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Conditions InDepth: Sleep Apnea by Rosalyn Carson-DeWitt, MD

Sleep apnea is a condition in which breathing stops for brief periods of time while a person is sleeping. These episodes of interrupted breathing last anywhere from 10-30 seconds at a time, and may occur up to 20-30 times per hour. Over the course of a single night’s sleep, this can mean up to 400 episodes of interrupted breathing.

Normal Upper Airway During Sleep

Every time you stop breathing, you interfere with the normal patterns of deep sleep. You may not even realize it, but you are awakening regularly in order to resume breathing. The quality of sleep that you get is greatly impaired. The next day, your level of alertness and your ability to pay attention may be seriously affected.

Blocked Airway

Some of the risks associated with sleep apnea include:

Increased risk of accidents (especially car accidents) due to inattention and inability to stay alert during normal waking hours
Higher risk of heart disease
Increased risk of stroke
Increased risk of lung disease
Increased risk of hypertension
Increased risk of diabetes

There are several different kinds of sleep apnea. These include:

Obstructive Sleep Apnea

This is caused by a temporary airway obstruction. This blockage may be partial or complete. Obstructive sleep apnea can occur when the tissues of your throat relax too much and cave in on each other. If you’re overweight, your excess tissue might be putting too much pressure on your airway, causing it to collapse. You may have a deviated septum , nasal polyps , large tonsils, or an elongated soft palate and uvula that obstruct your airway while you are sleeping.

For children, the most common reason for obstructive sleep apnea is enlarged tonsils and adenoids.

Central Sleep Apnea

This occurs when an area of the brain (called the lower brain stem) neglects to send signals to the muscles that control breathing. Conditions that cause problems with the lower brain stem include certain types of polio , encephalitis , stroke , brain tumors , and various degenerative diseases affecting the brain and central nervous system.

Mixed Sleep Apnea

This form includes aspects of both obstructive and central sleep apnea.

The National Heart Lung and Blood Institute estimates that 12 million Americans have sleep apnea, with more than half of these people being overweight.

References:

American Sleep Apnea Association website. Available at: http://www.sleepapnea.org/resources/pubs/evaluated.html . Published May 2005. Accessed September 17, 2008.
Botros N, Concato J, Mohsenin V, et al. Obstructive sleep apnea as a risk factor for type 2 diabetes. Am J Med . 2009;122(12):1122-1127.
Cecil R, Goldman L, Benett JC. Cecil Textbook of Medicine. 21st ed. Philadelphia, PA: WB Saunders Company; 2000.
NINDS sleep apnea information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/sleep_apnea/sleep_apnea.htm . Updated June 2008. Accessed September 17, 2008.
Sleep apnea: key points. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/SleepApnea/SleepApnea_Summary.html . Accessed September 17, 2008.

Last reviewed October 2012 by Rimas Lukas, MD

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