What Is Sleep Apnea?
Sleep apnea is a serious and sometimes life threatening sleep disorder that is characterized by periods of apnea (breathing pauses) during sleep. It is often accompanied by loud, disruptive snoring.
During an apneic episode, you may stop breathing for up to 10 seconds or more and, as your blood oxygen levels drop, you may awaken abruptly with a loud gasp or snort. The number of apneic events you experience may be as high as 20 to 30 per night or more, and the effects may lead to serious health complications.
Types of Sleep Apnea
There are three types of sleep apnea: Obstructive, central and mixed. Obstructive sleep apnea (OSA) is most commonly seen in the general population and in people with COPD. OSA occurs when your throat muscles, including your tongue, relax during sleep and block your airway. Because many people who suffer from OSA are overweight, they often have an enlarged tongue and soft palate and/or excess fat in their throat area.
Risk Factors for Obstructive Sleep Apnea
Although anyone can have sleep apnea, the following risk factors may increase your risk:
- Being male
- Being older
- Being African-American, Hispanic or Pacific Islander
- Being obese
- Having a large neck circumference (17" or more for men and 16" or more for women)
- Drinking alcohol
- Associated medical conditions, such as gastroesophageal reflux disorder (GERD), diabetes, or polycystic ovary syndrome
Symptoms of Sleep Apnea
Along with periodic episodes of apnea during sleep and intermittent snoring, symptoms of sleep apnea include:
- Excessive daytime sleepiness
- Morning headache
- Sore throat
- Changes in your personality
- Mental deterioration
- Behavioral disorders
- Bed wetting
- Complaints from your partner that you snore too loudly
COPD and Sleep Apnea
Together, COPD and OSA are often coined as overlap syndrome (OS.) Both COPD and OSA are independent risk factors for heart problems that may include irregular heart beat, high blood pressure, heart attack and stroke, and their coexistence in OS may further increase these cardiovascular risks. This makes early identification of OSA in people with COPD extremely important.
People with OS may also have:
- A higher degree of hypoxemia and hypercapnia
- An increased prevalence of pulmonary hypertension and cor pulmonale
- Higher morbidity rates
Treatment for Obstructive Sleep Apnea in COPD Patients
Non-surgical treatment options for OSA include:
- Weight loss
- Continuous positive airway pressure (CPAP)
- Tongue-retaining devices or bite guards
If you are someone who cannot tolerate CPAP and your OSA is severe, you may want to discuss the following surgical options with your health care provider:
- Uvulopalatopharyngoplasty (UPPP)
- Laser-assisted uvulopalatoplasty (LAUP)
- Gastric bypass surgery (for people whose OSA is due to morbid obesity)
- Jaw surgery
What Should You Do If You Think You Have OSA?
If you have OSA, you may not even be aware of it, especially if you live alone. Paying close attention to your sleep patterns and your daytime symptoms will help you recognize a potential problem. If you think you may have OSA or, if your partner complains that your snoring is intense, it may be time to visit your health care provider for an evaluation and more information.
Need better, high quality sleep? Read 10 Tips for Getting a Good Night's Sleep With COPD.
Pronzato C. Chronic obstructive pulmonary disease and obstructive sleep apnea: Association, consequences and treatment. Monaldi Arch Chest Dis. 2010 Dec;73(4):155-61.
Victor, Lyle D. M.D. Obstructive Sleep Apnea. American Family Physician. November 15, 1999.