What is sleep apnea?
Sleep apnea is characterised by frequent periods of absence of breathing during sleep. There are three types of sleep apnea: obstructive, central, and mixed. Obstructive sleep apnea (OSA) is the most common; central sleep apnea is rare; mixed sleep apnea is a combination of the previous two with treatment being the same as OSA.

Obstructive sleep apnea
Obstructive Sleep Apnea can be visualised by thinking about what happens when you block the hose of a vacuum cleaner - the vacuum continues to try and suck up air, but the pathway is physically blocked. Obstructive Sleep Apnea is usually caused by soft tissue obstruction or collapse of the upper airway/throat. This can cause a drop in blood oxygen levels, making the body "wakes" up or enter a lighter "stage" of sleep ("arousal") in order to correct breathing. This is called an apnea event. The body continues to make an effort to breathe, but airflow in the upper portion of the airway (throat) is either decreased or stopped.  When the body "wakes" up or "arouses", this causes sleep to be interrupted or "fragmented".  Fragmented sleep causes the symptoms such a unrefreshed sleep or daytime sleepiness. 

Mixed Apnea
Mixed sleep apnea, is a combination of both Obstructive and Central Sleep Apnea. An episode of mixed sleep apnea usually starts out as central but then becomes obstructive and the body begins to make an effort to breathe. Often, on treating the Obstructive Apnea, the Central Apnea poses less of a problem.

Hypopneas
A hypopnea can be thought of as a partial apnea event. The difference between an apnea event and a hypopnea event is that during apnea, the airflow is blocked 100% - during a hypopnea, the flow is still partially able to get through. Both however disrupt the quality of your sleep and both can cause your oxygen levels to drop, both therefore need to be treated.

What are the Symptoms?
Often, your bed partner is the one to tell you you have a problem while you're sleeping, (such as snoring and cessation of breathing). Sleep Apnea will usually present with some or all of the following symptoms.

• Loud, frequent snoring especially combined with periods of silence for 10 seconds or more
• Loud snorts or gasps, moans or mumblings
• Unrefreshing sleep with groggy feeling in the morning
• Excessive daytime sleepiness and / or fatigue
• Inability to concentrate and remember things
• Falling asleep at inappropriate times, eg, when you're sitting down, driving, watching TV
• Morning headaches
• Dry mouth
• Mood Swings

It is important to remember that although common, not everybody that suffers from sleep apnea snores.

Wouldn't I know if I snore or wake up struggling to breathe?
Chances are you wouldn't. When you wake from an apnea event, most of the time it is only a partial awakening, just enough for your body's functions to resume to normal. While you are not necessarily aware of it, this does disrupt your different stages of sleep meaning the sleep experienced is unrefreshing. Very often the amount of time spent in REM and deep sleep is reduced. Many people do not know that they have sleep apnea

The same applies to daytime sleepiness, people aren't always aware the feel tired or abnormally sleepy. Sleep Apnea often develops over a long period of time, therefore the symptoms increase gradually. It is not uncommon for someone to only realise how tired they really were AFTER receiving treatment.

What should I do if I think I may have sleep apnea?
The only real way to diagnose Sleep Apnea is to have a polysomnogram also known as a Sleep Study. This involves spending a night in a sleep lab.

Does the fact that I snore mean I have sleep apnea?
While snoring is one of the most common symptoms of apnea, snoring is not a diagnostic tool as some who snore don't have apnea, and in some cases people who don't snore do have apnea.

When does it Require Treatment?
It is considered normal for people to have a minimal number of apnea events in any given night. However if this number of events is above five per hour, and longer than ten seconds in duration, it is considered as possibly requiring treatment. Other things to be considered are the associated daytime symptoms of excessive sleepiness. This can only be determined through a sleep study.

What are the effects of Sleep Apnea?
Apnea is something that makes you stop breathing, therefore, it is potentially life threatening. In addition, studies have also shown that apnea can increase your risk of stroke and heart disease. Poor quality sleep on a long term basis will also cause other potentially dangerous symptoms such as depression, loss of memory, inability to concentrate and will put you at risk of falling asleep while driving or operating machinery. Some doctors now state that untreated sleep apnea is one of the leading causes of heart attack and stroke.

Continuous Positive Airway Pressure (CPAP)
CPAP is the gold standard treatment of choice for most people with obstructive and mixed apnea. It is the most reliable and effective treatment in most cases. Hundreds of thousands of CPAP devices are now in use treating obstructive sleep apnea. CPAP

If my apnea is severe will I need high pressure?
Not necessarily. Some people will try to tell you that severe apnea means you need a higher pressure. There is litterally NO evidence to suggest this. A small study conducted  indicates that there is no relationship between severity and pressure at all.

Should I get a MedicAlert bracelet?
It is a good idea. If you are a CPAP user and are ever asleep or unconcious, your medical team need to be aware of it. If you are undergoing surgery, your anaesthesiologist will need to be aware of any complications that can occur. MedicAlert bracelets can be ordered online at http://www.medicalert.com/.

How often do I need a Sleep Study?
There is no hard and fast rule.  If you have had a significant weight change or if you find you are returning to your pre-CPAP symptoms, it is a good idea to have another study done, your pressure needs may change over time.