Sleep Apnea

Q: What are the symptoms of sleep apnea?

Symptoms include: chronic loud snoring, intermittent pauses in breathing during sleep, abrupt awakening with gasping or choking, headache, dry mouth or sore throat in the morning, excessive daytime sleepiness, difficulty concentrating during the day, high blood pressure and mood changes, including depression or irritability.

Q: How is sleep apnea treated?

The primary treatment for sleep apnea is CPAP – continuous positive airway pressure. The patient attaches a face mask that is attached to a tube and respiratory machine that blows pressurized air into the mask and through the airways during sleep. This helps keep the airways open.

Q: How can sleep apnea impact asthma?

It can cause or worsen gastroesophageal reflux disease (GERD), an asthma trigger. It can cause swelling and irritation of airways, leading to a nighttime asthma flare

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A person wearing a sleep apnea mask lies in bed on their back, covered by a white duvet. They are wearing gray pajamas. A wooden bedside table holds a phone and other items. The floor is wooden with a zigzag-patterned rug nearby.

What is sleep apnea?

Sleep apnea occurs when muscles relax during sleep, causing soft tissue in the back of the throat to collapse and block the upper airway – sometimes for 10 seconds or longer.

A nighttime snore might be obstructive sleep apnea, a disorder in which breathing is briefly and repeatedly interrupted during sleep. The result is a reduction in airflow and oxygen to the lungs, causing episodes of gasping, gagging, choking and coughing. Sleep apnea and asthma symptoms both can cause breathing problems at night.

Sometimes people with sleep apnea wake up and are not aware these episodes are happening multiple times each night.

Who has sleep apnea?

More than 18 million American adults have sleep apnea, according to the National Sleep Foundation. It can occur in children. African-Americans, Hispanics and Pacific Islanders are at greater risk.

People with asthma are at increased risk of developing sleep apnea. Both conditions cause airway inflammation. Being overweight, smoking and alcohol use are also risk factors. Any type of sleep-disordered breathing can impact asthma control.

Sleep apnea tends to run in families. In some cases, it results from body structure – having a small upper airway, for example, or a recessed chin, small jaw or large neck size.

What are the symptoms of sleep apnea?

Symptoms include:

Chronic, loud snoring
Intermittent pauses in breathing during sleep
Abrupt awakenings with gasping or choking
Headache, dry mouth or sore throat in the morning
Excessive daytime sleepiness
Difficulty concentrating during the day
High blood pressure
Mood changes, including depression or irritability

How is sleep apnea diagnosed?

If you suspect you have sleep apnea, schedule an appointment with your doctor. Keep track of your sleep patterns at night and fatigue levels during the day, and any other symptoms. Ask your bed partner to record snoring levels or if your breathing appears to stop for any length of time. You may want to ask your doctor for a referral to a sleep center, where you can get a precise diagnosis.

How is sleep apnea treated?

Doctors may first recommend lifestyle changes such as avoiding alcohol, quitting smoking and/or losing weight. You may need to stop taking any medications that relax the central nervous system – sedatives or muscle relaxers, for example. Some patients may benefit from special pillows that help them sleep on their side instead of their back.

If you have sleep apnea, you may be referred to a sleep specialist to complete a sleep study. It would be done at the specialist’s office, in a hospital, or at your home. The sleep specialist will determine a treatment plan for you. You may be given a respiratory machine called a CPAP – continuous positive airway pressure. This is the primary sleep apnea treatment.

How does CPAP work? The patient uses a face mask that is attached to a tube from the respiratory machine. It blows pressurized air into the mask and then into the airways. This helps keep the airways open during sleep.

Secondary treatments may include:

Surgical procedure to widen the airway by removing tissue
Dental device to reposition the lower jaw and increase airflow
An implant placed in the upper chest to stimulate muscles and restore normal breathing

The U.S. Food and Drug Administration (FDA) recently approved the first sleep apnea medication. It is called Zepbound® (tirzepatide). Zepbound treats moderate to severe obstructive sleep apnea in adults with obesity. It is used in combination with a reduced-calorie diet and increased physical activity.

How can sleep apnea impact asthma?

Sleep apnea can cause or worsen gastroesophageal reflux disease (GERD), an asthma trigger. It can cause airway inflammation and irritation, leading to a nighttime asthma exacerbation. This can lead to a difficult cycle where each condition worsens the other, causing sleep disturbances.

Asthma patients should talk with their doctor about obstructive sleep apnea risk factors. They should continue to take asthma medications as prescribed if diagnosed with sleep apnea. Controlling airway inflammation is essential for asthma treatment.