A Comprehensive Guide to Sleep Apnea

Updated: May 25, 2023

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Obstructive Sleep Apnea (OSA) is a disorder that occurs particularly in older and overweight adults. If you have sleep apnea, your breathing briefly and repeatedly stops during sleep – generally a pause of at least ten seconds’ duration. The muscles in the back of your throat do not continually keep the airway open. In central sleep apnea, the brain fails to properly control breathing during sleep. However, OSA is far more common than central sleep apnea.

Sleep apnea can cause low blood oxygen levels. This deprivation, combined with the lack of sleep itself, can lead to mood and memory problems. It also increases the chance that you will be drowsy during the day and cause a motor vehicle or other accident. In fact, the Center for Disease Control and Prevention (CDC) has declared sleep disorders a public health epidemic – and linked it to diabetes, depression, hypertension, heart disease, cancer, and obesity. Untreated sleep apnea has also been linked to parasomnias (involuntary behaviors like sleepwalking, repeated drops in blood oxygen levels), and premature death.

The Importance of Sleep

Sleep is essential to good human health. Research in mice has even shown that sleep functions as a kind of sewer system for the brain, flushing out beta-amyloid plaques known to accumulate in the brains of individuals with Alzheimer’s. The longer you are awake, the more pressure builds up for your body to sleep —and the harder it is to be alert.

A human’s sleep-wake cycle is determined by both homeostasis (the neurobiological need to sleep) and circadian pacemaker (an internal body clock that completes a cycle every 24 hours.) There is also a light/dark cycle which generally means sleeping during the dark periods of the day and being wakeful when it is light outside. If your job or lifestyle is out of phase with this natural cycle, you will likely have problems being alert during the day.

The important thing to know about the sleep-wake cycle is that it is internal, and you cannot fight it. Sleepiness is your brain’s neurobiological response to deprivation: Sleep debt catches up with your body if you don’t get enough shuteye. That is why it is so important not only to treat sleep apnea at night, but to establish healthful habits that are conducive to getting regular, adequate sleep.

Treating Sleep Apnea

Doctors generally treat obstructive sleep apnea with a Continuous Positive Airway Pressure device (CPAP). This highly effective motorized device pumps air through a mask over your mouth and/or nose. The CPAP gently blows air into your airway and keeping it open as you sleep. Its health benefits, when used correctly and consistently, are enormous for anyone living with sleep apnea. The most important part of your treatment is to use the CPAP whenever you sleep.

Some people can treat apnea issues with surgery to remove tissue in the upper airway. Those who can’t tolerate wearing a breathing mask all night may use as mandibular advancement devices in-side the mouth at night to open up space in the airway by pushing out the lower jawbone, and they make it less likely that the upper airway collapses during sleep. But for specialists, the first-choice, most-studied remedy is CPAP. It is the established, most effective therapy for dealing with sleep apnea.

Sleep medicine is a relatively new field, and researchers are still learning about how best to treat sleep apnea. No one has proven that CPAP helps those with sleep apnea live longer per se. But studies do show it can reduce blood pressure and snoring, improve daytime sleepiness, and reduce the number of apneas at night. This pays off in better mood, productivity, and quality of life.

Untreated sleep apnea has also been linked to parasomnias which include involuntary behaviors like sleepwalking, repeated drops in blood oxygen levels), and premature death.

Lifestyle

Living With Sleep Apnea

Avoid sleeping on your back. Sleeping on your back makes it easier for your tongue and throat muscles to relax, potentially blocking your airway. You can also raise the head of the bed a bit; studies have shown a four inch increase can help reduce snoring and mild OSA.

As with many diagnoses, diet and exercise play a huge part into the state of our health, or lack thereof. Weight loss ultimately decreases the fatty tissue built up in the throat and helps with increased air flow during sleep.

Smoking irritates and causes inflammation of the sensitive tissues in the throat and lungs. If you’ve been diagnosed with sleep apnea you should seriously consider quitting, if not reducing the amount you smoke.

Another evil to cut back on or quit is alcohol. Along with the relaxing effect of a couple of drinks, alcohol can loosen the throat muscles allowing them to collapse and cause an obstruction in the airway. And while alcohol can make you sleepy, it also disrupts your necessary restorative deep sleep cycles.

Statistic say some 12–25 million Americans suffer from sleep disorders, so it’s good to know you are not alone. There is a huge community with support groups across the country. One such organization is called A.W.A.K.E network, and they offer education and support groups in your area. The American Sleep Association offers interactive group discussion online, and cover a variety of different sleep disorders.

Tips For Living With Sleep Apnea

: Consistent exercise, even a half hour walk every other day, is beneficial because it helps with weight loss, but it also gets fresh air pumping through your lungs and veins and makes you tired so you can sleep better.
: Your bedroom should be a little cooler than the rest of the house, void of extraneous noise (although background ‘white noise’ can sometimes help), and be dark—turn bright lights off and if they shine through the windows, invest in blackout curtains for your room.
: If you’re not getting enough sleep, that afternoon coffee or coke may be the culprit. Keep an eye on, and limit, your caffeine intake.
: As best as you can, go to bed and get up at the same time every day. And keep the bedroom for sleeping. Remove the TV, tablet, and any other distracting type of electronics.

Working With A CPAP Machine

CPAP therapy only works if you use it correctly. Address any issue with your CPAP with the doctor who prescribed it for you as well as your supplier contact. Your doctor can explore options to improve the treatment. This may mean adjusting the CPAP’s pressure timing and settings. The answer could also be a new mask, nasal pillows, or a device with a humidifier chamber or auto-adjustable pressure settings.

Use your machine every time you sleep, even for naps.

How To Use A CPAP Machine

Always Use It

Use your machine every time you sleep, even for naps. To correctly assess whether your therapy is working, it is essential that you use your prescribed device regularly. Your CPAP comes with a data card that shows how often it is in use and whether its pressure settings are cutting back on apnea events. Your doctor may use this card check to see whether you still experience excessive sleepiness during the day.

Another reason to be diligent about using your CPAP: Some insurance companies check the data card from patients’ machines. If you rent a CPAP machine but do not use it regularly, Medicare or your insurance provider may stop payments on it.

Use Patience

Be patient when you first use your CPAP machine or breathing device. Some users experience congestion, runny nose, dry mouth, dry eyes, or nosebleeds when they adjust to their new machine. If you experience stomach discomfort or bloating, you should stop using your CPAP and contact your doctor.

Some insurance companies check the data card from patients’ machines. If you rent a CPAP machine but do not use it regularly, Medicare or your insurance provider may stop payments on it.

CPAPs have evolved over the years and continue to do so. Airway pressure masks have gotten smaller and quieter, and you can try different models if your first CPAP does not work for you. Different products come out on the market all the time to help sleep apnea. For you, the answer to your discomfort may be a dentist-fitted mouthpiece or a device to discourage back sleeping during the night. There is even a surgical implant that pushes the tongue forward with each breath.

Don’t Forget Your Dentist

If your personal CPAP includes a mouthpiece, ask your dental professional how to properly care for it. He or she can even adjust the device for you. It is common to feel some discomfort after a device is adjusted and until your mouth and facial muscles get used to the new fit. Follow up with your dentist after six months and then annually to see if your mouthpiece needs adjusting or replacing.

Even though you may have undergone sleep studies before you were diagnosed with sleep apnea, you may need to do it again. This is especially true if your weight changes or you still have sleep issues. This will help your doctor monitor your response to your treatment. Some employers even require this test.

Understand How To Set Up And Properly Clean All Parts Of Your CPAP

Be sure to refill prescriptions on time for all of the device’s replaceable parts, including the tubes, masks, and air. Cleaning the mask and washing your face before putting your mask on can help make a better seal between the mask and your face.

If you are going abroad, bring a universal power adapter that will work in most countries.

Work Your CPAP Into Your Travel Plans

Carry a copy of your prescriptions for a PAP machine, mask, filters, tubing and humidifier along with your other essentials. Ask your airline what you may need to do to prepare for going through airport security. Your doctor can provide a letter if needed. Keep your machine clean by putting it in a large, clear plastic bag and securing that bag in its travel case. You can ask a TSA agent to wear new gloves and clean the table. He or she can even use a new explosive trace device sampler before inspecting your CPAP. If you are going abroad, bring a universal power adapter that will work in most countries.

Even for the shorter trips, it’s important to bring all your CPAP supplies when you spend the night away from home. Make sure to bring your own extension cord and a backup power supply like a portable battery, which you should charge before you leave home. It’s also important get to bed at the same time you would at home.

Plan Ahead For Any Surgery

Tell your surgeon and medical professionals that you have sleep apnea. Your surgical team may need to take extra steps to ensure that your airway remains open during your procedure.

Adjust Your Attitude

Proper use of a CPAP is life-changing. You can do many of the same things you did before acquiring your device, and now you can be more fully awake to enjoy it all. You can be sexually active even with your CPAP – in fact, a recent study suggests that intimacy is easier by wearing a CPAP to bed. When you consider the problems dangers of untreated apnea, you may find that the inconvenience of sleep apnea therapy is manageable.

Health

How You Can Stay Healthy With Sleep Apnea

You don’t have to be overweight to have sleep apnea (although people who carry extra weight are at a higher risk), but that doesn’t mean you’re completely healthy, nor does it mean your airways are getting enough of a workout. Simple daily walks can get fresh air pumping through your lungs and veins and also makes you tired.

Establish and practice healthy sleep hygiene. Practices, rituals, and good choices can help you get to sleep on time, stay asleep longer, and have a solid, restorative sleep every single night. Good practices include eliminating electronics from the bedroom, and coming up with a routine to get your mind and body relaxed and ready for sleep. Some people take a warm bath or shower, while others do a 10 minute meditation series or a simple, gentle yoga series.

If you do want a snack before you go to bed, look for foods that aid in promoting sleep. Foods with tryptophan, magnesium, calcium, and B6. These include dairy product, nuts & seeds, fruits, and vegetables.

Talk to your doctor about the medications you take, including over-the-counter and herbal remedies. Medications such as muscle relaxants and tranquilizers can make sleep apnea worse.

Be aware that sleep apnea can run in families, and some diagnoses can be made as early as two years old. Look for inherited facial features—a large overbite, large tonsils, or a recessed chin—can all contribute to sleep apnea issues. And older women are three times more likely than premenopausal women to have OSA, due to the decreased level of hormones.

Sleep Apnea Health Tips

: Snoring is the most common indicator of sleep apnea. If your partner of a friend notices or complains about your constant snoring, you should mention it to your doctor.
: Many drinks have the essential vitamins and minerals that aid with sleep, so help yourself to a cup of warm milk, almond milk, chamomile tea, peppermint tea, or tart cherry juice.
: Avoid heavy meals within three hours of bedtime, but also avoid foods that cause your body to work while you are trying to sleep. These include red meat, celery, dark chocolate, and spicy foods.
: Smokers put themselves at greater risk of developing sleep apnea. Smoking can make your nose stuffy and irritable, and causes inflammation of the sensitive tissues in the throat and lungs.
: Regular exercise can help with sleep apnea diagnoses by improving circulation, lowering blood pressure, decreasing tension, depression and anxiety, and affording more energy and endurance.

Practice Good, Overall Sleep Health

Both sleep apnea patients and society at large have trouble getting all the sleep they need. Your CPAP therapy can be more effective if you practice good habits conducive to a good night’s sleep. You should also be aware that sleep apnea therapy doesn’t cure insomnia. If you have trouble falling asleep, staying asleep, or waking up unrefreshed, talk to your doctor about treatment options for that issue.

Improve Sleeping Positions

Sleeping on your side can help prevent obstruction of airways. Try lying on your side rather than your back while sleeping to improve breathing problems. Some heavy snorers or mild cases of sleep apnea experience fewer breathing problems this way.

Doctors often recommend patients with sleep apnea to sleep on their side or stomach, or elevate their head. These positions can reduce snoring and help airways stay clear.

It’s also important to sleep on something comfortable that offers support. Most good quality mat-tresses last nine or ten years. Make sure you have all the comfortable, allergen-free pillows you need to make your bed feel inviting for a deep slumber. For extra comfort, investing in adjustable bed set up might also be an option.

Find A Nighttime Routine That Works For You

Stress and excitement can make it more difficult to get in the appropriate amount of sleep hours that your body requires. This can mean getting offline your phone and computer well before bedtime or turning off the TV.

Reconsider naps. Napping has short-term benefits during the day, but if you take naps and can’t fall asleep at the end of the evening, consider waiting until the end of the day to lie down.

Keep Your Bedroom Inviting And Conducive To Sleep

For you, this can mean blackout curtains, white noise machines, or fans. Check your room for noises or other distractions. If you work from home, keep your office and paperwork elsewhere. If you associate a particular activity or item with anxiety about sleeping, omit it from your bedtime routine.

Adjust Light To Help Manage Your Circadian Rhythms

Avoid bright light in the evening and expose yourself to sunlight in the morning. Computers can make it more difficult to fall asleep because the light that emanates from their screens amps up brain activity. Check your electronics for light settings if you use them after dark. There may even be apps or settings on your electronic readers to help with this. You can also limit your bedtime read-ing to physical books.

It’s also important to be consistent in sleep routines. This helps regulate your internal clock. Even on weekends and holidays, try to go to sleep and wake up at the same set time.

Mobility

How Your Can Stay Mobile With Sleep Apnea

Don’t let your condition define you, and DON’T let it stop you from traveling. Today’s technology lets OSA patients travel with ease. A little extra trip prep is all you needs. Things to consider when flying include: pack your CPAP as a carry on and keep your prescription with you; before the flight, check with the airline about on board use and electrical outlets.

Outdoors enthusiasts can even take their machine with them when they go camping, hunting, and/or fishing as this Transcend video demonstrates.

Not all CPAP machines used to treat sleep apnea are the same. The most common device has a mask for the patient to wear over their nose and mouth at night which provides continuous air pressure and keeps the nasal passages open. Other sleep apnea devices include oral appliances, and adjustable airway pressure devices. Units that supply bilevel positive airway pressure (BPAP) are also available.

Sleep Apnea Mobility Tips

: CPAP masks vary from fit to style to size and weight. It’s recommended that you make a trip to your local sleep center or clinic to test out the masks available. This gives you control over your condition and ensures you find the mask that’s the right fit for you, which will increase the chances that you’ll actually use it!
: If other options and treatments have failed, there are a number of surgical options available from tissue removal and/or shrinkage, jaw repositioning, implants, and nerve stimulation. Make sure you talk to your doctor about other treatments thoroughly before you start thinking about surgery.
: There are several oral appliances that look like mouth guards and work to stabilize the jaw to maintain proper upper airway during sleep.

Make Conscious Health Choices

You Are What You Eat

Your diet plays a huge role in many of your daily functions including your ability to get a good night’s rest. If you suffer from sleep apnea paying close attention to what you eat can help ease your condition and result in a better slumber.

Limit Alcohol And Quit Smoking

Limit your alcohol intake. Drinking alcohol relaxes upper airway breathing muscles and can cause you to wake frequently during the night. Smoking also can worsen your sleep apnea condition. Smoking exacerbates swelling in the upper airway, worsening both your apnea and your snoring.

Cut Back Caffeine

Caffeine lasts about five to six hours in the body before wearing off. But if it’s a regular part of your day, phase it out gradually: limit yourself to one cup in the morning and perhaps a cup of tea with less caffeine in the afternoon.

Avoid Heavy Or Spicy Meals In The Evening

You could get indigestion and have an even harder time getting to sleep. Have your last meal two to three hours before bedtime. If you are truly hungry, try eating something light 45 minutes
before bed.

Practice Good Health and Wellness Habits

In some cases, self-care might be highly beneficial to deal with obstructive sleep apnea. Changing small habits on a daily basis could make a tremendous difference in your sleep quality.

Exercise Regularly

Light exercise is better than none at all. People who are more physically active sleep longer and more deeply than those who are sedentary. Even a small effort every day like going for a brisk walk could be beneficial to improving your sleep schedule.

Lose Weight

For adults with sleep apnea, it’s a great idea to make extra efforts in establishing a consistent fit-ness and exercise schedule. Studies have shown that even light exercise and weight loss can help cut the severity of the disorder.

Being overweight is a well-known risk factor for people with sleep apnea. If excess weight is a major contributing factor to your condition, losing some extra weight may help resolve the problem.

Don’t Self-Medicate

Work with your healthcare team and consult your doctor before taking any over-the-counter medications. Some sleep aids, even those prescribed, can impair breathing for someone with sleep apnea. Studies do show that Ramelteon, which works like a natural substance called melatonin that your body produces, is not harmful in mild or moderate sleep apnea cases. Ramelteon may be helpful in regulating your sleep-wake cycle.

Technology

Technology To Help Sleep Apnea Patients

The Continuous Positive Airway Pressure (CPAP) machine is the best device in dealing with sleep apnea. Studies indicate most users don’t like the treatment and/or stop using it because of discomfort. The key to a successful CPAP machine is a properly fitting mask. There are also several tips and tricksthat make CPAP treatment easier. There are a number of companies that now market equipment for reliable home assessment of sleep apnea, including:

Cleveland Medical Devices’ “SleepScout”
Instant Diagnostic Services’ home sleep testing systems
ResMed’s “Apnea-Link”
Itmar-Medical’s “Watch-PAT”

If you have a tendency to sleep on your back, the Night Shift is a device worn on the back of the neck which vibrates when sleepers shift to their back, and slowly increases in intensity until they change position.

Sleep Apnea Technology Tips

: As we get older our attention to our eating habits tend to slack, and eating a healthy and proper diet can go a longer way in the battle with sleep apnea. With all the new technology today comes several meal delivery services. Many meal delivery services now offer specialized meal plans for specific diets which can be delivered to your home on a schedule. If you feel you need to improve your eating habits, perhaps one is a good fit for you.
: The 2017 CES Global Stage for Innovation featured a section sponsored by the National Sleep Foundation and a number of notable products were featured. Take a look at the Top 8 Innovations from that conference.

A New Attitude On Sleep

Sleep apnea therapy means changing your relationship with sleep. Sometimes it helps to think long-term rather than short term while you are adjusting to a new routine. Don’t fixate on today or tomorrow. Instead of worrying about getting up at the right time tomorrow morning or being alert for a specific event, focus on your overall health. It may take time and patience to tailor the right therapy to your life, but the benefits of living with CPAP – and a new sleep routine – will pay off in the long run.

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