Diagnosing Sleep Apnea

Sleep apnea is a serious sleep disorder that involves chronic breathing disruptions and snoring. This condition occurs in two primary types. Obstructive sleep apnea, the most common form, involves throat-muscle relaxation that creates complete or partial blockage of the upper airway. In contrast, central sleep apnea occurs when the brain does not signal the respiratory muscles to breathe for several seconds or more. Diagnosing sleep apnea is based on a combination of your and your family’s medical history, a physical exam, and the results of a sleep study.

If you think you have a sleep problem, keeping a sleep diary for a few weeks can be helpful for you and for your doctor. Be sure to note in this diary how you sleep, function during the day, and whether you snore, choke, or gasp in your sleep. Bring this sleep diary to your appointment with your primary-care physician to assess your symptoms in light of your personal and familial medical histories. He or she will examine your mouth, nose, and throat for excess or enlarged tissue. Based on your doctor’s exam and assessment of your medical history, he or she can then advise you about seeing a sleep specialist or other medical professional for further evaluation.

For most patients who present with sleep apnea symptoms, doctors will recommend a sleep study before giving any formal diagnosis. These studies are monitored by technicians to measure how well you sleep and how your body reacts to sleep issues. Sleep specialists generally administer a polysomnogram (PSG) to record heart rate, brain activity, blood-oxygen levels, eye movements, and blood pressure during sleep. Alternatively, your specialist may advise a home-based portable monitor to record similar information to a PSG, such as heart rate, chest movements, blood-oxygen levels, and nasal airflow. Based on the results of these assessments, your medical team can ascertain whether you have sleep apnea and plan your treatment accordingly.

Connection Between Obesity and Sleep Apnea

Of the 12 million Americans with sleep apnea, over half are overweight. Sleep apnea involves chronically shallow, irregular, or stopped breathing and periodic snoring during sleep. Sleep apnea may be obstructive (when weak throat muscles hinder breathing) or, in rarer cases, central (when the brain fails to signal respiratory muscles).

Although thinner individuals can develop sleep apnea, this condition is most common among people with large neck circumferences (over 17 inches for men and over 16 inches for women). Over half of those with obstructive sleep apnea are overweight or obese, defined as a body mass index (BMI) of 25-29.9 or 30.0 and above, respectively. This is partially because excess weight can form fatty deposits around your upper airway. In addition to creating other problems, these deposits may also obstruct breathing and elevate your risk of cardiovascular complications.

The correlation between excess weight and sleep apnea also works the other way: sleep apnea increases your risk of becoming overweight or obese. Sleep apnea leads to sleep deprivation, which often prompts people to eat more. This is likely due to the relationship between hunger and satiety hormones (leptin and ghrelin) and sleep deprivation, although researchers are not yet certain about the nature of this relationship.

To make matters worse, people with sleep apnea often have high blood pressure, high fasting glucose, and high cholesterol. When hunger and satiety hormones are not operating effectively, it is much easier to overeat and gain even more weight. This can aggravate the effects of sleep apnea, worsening hormonal disturbance and eating habits and prompting further weight gain.

The vicious cycle of obesity and sleep apnea can worsen if these disorders are left untreated. If you suffer from sleep apnea, and especially if you are overweight or obese, speak to your doctor to determine the best lifestyle changes, surgical procedures, and treatments for your symptoms.

Choking Noises In One’s Sleep and Sleep Apnea

Many individuals are mildly affected by snoring during sleep. For some people, however, snoring can indicate the presence of a more-serious medical condition with additional complications. If your snoring is chronic and involves choking episodes, you are most likely suffering from obstructive sleep apnea.

Sleep apnea is a serious sleep disorder that is created by obstruction from enlarged throat tissue, tonsils, and adenoids. These enlarged structures block upper airway passages during sleep, making breathing labored and difficult. Noisy and persistent snoring is a common sign of obstructive sleep apnea. Pauses of breathing often punctuate snoring in those with this condition, and choking or gasping usually follows these pauses.

Individuals with obstructive sleep apnea have continual shallow or irregular breathing during sleep, and may even stop breathing up to hundreds of times per night.

An estimated 12 million people in the U.S. suffer from sleep apnea. During an obstructive sleep apnea episode, the chest muscles and diaphragm labor extensively to open the blocked airway and restore airflow to the lungs. Breathing usually resumes with a loud choking sound, gasp, or body jerk. Someone with sleep apnea generally will not remember these episodes, since the body stirs just enough to tighten the throat muscles and open the windpipe. Sleeping partners of those with sleep apnea are often the first to notice these choking episodes and may become alarmed at the labored breathing of the snorer.

Choking, gasping, and experiencing the other effects of sleep apnea reduces the flow of oxygen to vital organs during sleep, causing irregular heart rhythms and daytime sleepiness. If left untreated, this condition can lead to extensive cardiovascular issues and impair daily activities. See your doctor to address any concerns about choking during sleep and to suggest lifestyle adjustments such as weight loss and quitting smoking. He or she may refer you to a specialist or a surgeon to reduce sleep apnea and related breathing issues.

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