Breathing disorders during sleep can lead to disturbances as commonplace as snoring. In more extreme cases, they may cause daytime hypersomnolence - the inability to stay awake during the day. The term apnea is used to describe a pause in breathing of 10 or more seconds. Sleep apnea is defined as having 30 or more apneic episodes per 8 hours of sleep. Sleep Apnea Syndrome (SAS) is characterized by numerous apneic episodes along with loud snoring and daytime sleeping.

Daytime sleeping is a real problem on the job or while driving. Falling asleep at the wheel is a common problem for SAS patients and the cause of numerous accidents. Falling asleep at work frequently results in injury and/or job loss.

Believe it or not, SAS can also lead to memory problems as well as difficulty concentrating and thinking. Anxiety and/or depression are frequent symptoms, as is irritable and aggressive behavior. Physically, a person with SAS may experience early morning headaches, sexual dysfunction, chronic tiredness, high blood pressure, and swelling of the extremities.

Treatment
There are numerous treatment possibilities available for people experiencing sleep apnea. Obese patients must lose weight. There is very little risk associated with medically supervised weight-loss programs, and the weight loss may offer additional physical benefits.

Sleeping on your side may reduce the number of apneic episodes you experience by nearly 50%.

If you have sleep apnea, do not drink alcoholic beverages or take sleeping pills before bedtime. This will make your condition worse by depressing your respiratory system's drive to breathe.

Nonsurgical treatments for SAS include supplemental oxygen and continuous positive airway pressure (CPAP). CPAP is effective but it is uncomfortable, and wearing a mask while sleeping is inconvenient. Bilevel positive airway pressure (BiPAP®) also provides noninvasive ventilatory support through a nasal mask offering alternated levels of gas flow.

Sometimes surgery will be required. There may be an obstruction that has to be removed or the situation may warrant a tracheostomy. A tracheostomy requires the surgical insertion of a tube into the trachea. This procedure is intended for people with severe symptoms.

Patient history and a physical exam may indicate the need for a polysomnogram (a formal sleep study) to confirm a diagnosis of SAS. It will document the number and length of each apneic episode and help to determine the severity of the breathing disorder. A polysomnogram is only one of a series of tests that will probably include an electrocardiogram (ECG), a chest x-ray, a pulmonary function test, and arterial blood gas analysis.

Polysomnography requires the attachment of sensors to various parts of the body. These sensors provide signals that are amplified and recorded on a printout. The printout can be analyzed to determine how severe the condition is as well as what therapy is most desirable.

Reviewed: March 20, 2005
Revised: March 20, 2005