What Are the Steps to Treating Sleep Apnea?

Your alarm goes off in the morning, and immediately the first thought that enters your head is how tired you feel. You went to bed at a decent hour and fell asleep relatively quickly, but the fact remains that you are constantly tired no matter how much you sleep. This has been going on for longer than you can remember, and it’s really starting to affect your quality of life. This kind of chronic exhaustion often points to a very common disorder called sleep apnea, which affects about 20 million Americans every night. Read on to learn more about what you should do if you think you (or maybe even a loved one) have sleep apnea.

First Things First: How Can You Know if You Have Sleep Apnea?

Do you experience any of the following symptoms?

• Loud, chronic snoring
• Persistent daytime exhaustion
• Problems with memory and/or concentration
• Consistent morning headaches
• Sore throat in the morning
• Dry mouth in the morning
• Depression and/or constant mood swings
• Choking, gasping, or periods of complete silence during sleep (usually observed by a bed partner)

Snoring is the most common sign of sleep apnea, but snoring can manifest itself in a variety of ways that may or may not require treatment. Snoring can be benign, be a sign of a condition called upper airway resistance syndrome, or be a symptom of sleep apnea. Each condition has its own unique qualities and treatment options (check out our blog “The Stages of Sleep Apnea: Is Treatment Necessary?” to learn more about the differences between these three conditions). Nonetheless, if any of the above symptoms sound familiar, you should take the steps we’ve listed below.

Step 1: Getting Tested

If you believe that you might have sleep apnea, the first step is to get tested to determine the actual problem. A sleep test will reveal the root cause of your sleep issue as well as its severity. Only after you have a proper diagnosis will a doctor be able to offer the appropriate treatment options.

Step 2: Diagnosis

After being tested, if you receive a sleep apnea diagnosis, your doctor will then determine if you have central or obstructive sleep apnea. Central sleep apnea (CSA) stems from a problem with the brain’s communication to the body — more specifically, the brainstem doesn’t tell the breathing muscles to function properly during sleep. Certain underlying medical conditions can make a person more likely to develop CSA, including

• Stroke
• Heart attack
• Congestive heart failure
• Encephalitis (inflammation in the brain)
• Arthritis in the cervical spine
• Parkinson’s disease
• Surgery or radiation treatments in the spine

Certain medications can also contribute to central sleep apnea:

• Codeine
• Morphine
• Oxycodone

Obstructive sleep apnea (OSA), on the other hand, occurs when something literally blocks the airway during sleep, whether it be the tongue, soft palate, fatty tissue around the throat, etc. OSA is by far the most common type of sleep apnea, and its risk factors include:

• Obesity – Obesity can cause excess tissue around the throat, narrowing the airway and making it easier to become blocked
• Having large tonsils or adenoids
• Having a larger than average tongue or thick neck
• Chronic nasal blockage issues, whether due to allergies or a deviated septum
• Smoking
• A recessed chin or large overbite

Step 3: Receiving Treatment

If central sleep apnea is identified as the cause, a number of treatment options may be suggested:

• Treating an underlying medical problem (such as those listed above)
• Change in medication (especially if a person is taking opioids)
• CPAP, BPAP, or ASV therapy, which all work to keep the airway open and establish a consistent breathing pattern
• Certain medications, including acetazolamide (Diamox) or theophylline (Theo-24, Theochron, and others) can also be used to stimulate breathing in people with CSA.

If obstructive sleep apnea is identified as the cause, your doctor will then determine if the condition is mild, moderate, or severe. To do this, your doctor will simply look at the results from your sleep test, specifically the number of apnea events that occur in an hour. To have an apnea event means to experience a cessation in breathing during sleep. This doesn’t necessarily mean that breathing has stopped completely; it just means that reductions in respiratory effort and airflow have occurred. Doctors typically classify the severity of sleep apnea in the following ways:

• Mild: Apnea events ≥ 5, but < 15 per hour
• Moderate: Apnea events ≥ 15, but < 30 per hour
• Severe: Apnea events ≥ 30 per hour

After severity has been determined, your doctor can then recommend the best treatment option — oral appliance therapy, CPAP, or surgery. CPAP is a common treatment option prescribed to those with obstructive sleep apnea. Although it is the most commonly prescribed treatment, many sleep apnea sufferers are intolerant to it. Oral appliances are a clinically proven option for mild, moderate and severe sleep apnea sufferers, and a comfortable alternative for those that are unable or unwilling to use CPAP. Surgery is only considered in rare cases as a last line of treatment if other therapies haven’t been effective.

How to Get Started

To begin your journey to getting a full night’s rest and waking up feeling energized again, you should consult a local sleep expert, like Dr. Jeff Rodgers at Sleep Better Georgia. He can help provide the answers you need and determine which treatment option may be best for you. To get started, all you need to do is schedule a free consultation.