Sleep apnea

Sleep apnea is a condition that occurs when your breathing stops repeatedly while you sleep, which briefly wakes you up throughout the night. You can stop breathing dozens of times an hour, although you may not be aware that you’re waking so often. The cause of your breathing pauses depends on the type of sleep apnea you have. A lack of restful sleep isn’t something to ignore—it can lead to severe daytime fatigue and may trigger health conditions, like heart problems.

Penn Medicine has nationally recognized sleep centers with specialists in sleep apnea care who can evaluate your condition using a range of diagnostic tools, including sleep studies and other specialized tests. Once you’re diagnosed, our providers can determine the best treatment option for you, which may include a positive airway pressure (PAP) device or surgery. With the right therapy, you can sleep uninterrupted and wake up feeling refreshed and ready for your day.

Difficulty breathing at night can be caused by one of three types of sleep apnea.

• Obstructive sleep apnea (OSA): This is the most common type of sleep apnea, and it’s caused by your throat muscles relaxing, which narrows or completely blocks your airway during sleep.
• Central sleep apnea: This type is less common and happens because your brain doesn’t send the right signals to the muscles that control your breathing during sleep.
• Complex sleep apnea: Also known as mixed sleep apnea, having this type means you experience both OSA and central sleep apnea.

The symptoms of sleep apnea are similar, whether you have obstructive, central, or complex sleep apnea. Your partner might notice that you stop breathing during sleep before you do. Symptoms may include:

• Pauses in breathing while sleeping
• Snoring and gasping for air during sleep
• Frequently waking up or feeling restless during sleep
• Waking up short of breath or with a dry mouth
• Night sweats
• Headaches in the mornings
• Daytime sleepiness
• Mood changes, like irritability, anxiety, or depression

Anyone, including children, can have sleep apnea. It can occur due to a combination of genetics and your environment.

Sleep apnea causes may include:

• Obesity
• Structural features, like large tonsils, a thicker than usual neck, and other anatomical issues that narrow your airway
• Taking opioids and other sedating medications or drinking alcohol, which can relax your throat muscles
• Medical conditions, like congestive heart failure, stroke, allergies, asthma, and others

People assigned male at birth, older adults, and smokers are at higher risk of sleep apnea. Having a family history of the condition also increases your chances of developing the disorder.

The extreme daytime drowsiness caused by sleep apnea can make it dangerous to drive, and sleepiness often interferes with work and school. Because sleep apnea causes drops in your oxygen level, you can develop high blood pressure or an irregular heartbeat (atrial fibrillation), and your risk for a heart attack and stroke increases. You’re also at higher risk of metabolic disorders, like type 2 diabetes, and other conditions.

Your health care provider will ask about your symptoms and your health history. You may be asked to keep a sleep diary to bring to your appointment. Sleep apnea tests include an overnight sleep study at a sleep center and a test that you do at home. During these tests, your breathing, heart rate, oxygen levels, brain waves, and other measurements are taken to diagnose sleep apnea.

Your doctor might suggest that you make lifestyle changes to improve your breathing while you sleep, like changing your sleep position or avoiding alcohol. If you have sleep apnea and obesity, taking weight loss medication may be an option. The most common type of sleep apnea treatment is a device that uses air pressure to open your airway and regulate your breathing, such as continuous positive airway pressure (CPAP), bilevel positive airways pressure (BPAP), and adaptive servo-ventilation (ASV) machines. Another option is to wear a mouthpiece while asleep. There are also several types of surgeries that can treat sleep apnea.

Penn Medicine’s specialists treat every type of sleep apnea, and our sleep centers are accredited by the American Academy of Sleep Medicine for meeting high standards in helping people with sleep disorders. We’re also one of three sleep centers in the United States designated by the National Institutes of Health as a specialized center for sleep research. Our study of the latest diagnostic tools and therapies means we can offer new treatments as soon as they become available.

We have a team of experts who work together to create your treatment plan, including specialists in sleep medicine, pulmonology, oral and maxillofacial surgery, head and neck surgery, and ear, nose, and throat medicine. If you’re having trouble with your CPAP device, an advanced diagnostic tool called DISE-PAP can measure how your airway reacts to air pressure to determine the best treatment for you. We also offer alternatives to CPAP therapy, including a minimally invasive procedure called transoral robotic surgery invented at Penn Medicine, and other surgeries. When you breathe better during sleep, you’re able to enjoy more productive days.