Tired of being tired?  Sleep apnea is a serious condition affecting more than 22 million Americans.  It is a sleep disorder in which breathing repeatedly stops and starts.  There are three categories of sleep apnea:

• Obstructive sleep apnea, the more common form that occurs when throat muscles relax 
• Central sleep apnea, which occurs when your brain doesn't send proper signals to the muscles that control breathing
• Complex sleep apnea syndrome, also known as treatment-emergent central sleep apnea, which occurs when someone has both obstructive sleep apnea and central sleep apnea

If you think you may have sleep apnea, answer the following questions to help assess your risk:

1. Do you experience any of these problems?

• Daytime sleepiness
• Unrefreshing sleep
• Fatigue
• Insomnia

2. Do you ever wake from sleep with a choking sound or gasping for breath?

3. Has your bed partner noticed that you snore or stop breathing while you sleep?

4. Do you have any of these other symptoms?

• Waking during the night to go to the bathroom
• Morning headaches
• Difficulty concentrating
• Memory loss
• Decreased sexual desire
• Irritability

5.  Do you have any of these physical features?

• Obesity - body mass index (BMI) of 30 or higher
• Large neck size - 17 inches or more for men, 16 inches or more for women
• Enlarged tongue or tonsils
• Recessed jaw
• Nasal polyps or deviated septum

6. Do you have any of these other medical problems that are common in people with sleep apnea?

• High blood pressure
• Mood disorders
• Coronary artery disease
• Stroke
• Congestive heart failure
• Heart attack
• Atrial fibrillation

After answering these questions and you believe you may have sleep apnea, further testing should be performed to diagnosis and develop a treatment plan.

The most common symptom of sleep apnea is snoring. However, not everyone who snores has sleep apnea. Snoring is likely to be a sign of sleep apnea when it is followed by silent breathing pauses and choking or gasping sounds. People with sleep apnea often have daytime sleepiness or fatigue. Common symptoms of sleep apnea include:

• Loud or frequent snoring
• Silent pauses in breathing
• Choking or gasping sounds
• Daytime sleepiness or fatigue
• Unrefreshed sleep
• Insomnia
• Morning headaches
• Nocturia (waking during the night to go to the bathroom)
• Difficulty concentrating
• Memory loss
• Decreased sexual desire
• Irritability

Your diagnosis starts with your first office visit.  A complete history and physical will be performed to determine if a sleep study is needed.

• In-lab overnight sleep study -  This type of sleep study requires you to stay overnight at a sleep center.  You will sleep with sensors hooked up to various parts of your body. These sensors record your brain waves, heartbeat, breathing and movement. 
• Home sleep apnea test  - Some patients with high risk factors for obstructive sleep apnea and no other medical disorders may be candidates for a home sleep apnea test. This type of sleep study lets you sleep in the comfort of your own home while a small monitor collects data as you sleep.

Sleep apnea is a serious sleep disorder that needs to be treated. A board certified sleep physician can help you select a treatment plan that is right for you. Depending on the treatment, he or she may work in collaboration with other members of the sleep team, including dentists, psychologists, physician assistants, nurses and technologists. Your plan may include any combination of these treatments:

• CPAP (Continuous Positive Airway Pressure)  - CPAP is a machine that uses a steady stream of air to gently keep your airway open throughout the night so you are able to breathe. You sleep with a mask with a hose that is attached to a machine kept at the bedside.  CPAP is the front-line treatment for obstructive sleep apnea and is recommended for all cases. 
• Oral Appliance Therapy  - An oral appliance is a device that fits in your mouth over your teeth while you sleep.  The device prevents the airway from collapsing by holding the tongue in position or by sliding your jaw forward so that you can breathe when you are asleep. 
• Weight Management In some cases weight loss can help improve or eliminate your sleep apnea symptoms if you are overweight or obese. Overweight people often have thick necks with extra tissue in the throat that may block the airway. 
• Positional Therapy   - Positional therapy is a behavioral strategy to treat positional sleep apnea. Some people have sleep apnea primarily when sleeping on their back. This is called the “supine” position. Their breathing returns to normal when they sleep on their side. Positional therapy may involve wearing a special device around your waist or back. It keeps you sleeping in the side position.  Positional therapy can be used alone or together with another sleep apnea treatment.
• Lifestyle Changes There are a variety of lifestyle changes that you can make to help you reduce your snoring and improve your sleep apnea symptoms. Behavioral changes such as quitting smoking or not drinking alcohol may improve sleep apnea symptoms. Alcohol relaxes your throat muscles which can cause you to snore or for your airway to collapse.