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Providers’ Guide to Sleep Apnea: Types, Risks, and Complications

The First in a Series Providing Busy Physicians With a Helpful Overview of This Serious Sleep Disorder

More than 22 million Americans and more than 100 million people worldwide suffer from apneic episodes. But unlike other conditions, where patients can verbalize the symptoms they are experiencing, people who have sleep apnea are typically unaware since they are sleeping through these episodes.

To help healthcare providers recognize and treat sleep apnea, Apria has created three posts examining this condition.

This first post provides a brief overview of sleep apnea, including the types of sleep apnea, its risks, and the complications it poses to your patients.

The Three Types of Sleep Apnea

Obstructive Sleep Apnea (OSA): The most common form of sleep apnea, OSA occurs when there is a blockage at the back of the throat, causing a temporary lapse in breathing. The brain senses this and briefly wakes the patient to reopen the airway. This pattern can repeat itself five to 30 times or more every hour throughout the night.

Central Sleep Apnea (CSA): CSA affects about 0.9% of adults over the age of 40. Unlike OSA, the airway is not blocked; instead, the brain doesn’t send proper signals to the muscles that control breathing because of problems with the body’s central nervous system. As a result, the patient makes less effort to regain breathing, producing slower, shallower breaths.

Mixed Sleep Apnea (MSA): Also called complex sleep apnea and treatment-emergent central sleep apnea, this type occurs when someone has both obstructive sleep apnea and central sleep apnea.

Sleep apnea can affect anyone, male or female, young or old. But certain factors increase the risk.

Your Patients Who May Be at Risk for Sleep Apnea

Obstructive Sleep Apnea Risks

Many factors may increase the risk of airway blockage and OSA:

  • Anatomy: The position and size and of the patient’s neck, jaw, tongue, tonsils, or adenoids can interfere with airflow.
  • Obesity: Being overweight is a leading cause of OSA and an underlying risk factor in up to 60% of cases. Obesity narrows the airway; research shows that even a 10% increase in weight increases the risk of OSA 6x.
  • Alcohol/Drug Use: Alcohol and drugs can relax throat tissue, making it easier for the airway to become obstructed.Family History: People with a family history of OSA are more likely to develop it.
  • Smoking: Smokers are 3x more likely to have OSA than people who’ve never smoked
  • Sleeping Position: Sleeping on the back makes it easier for tissue to collapse around the airway and block airflow.
  • Nasal Congestion: People who have difficulty breathing through their nose, because of congestion or allergies, are more likely to have OSA.
  • Hormone Abnormalities: Hormone conditions like hypothyroidism and acromegaly may increase the risk of OSA by causing swelling of tissue near the airway or by contributing to a person’s risk of obesity.
  • Menopause: Women’s risk increases after menopause.
  • Gender: Men tend to have a higher prevalence of OSA.
  • Age: People become more susceptible to OSA as they get older.
  • Other Medical Conditions: Having any of the following chronic medical conditions may increase the risk of developing OSA: type 2 diabetes, congestive heart failure, high blood pressure, Parkinson’s disease, polycystic ovary syndrome, stroke, chronic lung diseases, and asthma.

Central Sleep Apnea Risks

One or more of the following factors may increase the risk of airway blockage and CSA:

  • Diseases that affect the central nervous system, such as encephalitis or neurological and kidney disorders.
  • Underlying medical conditions such as a stroke, infection of the brain or, in rare cases, a brain tumor that damages the brain stem.
  • Heart failure and other forms of heart, kidney, or lung disease.
  • Neuromuscular diseases like amyotrophic lateral sclerosis.
  • Opioids and other pain medicines that interfere with the normal process of breathing.
  • Being older.
  • Being male.
  • High altitudes, which disrupt a person’s oxygen levels.


Complications Associated with Sleep Apnea

If untreated, sleep apnea increases the risk for a variety of other serious health issues:

  • Type 2 diabetes
  • Heart disease, atrial fibrillation, and stroke
  • High blood pressure
  • Obesity
  • Metabolic syndrome
  • Liver problems
  • Cancer
  • Chronic kidney disease
  • Asthma symptoms
  • Pregnancy complications
  • Eye disorders such as glaucoma
  • Depression
  • Memory loss
  • Acid reflux

It’s also important to understand that sleep apnea doesn’t just complicate the patients’ lives—it also complicates the lives of their sleep-deprived partners. Loud, chronic snoring can prevent anyone in the vicinity from getting a good night’s sleep.

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