Sleep Apnea Treatment

Before diagnosing sleep apnea you must understand what it is.  Sleep apnea occurs when someone has completely stopped breathing for 10 seconds or more while they are sleeping.  Sometimes these apnea episodes completely wake a person, other times they just bring someone to a shallow level of sleep from a deep level.  This interrupted sleep may not be noticed by the person with the sleep apnea, instead it may alert your bed partner.  There are two types of sleep apnea: central sleep apnea and obstructive sleep apnea.  Central sleep apnea occurs when the brain doesn’t send the signal to breathe to the breathing muscles.  This is more common in people with brain injuries or heart diseases.  Obstructive sleep apnea means the airway has actually been obstructed by your tongue going backwards or enlarged tonsils.  Sleep apnea is a serious sleep disorder.

If you have symptoms of sleep apnea your doctor may ask you to have a sleep apnea test done at a sleep disorder center.  This test would be done after a physical exam and medical history.  People who have sleep apnea in their family history are at a higher risk for sleep apnea themselves.  A sleep study (polysomnogram) is a multiple-component test that electronically transmits and records specific physical activities while you are sleeping.  In a polysomnogram an EEG is used to record brain wave activity, an EMG records such things as teeth grinding, an EOG to record eye movements which tells the sleep stage you are in, an EKG for your heart rate, a nasal airflow sensor to record airflow, and a snore microphone records your snoring activity.  All of these results are then read by a sleep specialist and given to your doctor to determine if you have sleep apnea.

For someone who reports being sleepy during the day or has sleep apnea and needs to see if it is improving, there are two more tests.  The Multiple Sleep Latency Test is done after the polysomnogram and consists of taking 4 or 5 naps that last for 20 minutes where you are told to “try and fall asleep.”  The average time to fall asleep is taken from the 4 or 5 tests.  The normal time it takes people to fall asleep is 10 minutes or more since the test is done after a documented full-nights rest.  Excessive sleepiness is when someone takes less than 5 minutes to fall asleep.  Another test for daytime sleepiness is the Maintenance of Wakefulness Test.  In this test you are told to “try to stay awake” for four 40 minute sessions 2 hours apart.  Some agencies use this test for their employees to test how tired they are at work, such as pilots and truck drivers.