Warning signs and symptoms of sleep apnea include:

  • Frequent cessation of breathing (apnea) during sleep

  • Your sleep partner may notice repeated silences from your side of the bed

  • Choking or gasping during sleep to get air into the lungs

  • Loud snoring

  • Sudden awakenings to restart breathing

  • Waking up in a sweat during the night

  • Feeling unrefreshed in the morning after a night's sleep
    Headaches, sore throat, or dry mouth in the mornings after waking up

  • Daytime sleepiness, including falling asleep at inappropriate times, such as
    during driving or at work

    Is snoring the same as sleep apnea?

    Snoring and sleep apnea are not the same thing. Snoring is simply a loud
    sound that you make during breathing while asleep if there is any
    obstruction in your airway. While it may be unpleasant for your sleep
    partner, snoring is not in itself a harmful condition. On the other hand,
    people with sleep apnea are deprived of oxygen due to a complete blockage of
    airways, which can have a major impact on health.

    Snoring does often accompany sleep apnea, but just because you snore does
    not mean you have sleep apnea.

    Types of sleep apnea

    There are three types of sleep apnea: obstructive, central, and mixed.

    Obstructive Sleep Apnea (OSA)

    OSA is the most common type of sleep apnea. It is caused by a breathing
    obstruction, which stops the air flow in the nose and mouth.

    Central Sleep Apnea (CSA)

    Central sleep apnea is a far rarer type of sleep apnea, which occurs when
    the brain signal that instructs the body to breathe is delayed. This central
    nervous system disorder can be caused by disease or injury involving the
    brainstem, such as a stroke, brain tumor, viral brain infection, or
    chronic respiratory disease. People with CSA seldom snore, which makes it
    even harder to diagnose as they do not fit the "normal" profile of a sleep
    apnea sufferer. However, while the causes of the breathing cessation are
    different in CSA and OSA, the symptoms and results are much the same ­ a
    deprivation of oxygen and poor sleep due to repeated awakenings at night.
    The treatments for CSA include specific medications that stimulate the need
    to breathe and administration of oxygen.

    Mixed sleep apnea

    Mixed sleep apnea is a combination of the two types of sleep apnea,
    obstructive sleep apnea and central sleep apnea. A person with mixed sleep
    apnea will often snore, but finds that treatments which only help
    obstructions in the airways do not completely stop apnea episodes. Treatment
    usually includes a combination of the treatments used for OSA and CSA.

    Causes and risk factors of obstructive sleep apnea
    When you have obstructive sleep apnea, your throat collapses during sleep,
    blocking the airway and preventing air from getting to the lungs. Generally,
    your throat muscles keep the throat and airway open.

    Causes and risk factors of sleep apnea:

    • Shape of head and neck may create a smaller than normal airway
    • Large tonsils, adenoids or other anatomical differences (a deviated
      septum, enlarged tongue, or receding chin can also create difficulties
      breathing during sleep)
    • Being overweight or obese (almost 50% of people with sleep apnea
      are not obese)
    • Throat muscles and tongue relax more than normal during sleep (can be
      due to alcohol or sedative)
    • Snoring can cause the soft palate to lengthen, which in turn can
      obstruct the airway
    • Smoking or exposure to secondhand smoke
    • Nasal congestion, nasal blockages, and nasal irritants
    • Family history of sleep apnea - no specific genetic marker for sleep apnea
      has been discovered, but obstructive sleep apnea seems to run in families
      (may be a result of anatomic abnormalities that run in the family)
    • Other disorders and syndromes - hypothyroidism, acromegaly, amyloidosis,
      vocal cord paralysis, post-polio syndrome, neuromuscular disorders, Marfan's
      Syndrome, and Down Syndrome
    • Other physical conditions such as immune system abnormalities, severe
      heartburn or acid reflux and high blood pressure (it isn't clear whether the
      conditions are the cause or the result of sleep apnea)

    Effects of sleep apnea on health

    What happens when you stop breathing during sleep?
    If you have sleep apnea, you stop breathing during sleep and the balance of
    oxygen and carbon dioxide in the blood is upset. This imbalance stimulates
    the brain to restart the breathing process. The brain signals you to wake up
    so that the muscles of the tongue and throat can increase the size of the
    airway. Then, carbon dioxide can escape and oxygen can enter the airway.
    These waking episodes are necessary to restart breathing (and to save your
    life), but because of them, you become sleep-deprived.

    Sleep apnea has serious health consequences and can even be
    life-threatening. The main effects of sleep apnea are sleep deprivation and
    oxygen deprivation.

  • Sleep deprivation

    Both the person with sleep apnea and the bed partner suffer from sleep
    deprivation. A bed partner may lose an hour or more of sleep each night from
    sleeping next to a person with sleep apnea. Along with the apnea episodes,
    the person afflicted with sleep apnea may have additional trouble sleeping
    caused by side effects of the condition, including a frequent need to get up
    and urinate during the night, and excessive nighttime sweating.

    Some trickle-down effects of sleep deprivation are a compromised immune
    system, poor mental and emotional health, irritability, and slower reaction
    time, among other problems.

    Oxygen deprivation

    When you stop breathing, your brain does not get enough oxygen. Drastic
    problems can result from the oxygen deprivation of sleep apnea, including
    heart disease, high blood pressure, sexual disfunction, and learning/memory

    Depression and sleep apnea

    Approximately one in five people who suffer from depression also suffer from
    sleep apnea, and people with sleep apnea are five times more likely to
    become depressed. Existing depression may also be worsened by sleep apnea.
    While it is not clear whether the apnea causes the depression or vice-versa,
    studies show that by treating sleep apnea symptoms, depression may be
    alleviated in some people.

    Diagnosing sleep apnea

    Before you visit a doctor for a possible diagnosis of sleep apnea, ask your
    spouse or sleeping partner to keep a sleep diary for you. For a few nights,
    a willing sleep partner can record if you are snoring and how loud your
    snoring is, how well you are sleeping, whether you are having trouble
    breathing (that is, choking or gasping), and any other troubling symptoms.

    If you don't have someone to record your sleep patterns, try taping
    yourself. You can use a sound-activated audio recorder or a software program
    that turns your computer into a recorder. If you don't have access to
    recording equipment, it may be worthwhile to ask a friend or loved one to
    monitor your sleep pattern for a few nights, or visit a sleep center for

    With your sleep record in hand, consult a knowledgeable doctor or a sleep
    specialist. To diagnose for sleep apnea, the doctor or specialist will
    examine your mouth and nose to look for obstructions and possibly perform
    other tests such as an endoscopy of your nose and throat, x-rays, or a CT
    scan of the head and neck.

    If your doctor suspects sleep apnea, he or she will likely recommend an
    overnight sleep study in a sleep clinic (also known as a sleep lab or sleep
    center). Sleep tests in a sleep clinic help to diagnose sleep apnea by
    measuring how frequently you stop breathing.

    Gary Greenberg, DMD, F.A.G.D.

    Dr. Gary Greenburg, DMD, F.A.G.D. | 109 South Warren St. Suite 1700, State Tower Building Syracuse, NY 13202 | 315.422.1788