Are You at Risk for Sleep Apnea? Test Your Knowledge.

Sleep apnea can cause loud snoring, but just because you snore doesn't mean you have sleep apnea. Some 45% of men and 30% of women snore regularly. Most cases are harmless. But anyone who snores nightly and has other symptoms –– like pauses in breathing at night or daytime sleepiness –– should talk to a doctor to rule out sleep apnea.

It's important to treat sleep apnea, and not just because of daytime sleepiness. When oxygen levels in the blood drop, your body responds by releasing stress hormones and partially waking you up –– as many as 400 times a night. Over time, exposure to those hormones increases the risk of high blood pressure, heart attack, and stroke. The chronic exhaustion caused by sleep apnea increases the risk of depression. Daytime sleepiness is also a leading cause of car accidents.

One study found that practicing the Australian wind instrument called the didgeridoo –– for about 25 minutes a day six days a week –– improved sleep apnea symptoms like daytime sleepiness. Researchers speculated that playing the instrument strengthened the muscles around the airways, preventing them from collapsing during sleep.

Obesity is clearly linked with the risk of obstructive sleep apnea. As fat builds up in the throat, it narrows the airways, making airway obstruction more likely. But it seems that sleep apnea itself –– and the fragmented sleep it causes –– triggers hormonal changes that make you hungrier and increase the risk of weight gain.

CPAP uses a constant gentle stream of air through the nose to stop the airways from collapsing while you breathe. A small device with a fan pushes the air through a tube and facemask. Although CPAP can take some getting used to, it's worth the effort. CPAP can't cure sleep apnea – you have to keep using the machine –– but it dramatically reduces the symptoms. It can also help reduce your risk of heart disease, stroke, and diabetes, health problems that are associated with sleep apnea.

As you get older, the brain has a harder time keeping the muscles in the airways tight during sleep. During the night, they're more likely to sag, closing off the airways and momentarily cutting off the oxygen supply. Treating OSA is important because it's linked with other medical problems like high blood pressure, heart disease, heart failure, and atrial fibrillation. According to experts, at least one in 10 people over age 65 have sleep apnea.

For the majority of people with sleep apnea, CPAP improves their symptoms and their sleep. But it only helps as long as you use it -- if you stop, symptoms come back. And according to studies, 50% of people give up on treatment within a year, most of them in the first month. Why? They don't give themselves a chance to get used to the treatment.

If your CPAP isn't working for you, don't give up. Talk to your doctor. If you're not using CPAP as recommended, talk to your doctor. There are different kinds of machines and masks, and you may be able to switch to one that you're more comfortable using.

While CPAP is the standard treatment, losing weight if you are overweight often helps, too. Sleeping on your side may help, since airway collapse and obstruction tend to be worst when sleeping on your back. Some people prop themselves on their side using special pillows or wear something that makes sleeping on their backs uncomfortable. And there are devices you can wear in your mouth that push your jaw forward to help keep the airway open.

For some people, having surgery to widen the airway may help. A surgeon might remove the tonsils or excess tissue from the back of the throat or stiffen the area by implanting a plastic insert.

Although your doctor will ask questions about your symptoms and will check your mouth, nose, and throat for excess tissue, the only definitive test for sleep apnea is an overnight sleep study. It can be done at a sleep clinic or sometimes at home using portable equipment. It doesn't hurt – a technician places sensors on your head, face, chest, arms, legs, and finger and records the information. Although people may worry they won't sleep during the test, most people sleep enough so that the technician gets the information that's needed.

Putting blocks under the head of the bed to raise it 2 to 4 inches may help reduce symptoms for some people. Why? One of the reasons that the airways can close during sleep is that gravity pulls on the tissue in the throat as the muscles relax, causing it to droop. Sleeping on an incline reduces the effect of gravity, allowing the airways to stay open.

It's important to wear your CPAP every night – if you don't, sleep apnea symptoms will return. But it's common to have trouble adjusting to your CPAP machine. Some things that can help are putting on the mask briefly when you are awake, doing relaxation exercises to help you fall asleep, using the "ramp" feature that slowly increases air pressure as you fall asleep, and using a saline nasal spray to prevent a stuffy nose. If your mask doesn't fit right, tell your doctor – there are many styles available.

Alcohol, sedatives, and sleeping medications all relax the muscles in the airways, making them prone to collapse and block the airway during sleep. Smokers are more than twice as likely to have sleep apnea as nonsmokers and former smokers. Smoking can irritate the airways and cause inflammation and fluid retention in the airways, making reduced airflow more likely. Another problem for smokers: as nicotine levels drop during sleep, the airway muscles start to go slack.

Most often, it's the bed partner or other family member who first notices the signs of sleep apnea –– like loud snoring, pauses in breathing, and gasping. Your doctor probably won't notice anything during a regular exam. And because sleep apnea signs happen while they're asleep, even people with severe sleep apnea might have no idea that they have symptoms.