The main cause of Sleep Apnea,and when to see a Doctor.

RISK FACTORS

Sleep apnea can affect anyone. Even children can have sleep apnea. But certain factors put you at increased risk:

Obstructive sleep apnea

• Excess weight. Fat deposits around your upper airway may obstruct your breathing. However, not everyone who has sleep apnea is overweight. Thin people develop this disorder, too.
• Neck circumference. People with a thicker neck may have a narrower airway.
• A narrowed airway. You may have inherited a naturally narrow throat. Or, your tonsils or adenoids may become enlarged, which can block your airway.
• Being male. Men are twice as likely to have sleep apnea. However, women increase their risk if they're overweight, and their risk also appears to rise after menopause.
• Being older. Sleep apnea occurs significantly more often in adults older than 60.
• Family history. If you have family members with sleep apnea, you may be at increased risk.
• Race. In people under 35 years old, blacks are more likely to have obstructive sleep apnea.
• Use of alcohol, sedatives or tranquilizers. These substances relax the muscles in your throat.
• Smoking. Smokers are three times more likely to have obstructive sleep apnea than are people who've never smoked. Smoking may increase the amount of inflammation and fluid retention in the upper airway. This risk likely drops after you quit smoking.
• Nasal congestion. If you have difficulty breathing through your nose — whether it's from an anatomical problem or allergies — you're more likely to develop obstructive sleep apnea.

Central sleep apnea

• Being male. Males are more likely to develop central sleep apnea.
• Being older. People older than 65 years of age have a higher risk of having central sleep apnea, especially if they also have other risk factors.
• Heart disorders. People with atrial fibrillation or congestive heart failure are more at risk of central sleep apnea.
• Stroke or brain tumor. These conditions can impair the brain's ability to regulate breathing.

COMPLICATIONS

Sleep apnea is considered a serious medical condition. Complications may include:

• High blood pressure or heart problems. Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain the cardiovascular system. If you have obstructive sleep apnea, your risk of high blood pressure (hypertension) is greater than if you don't. The more severe your sleep apnea, the greater the risk of high blood pressure. However, obstructive sleep apnea increases the risk of stroke, regardless of whether or not you have high blood pressure. If there's underlying heart disease, these multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death from a cardiac event. Studies also show that obstructive sleep apnea is associated with increased risk of atrial fibrillation, congestive heart failure and other vascular diseases. In contrast, central sleep apnea usually is the result, rather than the cause, of heart disease.
• Daytime fatigue. The repeated awakenings associated with sleep apnea make normal, restorative sleep impossible. People with sleep apnea often experience severe daytime drowsiness, fatigue and irritability. You may have difficulty concentrating and find yourself falling asleep at work, while watching TV or even when driving. You may also feel irritable, moody or depressed. Children and adolescents with sleep apnea may do poorly in school or have behavior problems.
• Complications with medications and surgery. Obstructive sleep apnea is also a concern with certain medications and general anesthesia. People with sleep apnea may be more likely to experience complications following major surgery because they're prone to breathing problems, especially when sedated and lying on their backs. Before you have surgery, tell your doctor that you have sleep apnea and how it's treated. Undiagnosed sleep apnea is especially risky in this situation.
• Liver problems. People with sleep apnea are more likely to have abnormal results on liver function tests, and their livers are more likely to show signs of scarring.
• Sleep-deprived partners. Loud snoring can keep those around you from getting good rest and eventually disrupt your relationships. It's not uncommon for a partner to go to another room, or even on another floor of the house, to be able to sleep. Many bed partners of people who snore are sleep-deprived as well.

People with sleep apnea may also complain of memory problems, morning headaches, mood swings or feelings of depression, a need to urinate frequently at night (nocturia), and a decreased interest in sex. Children with untreated sleep apnea may be hyperactive and may be diagnosed with attention-deficit/hyperactivity disorder (ADHD).

PREPARING FOR YOUR APPOINTMENT

If you or your partner suspects that you have sleep apnea, you'll probably first see your primary care doctor. However, in some cases when you call to set up an appointment, you may be referred immediately to a sleep specialist.

Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

• Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as modify your diet or keep a sleep diary.
• Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including any major stresses or recent life changes.
• Make a list of all medications, vitamins or supplements that you're taking.
• Ask a family member or friend along, if possible. Someone who accompanies you may remember information that you missed or forgot. And, because your bed partner may be more aware of your symptoms than you are, it may help to have him or her along.
• Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions ahead of time will help you make the most of your visit. For sleep apnea, some basic questions to ask your doctor include:

• What's the most likely cause of my symptoms?
• Are there other possible causes for my symptoms?
• What kinds of tests do I need? Do these tests require any special preparation?
• Is my condition likely temporary or long lasting?
• What treatments are available?
• What are the alternatives to the primary approach that you're suggesting?
• Which treatment do you think would be best for me?
• I have other health conditions. How can I best manage these conditions together?
• Should I see a specialist?
• Is there a generic alternative to the medicine or product you're prescribing me?
• Are there any brochures or other printed material that I can take home with me? What websites do you recommend?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask additional questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Your doctor may ask:

• When did you begin experiencing symptoms?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• How does your partner describe your symptoms?
• Do you know if you stop breathing during sleep? If so, how many times a night?
• Is there anything that has helped your symptoms?
• Does anything worsen your symptoms, such as sleep position or alcohol consumption?