated clinic. There are also many free-standing "independent diagnostic and testing facilities" (IDTFs) throughout the country. Another option would be to use a national home sleep testing company, which can send you a home sleep apnea test to do at your home. You can find more information about sleep apnea testing on the American Sleep Apnea Association's website.
14) How much does a sleep apnea test cost?
Sleep apnea test costs vary widely by region. In-lab sleep apnea tests are more expensive than home sleep apnea tests. In lab tests generally range from $1,000 - $3,000 but we have seen some quotes as high as $8,000. Home sleep apnea tests are typically in the $200 - $600 range.
15) How is an OSA diagnosis made?
OSA is diagnosed by a sleep study with or without certain clinical criteria. If the sleep study shows an AHI >15, OSA can be diagnosed just based on these results. If the patient has mild sleep apnea (AHI is <15), the diagnosis requires one or more of the following:
- The patient complains of sleepiness, non-restorative sleep, fatigue or insomnia symptoms.
- The patient wakes with breath-holding, gasping or choking.
- The bed partner or other observer reports habitual snoring, breathing interruptions or both during the patient’s sleep.
- The patient has been diagnosed with hypertension, a mood disorder, cognitive dysfunction, coronary artery disease, stroke, congestive heart failure, atrial fibrillation or type 2 diabetes mellitus.
16) How do I find sleep apnea doctors near me?
Sleep apnea doctors are physicians that have been specially trained in a field called sleep medicine. Most academic centers, community hospitals, and large multispecialty groups have a sleep disorder center with a sleep doctor on staff. Unfortunately, some parts of the country are underserved in terms of sleep apnea doctors. In addition to a traditional "brick and mortar" sleep clinic, you can now be evaluated by a sleep apnea doctor online.
17) Are there any medications that can help or treat sleep apnea?
No, currently there are no medications that are FDA-approved for treatment of sleep apnea.
18) What is a "sleep machine"?
People generally use the term "sleep machine" to refer to continuous positive airway pressure (CPAP) devices. These are prescription medical devices that use pressurized air to prevent the repetitive upper airway collapse that is the underlying cause of OSA.
19) Are there other treatment options besides CPAP?
Yes, common alternatives to CPAP include oral appliances made by dentistis, nasal EPAP, and surgery. Talk with a sleep specialist to find the right approach for you.
Joseph Krainin, M.D., FAASM is the founder of Singular Sleep, the world's first online sleep center. He is a Fellow of the American Academy of Sleep Medicine and board-certified in both sleep medicine and neurology. He has been practicing medicine for over 10 years.
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