What is sleep apnea?


Sleep apnea is a disorder characterized by a reduction or pause of breathing (airflow) during sleep. It is common among adults but rare among children. Although a diagnosis of sleep apnea often will be suspected on the basis of a person's medical history, there are several tests that can be used to confirm the diagnosis. The treatment of sleep apnea may be either surgical or nonsurgical.
An apnea is a period of time during which breathing stops or is markedly reduced. In simplified terms, an apnea occurs when a person stops breathing for 10 seconds or more. If you stop breathing completely or take less than 25% of a normal breath for a period that lasts 10 seconds or more, this is an apnea. This definition includes complete stoppage of airflow. Other definitions of apnea that may be used include at least a 4% drop in oxygen in the blood, a direct result of the reduction in the transfer of oxygen into the blood when breathing stops.

Apneas usually occur during sleep. When an apnea occurs, sleep usually is disrupted due to inadequate breathing and poor oxygen levels in the blood. Sometimes this means the person wakes up completely, but sometimes this can mean the person comes out of a deep level of sleep and into a more shallow level of sleep. Apneas are usually measured during sleep (preferably in all stages of sleep) over a two-hour period. An estimate of the severity of apnea is calculated by dividing the number of apneas by the number of hours of sleep, giving an apnea index (AI in apneas per hour); the greater the AI, the more severe the apnea.

Sleep apnea is formally defined as an apnea-hypopnea index of at least 15 episodes/hour in a patient if they do not have medical problems that are believed to be caused by the sleep apnea. This is the equivalent of approximately one episode of apnea or hypopnea every 4 minutes. High blood pressure, stroke, daytime sleepiness, congestive heart failure (low flow of blood to the heart), insomnia, or mood disorders can be caused or worsened by sleep apnea. In the presence of these conditions, sleep apnea is defined as an apnea-hypopnea index of at least five episodes/hour. This definition is stricter because these individuals may be already experiencing the negative medical effects of sleep apnea, and it may be important to begin treatment at a lower apnea-hypopnea index.
  • What are the types of sleep apnea?

    There are three types of sleep apnea:
    1. central sleep apnea (CSA),
    2. obstructive sleep apnea (OSA), and
    3. mixed sleep apnea (both central sleep apnea and obstructive sleep apnea).

    During sleep, the brain instructs the muscles of breathing to take a breath.

    Central sleep apnea (CSA) occurs when the brain does not send the signal to the muscles to take a breath, and there is no muscular effort to take a breath.

    Obstructive sleep apnea (OSA) occurs when the brain sends the signal to the muscles and the muscles make an effort to take a breath, but they are unsuccessful because the airway becomes obstructed and prevents an adequate flow of air.

    Mixed sleep apnea, occurs when there is both central sleep apnea and obstructive sleep apnea.
  • What is central sleep apnea and what causes it?

    Central sleep apnea (CSA) occurs when the brain does not send the signal to breathe to the muscles of breathing. This usually occurs in infants or in adults with heart disease, cerebrovascular disease, or congenital diseases, but it also can be caused by some medications and high altitudes.
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