Sleep apnea is a common condition in which your breathing stops and restarts many times while you sleep. This can prevent your body from getting enough oxygen. You may want to talk to your healthcare provider about sleep apnea if someone tells you that you snore or gasp during sleep, or if you experience other symptoms of poor-quality sleep, such as excessive daytime sleepiness.
There are two types of sleep apnea.
- Obstructive sleep apnea happens when your upper airway becomes blocked many times while you sleep, reducing or completely stopping airflow. This is the most common type of sleep apnea. Anything that could narrow your airway such as obesity, large tonsils, or changes in your hormone levels can increase your risk for obstructive sleep apnea.
- Central sleep apnea happens when your brain does not send the signals needed to breathe. Health conditions that affect how your brain controls your airway and chest muscles can cause central sleep apnea.
Your partner may alert you to some of the symptoms of sleep apnea, such as:
- Breathing that starts and stops during sleep
- Frequent loud snoring
- Gasping for air during sleep
You may also notice the following symptoms yourself:
- Daytime sleepiness and tiredness, which can lead to problems learning, focusing, and reacting
- Dry mouth or headaches
- Sexual dysfunction or decreased libido
- Waking up often during the night to urinate
Children who have sleep apnea may be overactive and may experience bedwetting, worsening asthma, and trouble paying attention in school.
What causes sleep apnea?
Central sleep apnea is caused by problems with the way your brain controls your breathing while you sleep.
Obstructive sleep apnea is caused by conditions that block airflow through your upper airways during sleep. For example, your tongue may fall backward and block your airway.
Your age, family history, lifestyle habits, other medical conditions, and some features of your body can raise your risk of sleep apnea. Healthy lifestyle changes can help lower your risk.
What raises the risk of obstructive sleep apnea?
Many conditions can cause sleep apnea. Some factors, such as unhealthy lifestyle habits, can be changed. Other factors, such as age, family history, race and ethnicity, and sex, cannot be changed.
- Age: Sleep apnea can occur at any age, but your risk increases as you get older. As you age, fatty tissue can build up in your neck and the tongue and raise your risk of sleep apnea.
- Endocrine disorders, or changes in your hormone levels: Your hormone levels can affect the size and shape of your face, tongue, and airway. People who have low levels of thyroid hormones or high levels of insulin or growth hormone have a higher risk of sleep apnea.
- Family history and genetics: Sleep apnea can be inherited. Your genes help determine the size and shape of your skull, face, and upper airway. Also, your genes can raise your risk of other health conditions that can lead to sleep apnea, such as cleft lip and cleft palate and Down syndrome.
- Heart or kidney failure: These conditions can cause fluid to build up in your neck, which can block your upper airway.
- Large tonsils and a thick neck: These features may cause sleep apnea because they narrow your upper airway. Also, having a large tongue and your tongue’s position in your mouth can make it easier for your tongue to block your airway while you sleep.
- Lifestyle habits: Drinking alcohol and smoking can raise your risk of sleep apnea. Alcohol can make the muscles of your mouth and throat relax, which may close your upper airway. Smoking can cause inflammation in your upper airway, which affects breathing.
- Obesity: This condition is a common cause of sleep apnea. People with this condition can have increased fat deposits in their necks that can block the upper airway. Maintaining a healthy weight can help prevent or treat sleep apnea caused by obesity.
- Sex: Sleep apnea is more common in men than in women. Men are more likely to have serious sleep apnea and to get sleep apnea at a younger age than women.
A breathing device, such as a CPAP machine, is the most common treatment for sleep apnea. A CPAP machine provides constant air pressure in your throat to keep the airway open when you breathe in.
Breathing devices work best when you also make healthy lifestyle changes. Side effects of CPAP treatment may include:
- Dry eyes
- Dry mouth
- Runny nose
If you experience stomach discomfort or bloating, you should stop using your CPAP machine and contact your healthcare provider.
Depending on the type of sleep apnea you have, you may need another type of breathing device such as an auto-adjusting positive airway pressure (APAP) machine or a bilevel positive airway pressure (BPAP) machine. Living With Sleep Apnea has information about how to take care of your breathing device.
Oral devices, also called oral appliances, are custom-fit devices that you typically wear in your mouth while you sleep. There are two types of oral devices that work differently to open the upper airway while you sleep. Some hybrid devices have features of both types.
- Mandibular repositioning mouthpieces are devices that cover the upper and lower teeth and hold the jaw in a position that prevents it from blocking the upper airway.
- Tongue retaining devices are mouthpieces that hold the tongue in a forward position to prevent it from blocking the upper airway.
A new type of oral device was recently approved by the FDA for use while awake. The device delivers electrical muscle stimulation through a removable mouthpiece that sits around the tongue. You wear the mouthpiece once a day for 20 minutes at a time, for 6 weeks. The device stimulates the tongue muscle while awake to help prevent the tongue from collapsing backward and blocking the airway during sleep.
If you have sleep apnea, your provider may prescribe an oral device if you do not want to use CPAP or cannot tolerate CPAP. They will recommend that you visit a dentist who will custom make an appliance for you, make sure that it is comfortable, and teach you how to use it to get the best results.
Therapy for your mouth and facial muscles
Exercises for your mouth and facial muscles, also called orofacial therapy, may help treat sleep apnea in children and adults. This therapy helps improve the position of your tongue and strengthens the muscles that control your lips, tongue, upper airway, and face.
You may need surgery if other treatments do not work for you. Possible surgical procedures include:
- Adenotonsillectomy to remove your tonsils and adenoids
- Surgery to place an implant that monitors your breathing patterns and helps control certain muscles that open your airways during sleep
- Surgery to remove some soft tissue from your mouth and throat, which helps make your upper airway bigger
- Maxillary or jaw advancement surgery to move your upper jaw (maxilla) and lower jaw (mandible) forward, which helps make your upper airway bigger