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Sleep Apnea: Latest Research

Medically Reviewed by Neha Pathak, MD on June 18, 2021

Nearly 1 in 5 women and more than one-third of men in the United States have sleep apnea. This common sleep disorder causes you to stop breathing repeatedly in your sleep. It not only leaves you feeling groggy during the day, but it can also double or even triple your risk for heart disease and other serious health problems.

Since the early 1980s, continuous positive airway pressure (CPAP) has been the main treatment for sleep apnea. This mask, which you wear over your nose and mouth while you’re sleeping, connects to a machine and uses gentle air pressure to keep your airways open so that you can breathe at night. But not everyone is comfortable wearing the clunky mask. That’s why about 50% of people who try CPAP stop using it in the first year.

Researchers have been on the hunt for new ways to treat sleep apnea and prevent its complications.

Diagnosing Sleep Apnea

Symptoms like nighttime snoring and daytime sleepiness point to sleep apnea, but doctors order a sleep study to confirm the diagnosis. While you sleep in a lab, equipment monitors your breathing, heart and lung function, and oxygen levels.

But now, thanks to new portable monitoring tools, you may be able to do your sleep study at home in your own bed, instead of sleeping in a lab.

In the past, many women didn't get a correct diagnosis of sleep apnea because doctors thought of it as a man's disease. That view is changing.

After menopause, women are almost as likely to have sleep apnea as men, although their symptoms may be different. Women don't snore as much or feel as sleepy during the day as men.

Researchers are learning more about the differences in sleep apnea between men and women. For example, they've discovered that women have fewer breathing pauses than men during the early non-REM stage of sleep. But as they get into deeper REM sleep, their breathing stops just as many times as men's.

The discovery of these gender differences could one day steer researchers to new treatments targeted to women.

Protecting Your Brain and Heart

Researchers are studying the connections between sleep apnea, dementia, and heart disease to try to lower the risks for these diseases.

Scientists have discovered that the same abnormal protein that clumps up and damages the brains of people with Alzheimer's disease is also in the brains of people with sleep apnea. Understanding the reason for this shared link might lead to new treatments and ways to prevent Alzheimer's disease.

Treating sleep apnea may help prevent dementia. In one study, older adults with sleep apnea who used CPAP were less likely to develop dementia or early-stage memory loss called mild cognitive impairment than people who didn't use this treatment.

CPAP might also protect the heart. People with prediabetes who used this treatment had a lower resting heart rate -- the number of times the heart beats per minute while you're at rest. Having a lower resting heart rate could make you less likely to have a heart attack.

Studies find that people who stay on their CPAP treatment long term are less likely to have heart disease, type 2 diabetes, and a heart attack than those who don't get treated.

New Treatments

CPAP has been the main treatment for sleep apnea over the last 4 decades, but it's not for everyone. People who aren't comfortable wearing the mask to bed may consider surgery to widen their airway.

Uvulopalatopharyngoplasty (UPPP) is the main surgery for sleep apnea. It removes the tonsils and tissue in the back of your throat to open your airway and help you breathe better while you sleep. The downsides to UPPP are side effects like swallowing problems and voice changes.

A newer "multilevel" type of surgery removes the tonsils, adjusts the placement of the palate (roof of the mouth) and uses radiofrequency energy to slightly reduce the size of the tongue. In one study, this treatment reduced sleep apnea episodes and improved daytime sleepiness in people with moderate or severe sleep apnea who hadn't improved on CPAP.

Recent research has focused on the causes of sleep apnea to find new ways to treat it.

One new procedure works on the hypoglossal nerve that controls your tongue. A small device implanted in your chest senses when you start to breathe in during sleep. It stimulates your hypoglossal nerve, which pushes your tongue out to widen your airway.

People with sleep apnea who've had this procedure report less sleepiness and better quality of life afterward. A small number of people in the study had severe side effects, including bleeding and a heart attack.

All these treatments work while you sleep. In 2021, the FDA approved the first daytime device for treating mild sleep apnea.

The eXciteOSA delivers a mild electrical pulse to the muscles of your tongue. People who used this device for 20 minutes a day over 6 weeks, and then once a week afterward, snored less and breathed more easily while they slept.

Side effects of this treatment include:

Weight Loss

Surgery is one way to reduce the size of the tongue and improve sleep apnea symptoms. But if you don't want to go through a procedure, losing weight helps, too.

Researchers have known for a while that weight loss improves sleep apnea symptoms. Now they've found that losing weight also shrinks fat in the tongue and reduces muscles in the jaw and along the sides of the airway. Shrinking these areas also helps with sleep apnea symptoms.

The next step is to figure out which diet or other weight loss method works best at shrinking tongue fat.

Show Sources

SOURCES:

AANA Journal: "Hypoglossal Nerve Stimulation: Effective Longterm Therapy for Obstructive Sleep Apnea."

AAST: "What is CPAP (Continuous Positive Airway Pressure) Therapy?"

American Journal of Respiratory and Critical Care Medicine: "Effect of Weight Loss on Upper Airway Anatomy and the Apnea-Hypopnea Index. The Importance of Tongue Fat."

Annals of Saudi Medicine: "Obstructive Sleep Apnea: From Simple Upper Airway Obstruction to Systemic Inflammation."

Breathe: "Does personality play a role in continuous positive airway pressure compliance?"

ERJ Open Research: "Mortality and morbidity in obstructive sleep apnoea-hypopnoea syndrome: results from a 30-year prospective cohort study."

Fairview: "Uvulopalatopharyngoplasty (UPPP)."

Harvard Medical School: "High resting heart rate predicts heart risk in women at midlife," "What your heart rate is telling you."

JAMA: "Diagnosis and Management of Obstructive Sleep Apnea: A Review," "Effect of Multilevel Upper Airway Surgery vs Medical Management on the Apnea-Hypopnea Index and Patient-Reported Daytime Sleepiness Among Patients With Moderate or Severe Obstructive Sleep Apnea."

Journal of the American Heart Association: "Optimal Continuous Positive Airway Pressure Treatment of Obstructive Sleep Apnea Reduces Daytime Resting Heart Rate in Prediabetes: A Randomized Controlled Study."

Journal of Thoracic Disease: "New developments in the use of positive airway pressure for obstructive sleep apnea."

Mayo Clinic: "Obstructive sleep apnea."

News release, FDA, 2021.

News release, Penn Medicine, 2020.

NHLBI: "Sleep apnea in women: New research could lead to better diagnosis and treatment."

SLEEP: "Alzheimer's disease neuropathology in the hippocampus and brainstem of people with obstructive sleep apnea," "Obstructive sleep apnea treatment and dementia risk in older adults."

Stanford Health Care: "Uvulopalatopharyngoplasty (UPPP)."

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