Causes and Risk Factors

Causes vary by type:

  • OSA causes/risks: Excess weight/obesity (fat deposits narrow the airway), a thick neck circumference, narrowed airway (due to genetics, large tonsils, or adenoids), being male, older age, smoking, alcohol/sedative use, and chronic nasal congestion.

  • CSA causes/risks: Often associated with underlying medical problems, such as heart failure, stroke, or other brainstem injuries, as well as the use of certain narcotic pain medications. 

Sleep Apnea

Sleep apnea is a serious sleep disorder where breathing repeatedly stops and starts throughout the night, preventing restorative sleep and potentially leading to severe long-term health complications like heart disease, stroke, and type 2 diabetes. The primary symptoms include loud snoring and overwhelming daytime sleepiness. 

Types

There are three main types of sleep apnea:

  • Obstructive Sleep Apnea (OSA): The most common type, occurring when throat muscles relax and block the airway, leading to gasping or choking sounds as breathing resumes.

  • Central Sleep Apnea (CSA): A rarer form where the brain fails to send proper signals to the muscles that control breathing, so no effort is made to breathe for a period.

  • Complex Sleep Apnea: A combination of both obstructive and central sleep apnea. 

Symptoms

Symptoms of both types of sleep apnea overlap significantly:

  • Loud, chronic snoring (more common in OSA).

  • Observed episodes of stopped breathing during sleep.

  • Gasping or choking for air during sleep.

  • Excessive daytime sleepiness, fatigue, and irritability.

  • Waking up with a dry mouth or sore throat.

  • Morning headaches.

  • Difficulty concentrating, memory problems, or mood changes.

  • Restless sleep or insomnia. 

Treatments

Treatment aims to restore normal breathing during sleep and alleviate symptoms. 

  • Continuous Positive Airway Pressure (CPAP) Therapy: The most common and effective treatment for OSA, using a mask to deliver a constant stream of pressurized air that keeps the airway open during sleep.

  • Lifestyle Changes:

    • Weight loss: Can significantly improve or eliminate symptoms, especially for those who are overweight.

    • Avoiding alcohol and sedatives: These relax throat muscles and can worsen symptoms.

    • Quitting smoking: Smoking increases inflammation and fluid retention in the upper airway.

    • Changing sleep position: Sleeping on your side rather than your back can help keep the airway open.

  • Oral Appliances: Custom-made dental mouthpieces can reposition the jaw and tongue to keep the airway open, often effective for mild to moderate OSA.

  • Surgery or Implantable Devices: For some cases, procedures to reduce excess tissue or stimulate tongue muscles may be an option if other treatments fail.

  • Medication: In December 2024, the FDA approved the first medication for obstructive sleep apnea called Zepbound (tirzepatide), which works via weight loss. Otherwise, medication is typically used to manage underlying conditions in CSA or related symptoms. 

Consult a healthcare provider or sleep specialist if you suspect sleep apnea, as proper diagnosis through a sleep study is essential. 

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