People with untreated sleep apnea are at risk for high blood pressure, heart problems and stroke. They may also feel irritable, short-tempered or depressed.

Certain factors increase your risk of sleep apnea, including excess weight, age and a family history. People who smoke, drink alcohol or use narcotics are more likely to have this condition as well.

Obstructive Sleep Apnea

Obstructive sleep apnea occurs when something blocks part or all of the upper airway, leading to breathing disruptions. The interruptions cause the body to stop breathing for a short time — 5 to 30 times per hour each night — which interferes with achieving restful sleep. Then, breathing starts again, often with a loud gasp or snort. This snoring can disturb the sleep of those who share the bed with the snorer. The disorder also reduces the amount of oxygen reaching the brain and heart, which can lead to many health problems.

Symptoms of this type of sleep apnea include loud snoring (but not everyone who snores has sleep apnea) and excessive daytime sleepiness. The condition can lead to memory problems, mood changes and a higher risk of heart disease.

Obstructive sleep apnea is more common in people who are overweight, and it tends to get worse as you age. It affects more men than women, but it can occur in any age group and can affect people of any race or sex. Certain medical conditions and medications can increase the chance of getting the disorder, including enlarged tonsils, a fatty neck, excess fluid retention, a large soft palate or a narrowing of the upper airway. People who use sedatives, narcotics or anti-anxiety drugs are at higher risk.

Central Sleep Apnea

Unlike obstructive sleep apnea, central sleep apnea is characterized by a lack of airflow and insufficient respiratory effort. It is most often associated with heart failure, but may also occur in other medical conditions such as systolic heart disease and cancer. Central apneas are much less common than obstructive sleep apnea and can be difficult to diagnose and treat.

The condition is attributed to an abnormality of the brainstem, which controls a variety of functions including breathing. It is more common in men than women and is more prevalent in middle-aged adults. Certain medical conditions, such as congestive heart failure, high blood pressure and diabetes, increase a person’s risk of developing central sleep apnea. In addition, medications such as opioids and benzodiazepines can cause the condition by diminishing the brain’s ability to regulate breathing.

Symptoms of the disorder include excessive daytime drowsiness, poor quality of sleep, reports of abnormal breathing by bed partners and a heart murmur or irregular heartbeat. The doctor can diagnose the disorder by asking questions about symptoms and by performing a physical exam, taking a blood sample and listening to the heart. If the patient is not a candidate for surgery, treatment options include oxygen therapy and sleep-assisting devices. Medications like acetazolamide and theophylline can stimulate breathing, as can a device called the Remede System, which involves implanting a small machine that activates when the body stops breathing.

Treatments

The first step in diagnosing sleep apnea is an overnight study, either in the lab or at home. It records your brainwaves, eye movements, muscle tone, breathing patterns and oxygen levels.

Symptoms of obstructive sleep apnea include frequent awakenings with the feeling that you’re not getting enough air or feeling like your throat is closing up. You may also experience daytime sleepiness and headaches, as well as poor concentration and attention problems. People with obstructive sleep apnea are at higher risk for heart disease, high blood pressure and diabetes.

Lifestyle changes can help people with obstructive sleep apnea. Weight loss, quitting smoking and sleeping on the side instead of the back can all help improve symptoms. Some people find success with dental devices that help keep the upper jaw forward and the airway open. Newer EPAP (expiratory positive airway pressure) devices work by creating air pressure when you exhale, which keeps the throat open. Surgery can help some people with obstructive sleep pnea, as well. Surgery can remove extra tissue from the back of the mouth and throat, or reposition or shrink the tonsils or tongue base. Some people have a tube placed in their throat, called a tracheostomy, to help them breathe. For central sleep apnea, medications to stimulate breathing or a pacemaker-like device called a pharyngeal nerve stimulator can help.