Obstructive sleep apnea and sleep apnea treatment

Apnea. What is it? Is it "obstructive" sleep apnea (OSA) or "central" sleep apnea (CSA)? What can you do about it?

Apnea means you aren't breathing. Sleep apnea (the most common, by far) means you aren't breathing while you are sleeping. No, not all the time. Episodically.

Obstructive sleep apnea (the most common form of sleep apnea) means that something physical is getting in the way of your breathing... and stopping it.

Central sleep apnea means that your brain is not telling your body to breathe. Central apnea is much less common and is associated with severe illness like heart disease or cerebrovascular disease, which strongly implies that it is way beyond the scope of this website. You are probably under a doctor's care for something severe... or soon will be.

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Obstructive sleep apnea, being caused by physical obstruction, has causes that you can moderate/manage or eliminate. It's almost always associated with snoring. If you can stop snoring, you can usually put an end to obstructive sleep apnea, which means you'll live longer. No slightest exaggeration there, boyo. Obstructive sleep apnea is a killer.

Have you been to our other pages, particularly the one(s) about elevated blood pressure (hypertension)? There we mention that hypertension is one of the few things we discuss on this site that is deadly serious (as opposed to being a matter of convenience, cosmetics, or pain relief). Well, sleep apnea is another one. It's serious and, if you have it, it is shortening your life, inch-by-inch, night-by-night

This can kill you

Sleep apnea is not just a peaceful pause in breathing. The obstructive kind (that comes with snoring) just blocks your throat while you struggle and struggle to breathe. Eventually, you succeed in drawing a breath, but:

a) the struggle causes dramatic increase in your blood pressure - you are basically in a panic trying not to die, and you are working very hard -even though asleep (sort of) - to fight past the obstruction and get some air into you

b) you don't necessarily do the struggling quietly - your partner, if s/he still sleeps in the same room is treated to the jerking and shivering and throttled gasping, and then the final booming snore when you do get the air to move.

And it happens over and over, dozens or hundreds of time per night.

All the results are bad

As you can imagine, that sort of thing, going on nightly, has various nasty effects.

  • Your oxygen saturation goes down - that's the amount of oxygen dissolved in the blood, a measure of how much oxygen is available (and getting to) your body tissues and organs that need it... like... say... your brain.
  • Your blood pressure goes up while you struggle to breathe - it's a real, panic emergency and this is a legitimate reaction to it.
  • Your blood pressure tends to remain high through the following day, partly from the strain and partly because of lack of sleep from dozens, perhaps hundreds of emergencies all night.
  • Yes lack of sleep - you didn't think you could get a restful night while struggling in desperation, every few minutes, did you?
  • The chronic lack of sleep compromises your immune system, setting you up for all kinds of things that you would otherwise shrug off... but can't.
  • It's common to wake up with a headache - a dull, non-specific, all-over-the-head headache - failure to take in enough oxygen is accompanied by failure to clear enough carbon-dioxide.
  • It's also common to wake up with a sore throat from the straining of the episodes, and from the snoring between episodes.
  • Your personal life suffers because you are tired, unfocussed, crabby.
  • Your personal life suffers because your partner suffers each night and is probably not getting much more real sleep than you are.
  • Your work suffers because of the lack of sleep (again, mood, concentration/focus, stamina, and overall health are all affected negatively).
  • And the list wouldn't be complete without mentioning all the time you chew up, looking for ways to feel better, fix the problem, etc. (doctor visits, research, various remedies, sleep apnea treatment, and so on, that you might spend money and time on). Yes money. Your time is money, but so is what you pay for doctors, medicines, apparatus and gimmicks.

First find out if you have it

How do you do that? We think if you read the lists above, you'll have a clue.

If you live with somebody, they can probably tell you if you are a chronic snorer, and if you appear to struggle to breathe at night. If so, it's a pretty good bet and the cure for obstructive sleep apnea is pretty much the cure for snoring.

So there's a cure? An actual CURE??

Don't get all excited. As with many things in life, it's not absolute. The problem and its cause are something that you've been doing to yourself for years (knowingly or not), so there are multiple approaches and varying degrees of "cure". We'll get to that in a minute. First, let's complete our thought about finding out if you have a snoring and/or sleep apnea problem.

What if I live alone, or my roomie is deaf?

Two words: sleep study.

You will need to have it prescribed by your doctor - it's not a walk-in clinic (at least, not in Canada nor in most parts of the USA).

So, you tell your doctor that you have a sleep problem, or that you have a snoring problem and possibly an obstructive sleep apnea problem. Or your doctor tells you, but it's quicker to just lay it out if you already suspect - and having read this page, you do.

On the day of your appointment, you arrive at the hospital or clinic. You fill out some forms, including a little of your history - both about your sleep and about other things. There might have been an instruction sheet that you were supposed to obey, regarding drugs or foods to avoid, prior to the test.

How does the basic test go?

Ever had an electrocardiogram? How about an electroencephalogram? Similar idea. After the initial chat they sit you in a chair and hook up a complicated harness of wires, going to contact patches on your chest, face, skull, maybe groin, and leg. You might even have a stretchy band around your chest like in a polygraph (lie-detector) test, and a little clip with a red light on the tip of one finger (that's an oxygen-saturation monitor for your bloodstream - another popular location for the clip is on your ear-lobe, but some people find that interferes with sleep).

Then you get into bed and the technician hooks up the other end of the wiring harness to the monitoring equipment and tries to arrange it all so that it interferes as little as possible with your comfort.

The technician leaves your room, switching off the lights, and goes to his/her monitoring station - there might be several people in the clinic for various sleep studies that night.

You lie in the dark, possibly observed by an infrared camera, and with an audio link to the monitoring station. You wonder to yourself how-in-hell you are ever going to get to sleep.

Being a guy of a certain age, the next thing you know, you are waking up to go pee. You start to get up, realize where you are, turn to look for the call button... and the technician is coming through the door because s/he already noticed you waking up. The tech unhooks the harness from the machine. You shuffle to the washroom, do your business, come back, get checked and hooked up again.

You ask how you've been doing. The tech replies something like "snoring up a storm, and several apneic episodes. Do you want to try sleeping on your (other) side?"

In the morning.... very, very damn early in the morning,... you get unhooked, you get some-but-not-all of the contact gel/paste wiped off, you gather your stuff, and you leave. A report will be compiled when the sleep specialist looks at the sensor record of your night. They create some indices based on the frequency and duration of your episodes during the study. The index is a measure of how severe (or not) your problem is. The kinds of muscular and electrical activity that are recorded tell the doctor whether you were trying to breathe, but just couldn't make it happen (OSA) or whether you "forgot" to try (CSA).

You drive home and hit the shower. Aside from the general yuckiness of having been in a hospital (or clinic) you need to wash off residual contact paste, and probably some dissolving paper contact pads on your scalp. A bit of hot water does it.

Then what?

Days or weeks later, your doctor tells you the summary that you could have got by just asking your roomie if you had one.

OK, really, you needed to go through that study in order to get referred for a CPAP study. Your doctor probably wouldn't have taken your roomie's word for it.

So if I'm suffering OSA, what is it?

Well, you already know the most important part. You are asleep and you can't breathe. But you want to know why it happens.

This is the same thing we said about snoring.

When you sleep, you relax.

Really, really, relax.

Possibly to prevent you from acting out your dreams, your body is pretty much paralyzed while you sleep. It loses muscle tone all over, including inside your throat. The tonus that might have kept your breathing opening open is not there. Also, the same bit of muscle-tone that would have kept your jaw and tongue from sagging back under the pull of gravity, is not there.

Everything conspires to have soft bits crowd the air hole. Worse, men have proportionately smaller air passages than do women.

You put that all together, and if the passage remains open at all, it is considerably reduced and it has all this loose flesh flapping in the breeze as your breathe. That flapping is a vibration. Vibration is sound. The sound is you snoring.

If the sagging airway and the loose, floppy bits are loose and floppy enough, they completely close off the airway. The harder you struggle to pull in air the more thorough the airtight seal. If you have excess mucous, that makes things stickier and helps complete the seal. If you are dry and gummy - from breathing through your mouth... because your jaw was slack and your mouth sagged open - then the fleshy bits are even more likely to stick together.

Put all that together and it's a wonder there's anybody who DOESN'T snore. It's a wonder that apnea isn't more common.

Obviously you haven't died, so you must have resumed breathing. To do so, you had to come out of sleep enough to get your muscle-tone back and be able to pull back the fleshy bits, move your jaw and tongue forward, and open your airway. After pulling in a few breaths, your body calms from the emergency and you begin to relax back into sleep. You might not have come fully awake, but you definitely did disturb the rhythm of your much-needed deep sleep.

As soon as you've relaxed enough that things start to sag, you start to snore. You snore more and more heavily for a few minutes, as you relax further until... it all stops again, and you are once again struggling to breathe through a blocked straw. And around we go, over and over all night. Pity the poor life-partner who has to "sleep" next to that. It's almost as hard on them as it is on you.

Here's where gay guys might have a disadvantage. If you're both snoring and both struggling to breathe, you won't hear each other. The disadvantage to this arrangement is that it puts off both of you discovering that you have the problem and actually doing something to fix it.

Look back to that list of symptoms to help you decide if you have a problem.

And if I'm suffering from OSA, what do I do?

You stop it. As soon as possible you take corrective action and you make sure that the obstructive sleep apnea ceases to occur. That's really, really important. If you don't already have elevated blood pressure, it won't be long. You are risking a stroke and other nasty things while this nightly struggle continues.

And how DO I deal with the apnea?

Same ways you deal with snoring. The big one, if you happen to be a big one, is to lower your weight. Reduce the excess adipose. LOSE THE LARD!

Really, if you are fat/obese and if you suffer from obstructive sleep apnea, chances are very high that the overweight is the major cause of the apnea.

Unless you smoke.

If you are a smoker, then that is the likeliest proximate cause of your apnea. Smoking damages your airways all the way down, not just in the lungs themselves. Lots of smokers die of strokes and other effects of apnea before they ever have a chance to grow a cancer or develop emphysema.

If you are a smoker, you know. There's nothing further that needs to be said, here. You know what to do.

If you still have the snoring and apnea after you've been off the coffin-nails for six months, then come back here and look for something else to try.

So I don't smoke and I'm kinda heavy - is that it?

Nah. You do have to reduce your bulk. There's just no getting around that (ha-ha, a circumference joke). But just as with the blood pressure problem (which you probably have as well) there are things that you can do to lower the risk and reduce the problem while you are in the slow, steady process of dropping the poundage.

Such as?

You can try any of the anti-snoring solutions in this section of the site (see table of links below). If the snoring lessens or goes away, so does the obstructive sleep apnea - IN MOST CASES . Remember the good ole bell curve. Among the population that both snores and suffers OSA, there will be a few people for whom a slight reduction of snoring will completely eliminate the apnea. There'll be a whole bunch in the middle who will have a middling result with more or less correlation to the snoring and its stoppage. And there'll be a few up on the other end of the curve for whom snoring and OSA are somehow unrelated and curing the one does little to cure the other. We're talking to the more fortunate ones who will get good results from the same things that will lessen or completely stop their snoring.

There are special pillows that purport to position your head, neck (and jaw?) in such a way that snoring is reduced or stopped. If the pillow can get you in such an orientation that your tongue doesn't fall back, that's the usual biggest culprit that isn't trying to block your breathing tube - even if the other loose floppy bits are still contributing.

There are chemical sprays that purport to tighten the tissue lining the cake-hole and breathing hole. They are said to work for some people, at least for a while.

There are plastic mouthguard appliances that hold the jaw in the forward position, which also keeps the tongue forward .

There are various straps/harnesses that are worn around your head to cup your chin and keep the jaw in the forward position...

There's the good old half-a-tennis-ball sewn onto the back of your pajamas so that you are discouraged from lying/sleeping on your back... which is ok until you get so flaccid in the throat that you snore even when lying on your side.

And, for those with lots of money and a tolerance for equipment and noise, there are various flavors of the CPAP machine (see our CPAP pages). This is the major medical weapon against apnea, and it works against snoring, too. Chances are your roomie can become accustomed to the sounds of the machine and consider them much preferable to the muted sounds and bed-shakings associated with you struggling for your life in the night.... every night... all night long.

We suggest that you read our other snoring-related pages to find out more.

If this page wasn't where you wanted to be, then from this 'obstructive-sleep-apnea' page, go back to the home page.

Or, return to the snoring section intro page page where we have a table of links to all the other snoring-related pages in this section of MHT.

PLEASE be aware that by using this site you agree to our Terms and Conditions. If you foolishly click this Terms and Conditions link, you'll be snoring in no time.

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