Svefnapnea

Svefnapnea, or sleep apnea, is a sleep disorder characterized by repeated pauses or shallow breaths during sleep, leading to intermittent drops in oxygen and disrupted sleep.

There are three main forms. Obstructive sleep apnea (OSA) results from collapse of the upper airway despite ongoing respiratory effort. Central sleep apnea (CSA) involves a lack of respiratory effort due to brain signaling problems. A mixed or complex form combines features of both.

Common symptoms include loud snoring, observed pauses in breathing during sleep, gasping or choking at night, restless sleep, morning headaches, daytime sleepiness, poor concentration, irritability, and dry mouth upon waking.

Risk factors include obesity, older age, male sex, large neck circumference, smoking, alcohol or sedative use, nasal congestion, and certain craniofacial features. CSA is more often linked to heart failure, stroke, or the use of certain medications such as opioids.

Diagnosis is typically made with overnight sleep testing. Polysomnography in a sleep laboratory or home sleep apnea testing assesses breathing and other parameters, with the apnea-hypopnea index used to determine severity. Oxygen saturation and arousal data may also be considered.

Treatment aims to maintain airway patency and normalize breathing. Continuous positive airway pressure (CPAP) is the first-line therapy for moderate to severe OSA, with alternatives including bilevel PAP, oral appliances for some patients, weight loss, and positional therapy. Surgical options exist for selected cases. Central sleep apnea may require adaptive servo-ventilation or treatment of underlying conditions.

Untreated sleep apnea is associated with cardiovascular disease, hypertension, stroke, and daytime impairment. Optimal management improves symptoms and may reduce health risks.