Sleep Apnea is a common disorder that affects millions of men, women and children but is often undiagnosed, despite the potentially serious consequences of the disorder. It is estimated that at least ten million Americans have unrecognized Sleep Apnea.

"Apnea" is a Greek word meaning "without breath"; those with apnea literally stop breathing in their sleep. An apnea is clinically defined in adults as a cessation of breath that lasts at least ten seconds and in children as a cessation of breath that lasts the equivalent of two-and-a-half missed breaths. In addition to apneas, hypopneas are often present. "Hypopnea" also comes from Greek: "hypo" meaning "beneath" or "less than normal" and "pnea" meaning "breath." A hypopnea is not a complete cessation of breath but a reduction in airflow or a struggle to breathe. With each apnea and hypopnea, the oxygen level in the bloodstream typically drops.

Various Types of Apnea

Scientists agree that there are 3 types of sleep apnea: Obstructive, Central and a combination of both.

Obstructive Sleep Apnea

Obstructive Sleep Apnea is characterized by repetitive pauses in breathing during sleep due to the obstruction and/or collapse of the upper airway (throat), usually accompanied by a reduction in blood oxygen saturation, and followed by an awakening to breathe. This is called an apnea event. Respiratory effort continues during the episodes of Apnea. An analogy might be helpful: OSA is like putting your hand over your vacuum cleaner intake nozzle. Your hand blocks all air from getting through (upper airway collapse) even though the vacuum cleaner is still applying suction (respiratory effort continues). The vacuum cleaner is usually straining somewhat at this time, and so does the human body.

Central Sleep Apnea

Central Sleep Apnea is defined as a neurological condition causing cessation of all respiratory effort during sleep, usually with decreases in blood oxygen saturation. To return to the vacuum cleaner analogy: central Sleep Apnea would be like pulling the plug on the vacuum cleaner. No power, no suction: if the brainstem center controlling breathing shuts down there's no respiratory effort and no breathing. The person is aroused from sleep by an automatic breathing reflex, so may end up getting very little sleep at all.

Note that CSA, which is a neurogical disorder, is very different in cause than OSA, which is a physical blockage - though the effects are highly similar.

Mixed Apnea

Mixed Sleep Apnea, as the name suggests, is a combination of the previous two. An episode of mixed Sleep Apnea usually starts with a central component and then becomes obstructive in nature. Generally the central component of the Apnea becomes less troublesome once the obstructive Apnea is treated.

With each apnea, the brain receives a signal to arouse the person from sleep in order to resume breathing, but consequently sleep is extremely fragmented and of poor quality. People with untreated Sleep Apnea are generally not even aware of the awakenings but only of being extremely sleepy during the day. They may, however, realize that they snore or gasp for air during sleep. Loud snoring, punctuated with periods of silence (the apneas), is typical but is not always present, especially in children.

Dont be left undiagnosed or untreated...

The consequences of untreated Sleep Apnea include high blood pressure and other cardiovascular disease, and weight gain. People with untreated Sleep Apnea may also complain of falling asleep inappropriately, morning headaches, memory problems, feelings of depression, reflux, nocturia (a need to use the bathroom frequently at night), and impotence. Children with untreated Sleep Apnea may be hyperactive. Untreated Sleep Apnea, like sleep deprivation, may be responsible for job impairment and motor vehicle accidents. Apnea is a concern with certain medications and general anesthesia.

Risk Factors

Your answers to this quiz will help you decide whether you may suffer from Sleep Apnea:

1. Are you a loud, habitual snorer?
    Yes  No

2. Do you feel tired and groggy on awakening?
    Yes  No

3. Are you often sleepy during waking hours and/or can you fall asleep quickly?
    Yes  No

4. Are you overweight and/or do you have a large neck?
    Yes  No

5. Have you been observed to choke, gasp, or hold your breath during sleep?
    Yes  No

If you or someone close to you answers "yes" to any of the above questions, you should discuss your symptoms with your physician or a sleep specialist. Or ask the American Sleep Apnea Association for more information on the diagnosis and treatment of Sleep Apnea. Different treatment options exist; which one is right depends upon the severity of your apnea and other aspects of the disorder. Talk to your doctor about your choices. Untreated, Sleep Apnea can be extremely serious and cannot be ignored.