Merck Manual

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Commentary: Is Your Snoring Sleep Apnea? 4 Questions Your Doctor Will Ask

Commentary
7/22/2020 Kingman P. Strohl, MD, Case School of Medicine, Case Western Reserve University

Not all sleep is created equal. Many different factors impact your ability to get a good night’s sleep. One serious factor worth paying close attention to is sleep apnea. Sleep apnea is a condition characterized by abnormal breathing during sleep. People have long or repetitive pauses in breathing that can make sufferers sleepy the next day and lead to a host of other health issues.

Many people first suspect they have sleep apnea after an exasperated partner, suffering from their own poor sleep, complains about their partner’s snoring. Not everyone who snores has sleep apnea, but most people who have sleep apnea experience loud snorts, snoring, and gasping during sleep.

If you have this kind of snoring and feel sleepy during the day, it’s time for a conversation with your doctor about sleep apnea. During that appointment, your doctor will ask some specific questions about your sleep. Depending on the responses, your doctor may recommend a sleep study known as polysomnography or an at-home sleep test. As you prepare for your appointment, make sure you can answer these questions your doctor is likely to ask.

1. What are your sleep habits?

Understanding sleep apnea starts with understanding sleep. Despite spending about one third of our lives asleep, sleep not something most people understand or spend much time thinking about. Be prepared to talk to your doctor about your sleep habits, including:

  • How much sleep you’re getting at night
  • Your sleep preferences – are you a morning person or a night owl?
  • Your bedtime routine – what you do in the hours before sleep
  • Your caffeine intake
  • What medications you take and when

Spend the week or two before your appointment tracking these factors, and use them as a jumping off point for an honest conversation about your sleep habits.

2. Do you have a family history of sleep apnea?

Many of the factors that contribute to sleep apnea tend to run in families, including a narrow throat, thick neck, and round head, as well as obesity and the kind of sleeper you are. As a result, people with an immediate family member with sleep apnea are more likely to have it themselves. People who think a family member may have undiagnosed sleep apnea should also bring this up with their doctor. Sleep apnea also becomes more common with age. Prepare for a conversation with your doctor by talking to parents and siblings about if – and when – they were diagnosed with sleep apnea.

3. Do you fall asleep during the day?

Sleep apnea rises to the level of a disorder when being tired impacts your day-to-day life. But there’s a difference between feeling fatigued (cannot get anything done) and actually being sleepy (actually falling asleep). If you feel like you have little energy during the day but don’t actually fall asleep, the underlying cause may be something other than sleep apnea, such as anemia, a thyroid condition, or chronic fatigue syndrome.

If you are sleepy, note if it’s active or passive sleepiness. Active sleepiness involves falling asleep while engaged in a task, such as during a conversation or while driving. This is dangerous. Passive sleepiness means falling asleep when inactive, during less engaging tasks, such as reading or watching television. Make sure you’re accurately describing your tiredness during the day so your doctor can make the correct diagnosis.

4. What other conditions do you have?

The unrefreshing sleep and periods of not breathing that come with sleep apnea increase with serious health concerns, including stroke, heart attack, and high blood pressure. Doctors will ask about these conditions, as well as obesity, when discussing sleep apnea. Often, treating sleep apnea can lead to improvement in these conditions and other aspects of your health like alertness and sense of wellbeing.

Treating Sleep Apnea – The Power of a Positive Attitude

Sleep apnea treatment typically falls into two categories. The first is to look at lifestyle and behavior changes you can make. Losing weight and drinking less alcohol can have a dramatic effect on sleep apnea’s severity. In more severe cases, wearing an oral splint during sleeping or having surgery can open the airway.

In some severe cases, doctors will discuss the use of a continuous positive airway pressure (CPAP) machine. This machine has a mask connected to a small air pump that increases pressure in the airway, thus helping to hold the person’s throat open as they breathe. While many people don’t like the idea of having a machine cover a part of their face while they sleep, CPAP machines have come a long way in terms of design and comfort. What’s more, their in ability to improve people’s day to day lives can be transformational. Remember that the purpose is to wear it during sleep, so don’t let yourself be self-conscious!

Treating sleep apnea starts with recognizing just how effective that treatment can be. A good night’s sleep, night after night, can improve your relationships, your daily energy levels, and your overall outlook on life. It’s a significant step in reducing the risk or severity of a number of serious chronic conditions. Refer to The Merck Manuals page on sleep apnea for more information and to prepare for a conversation with your doctor.
Dr Kingman Strohl

Test your knowledge

Temporomandibular Disorders
The temporomandibular joints are the connections between the temporal bones of the skull and lower jawbone (mandible). Temporomandibular disorders are caused by problems with the jaw muscles or joints, or the fibrous tissue connecting them. In which of the following groups are temporomandibular disorders most common?