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leep apnea (AP-ne-ah) is a disorder is more com- that pauses your during mon in those who are overweight, have Ssleep. You may experience shallow high pressure, and/or have a family breaths or breathing pauses that last from history of the disorder. Using alcohol, seda- a few seconds to minutes. Sleep apnea tives, or tranquilizers relaxes the muscles in causes you to move out of deep sleep your throat and, thus, should be avoided. and into light sleep, disrupting your sleep Central sleep apnea is more common pattern and causing you to become tired in men and people older than 65 years of during the day. age, especially if they have other risk fac- The 2 kinds of sleep apnea are called tors. Heart disorders, such as atrial fibril- obstructive and central. Obstructive sleep lation or congestive heart failure, also put apnea is the most common and occurs you at a higher risk of central sleep apnea. because the airway has collapsed or is blocked. It is particularly more common What are the warning signs? in people who are overweight, but it can Most people who have sleep apnea aren’t affect anyone. The muscles in the back aware they have it, because it occurs dur- of your throat relax, causing your airways ing sleep; however, a bed partner may to narrow and close, ultimately stopping notice the signs. The most common warn- breathing momentarily. The brain is alerted ing sign is loud . Awakening with a that the level in the blood is low, dry mouth or sore throat, chronic morning and you are awakened briefly. headaches, or are also Central sleep apnea, although less com- warning signs of sleep apnea. mon, occurs when the area of your brain If your snoring is loud enough to disturb that controls breathing does not send sig- the sleep of others, or yourself, it is impor- nals to the breathing muscles. This results tant to contact your doctor. Excessive day- in brief periods with no breathing. One of time drowsiness, sometimes causing you the most common causes of central sleep to fall asleep during your daily activities, is apnea is heart disease. also a warning sign that professional assis- tance is needed. How do I know if I’m at risk? Fighting drowsiness during the day, at Anyone, young or old, men or women, work, or while driving, is a common sign can experience sleep apnea. Although it is of sleep apnea. The lack of sleep can also more common in adults, with 1 in 10 peo- make you feel irritable or depressed, or ple older than 65 years affected, it is pos- cause you to have mood swings. sible for children to develop the disorder. However, certain risk factors may cause What tests do I need? you to become more prone to developing In order to diagnose sleep apnea, doctors

the disorder. will look at your medical and family history, " This page may be reproduced noncommercially by federal practitioners for their patients.

AUGUST 2011 • FEDERAL PRACTITIONER • 45 PATIENT INFORMATION

perform a physical exam, and order a sleep How is it treated? study. After your doctor evaluates your Lifestyle changes, such as losing weight or symptoms, he or she will determine if you smoking cessation, may be recommended need to see a sleep specialist. for milder cases of sleep apnea. It is also A physical examination may show what recommended that you avoid sleeping on is causing the sleep apnea. However, a your back. This may cause your tongue sleep study may be necessary for diag- and soft palate to block your airway. Using nosis. A polysomnogram (poly-SOM-no- a saline nasal spray will keep your nasal gram), or PSG, is a test that your doctor passages open, allowing more oxygen to may recommend. A PSG examines your reach your and preventing snoring. breathing patterns during sleep with a However, this is only recommended for home-based portable monitor. It records short-term use. brain activity, eye and other muscle activity, If these changes do not improve your amount of oxygen in the blood, and how , your case may be much air moves in and out of your lungs more severe. Other treatments, such as during sleep. therapy or, in some cases, surgery, may be The process is painless, and you should necessary. sleep as usual, except you will have sen- Continuous , or sors on your scalp, face, chest, limbs, and CPAP, is one of the most beneficial thera- fingers to monitor the activity in your body. pies for sleep apnea. A machine admin- isters air pressure through a mask that How can I avoid the problem? is placed over your nose during sleeping Sleeping on your side, rather than on your hours. The pressure of the air is slightly back, can help prevent the symptoms more intense than normal breathing, but of sleep apnea. It is also important to stay it is the right amount to keep your airway away from stimulants, such as alcohol, passages open to prevent sleep apnea or when bedtime is approaching. Stimulants snoring. relax the muscles and will worsen the un- For more information on sleep apnea, visit wanted effects of sleep apnea. the American Sleep Apnea Association’s Because obesity can cause complica- Web site at http://www.sleepapnea.org/ l tions with sleep apnea, living a healthy lifestyle is important. The excess soft fat tissue thickens the walls of the windpipe and causes the inside opening to become narrow, making it harder to keep open. A mouth piece, or an oral appliance, may also help you breathe better while sleeping. A dentist or orthodontist can customize a plastic mouthpiece that will lower your jaw 7 Century Drive, Suite 302

and tongue, keeping airways open. Parsippany, NJ 07054-4609 "

46 • FEDERAL PRACTITIONER • AUGUST 2011