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Sleep Apnea: Should I Have a Sleep Study?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Sleep Apnea: Should I Have a Sleep Study?
Get the facts
- Have a sleep study.
- Don't have a sleep study. Instead, use lifestyle changes to try to reduce snoring.
Key points to remember
- If you snore but don't have other symptoms of sleep apnea, you may not need a sleep study. Lifestyle changes, such as losing weight (if needed), sleeping on your side, and sleeping at the same time every night, may reduce your snoring.
- If you have symptoms of sleep apnea, including being very tired and sleepy during the day, your doctor will probably suggest a polysomnography sleep study. This test is the only sure way to find out if you have sleep apnea.
- You may want to know if you have sleep apnea, because it has been linked with other health problems including high blood pressure, stroke, diabetes, heart failure, and depression. It also can lead to car accidents.
- If you know that you have sleep apnea, you can treat it. Treatment usually helps people who have sleep apnea and may lower your risk of problems such as high blood pressure or stroke.
You have sleep apnea when your breathing is often blocked or partly blocked while you sleep. It can be mild, moderate, or severe, depending on the number of times an hour that you have less airflow to your lungs. Apnea may occur from 5 to 50 times an hour.
The most common form of sleep apnea is obstructive sleep apnea. Although doctors use sleep studies to diagnose both obstructive sleep apnea and central sleep apnea, this Decision Point focuses on obstructive sleep apnea.
Obstructive sleep apnea happens when the airways in your nose, mouth, or throat are blocked or become narrow. Everyone's throat muscles and tongue relax during sleep. But in some people, certain things can cause this normal process to partly or completely block the airway.
This can happen because:
- You have bones that aren't a normal shape or you have tissues in your nose, mouth, or throat that are too big. For example, you may have large tonsils. During the day when you are awake and standing up, this may not cause problems. But when you lie down at night, the tonsils can press down on your airway, narrowing it and causing sleep apnea.
- You are very overweight.
- You take certain medicines or drink alcohol before bed.
- You sleep on your back.
Symptoms of sleep apnea can include:
- Being so sleepy during the day that you fall asleep while working or driving.
- Feeling tired in the morning.
- Having trouble concentrating.
- Waking up with a headache.
Your bed partner may notice that while you sleep:
- You stop breathing.
- You often snore loudly.
- You gasp or choke.
- You toss and turn.
Snoring and lack of sleep from apnea can make it hard to get through the day. You may feel grouchy a lot and have trouble focusing on work and activities. If you snore, your bed partner also might not get enough sleep. This can make your relationship suffer.
A study in a qualified sleep lab is the only sure way to know if you have sleep apnea. Experts recommend an all-night sleep study called polysomnography (say "pawl-ee-sawm-NAW-gruh-fee").1
You might want a sleep study, because if you have sleep apnea and it's not found and treated, it can interfere with your quality of life. It can make you too sleepy when you should be awake.
It also is linked to problems such as:
- High blood pressure.
- High blood pressure in the lungs (pulmonary hypertension).
- Irregular heart rhythms.
- Heart failure.
- Coronary artery disease.
Early treatment of sleep apnea can reduce your risk of these problems. It also can reduce your symptoms, such as headaches, snoring, and daytime sleepiness.
If you snore but don't have other symptoms, you may not need a sleep study. Lifestyle changes—such as losing weight (if needed), sleeping on your side, and going to bed at the same time every night—may reduce your snoring.
Treatment for sleep apnea can include:
- Lifestyle changes, such as losing weight (if needed), sleeping on your side, going to bed at the same time every night, avoiding alcohol just before bedtime, and not smoking.
- Continuous positive airway pressure (CPAP). This uses a machine to keep your airway open while you sleep.
- Oral breathing devices that you wear while you sleep to help keep your airway open.
- Medicines to help you stay awake during the day.
- Surgery. There are
several types of surgery, including:
- Surgery to remove extra tissue in the throat (uvulopalatopharyngoplasty).
- A procedure that moves the upper and lower jaw forward to enlarge the airway (maxillo-mandibular advancement, or MMA).
- A procedure that shrinks the size of the tongue and other tissues in the mouth that can interfere with breathing while sleeping (radiofrequency ablation, or RFA).
- Surgery to implant small plastic rods in the soft palate (palatal implants). The implants make the soft palate stiffer to keep the tissue from blocking the airway.
- Laser-assisted surgery to reshape the tissue of the palate so it does not block the airway (laser-assisted uvulopalatoplasty, or LAUP).
- Surgery that makes a hole through the neck and the windpipe (tracheostomy).
Your doctor probably will have you try lifestyle changes and CPAP first. But surgery might be your first choice if your sleep apnea is caused by a blockage that can be fixed easily.
It may also improve blood pressure.4, 5, 6 For people who have sleep apnea and coronary artery disease, treatment of sleep apnea can lower the risk of some problems such as heart failure.7 But if you have mild sleep apnea, treatment may not work as well as it can for people with more severe apnea.
Your doctor might recommend a sleep study if:
- You have symptoms of sleep apnea, such as heavy snoring and being sleepy during the day.
- You have a risk of other health problems from sleep apnea.
- Lack of sleep is hurting your quality of life.
Compare your options
What is usually involved?
What are the benefits?
What are the risks and side effects?
- You spend the night in a sleep lab. Your breathing, your eye movements, how much oxygen you're getting, and other physical signs are measured while you sleep.
- It's the only way to know for sure if you have sleep apnea.
- There aren't any health risks to having a sleep study.
- A sleep study can cost a lot.
- It takes a lot of time.
- It might not be available in your area.
- It might not find out what is causing your symptoms.
- You can try lifestyle changes (such as losing weight and quitting smoking) to reduce your snoring and mild sleep apnea.
- You won't have the cost of testing.
- You won't have to spend a night in a sleep lab.
- You can decide to have a sleep study later if lifestyle changes don't reduce your symptoms.
- If you have sleep apnea and don't treat it, it could lead to other health problems.
Personal stories about sleep studies
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
My husband snores so much when he sleeps that he has been keeping me awake. I don't think that he has been sleeping well either, because sometimes he falls asleep when he is just talking to me. I discussed it with him, and we decided that he should have a sleep study to see if he has sleep apnea.
Margaret, age 47
Sometimes I snore so loudly that I wake myself from sleep. I am also tired during the day. I read somewhere that snoring could be a symptom of sleep apnea. I called my doctor and told her about my symptoms. She gave me a few tips to prevent snoring. I am going to try these methods first to see if they work before I think about having a sleep study to diagnose sleep apnea.
Jamal, age 37
I have been a truck driver for almost 20 years. In the last 2 years I have almost had a few driving accidents because I have a hard time staying awake while driving. When I sleep at home, my wife says that I stop breathing while I sleep. I am going to have a sleep study to see if I have sleep apnea.
Hal, age 41
My partner says that sometimes I stop breathing while I am sleeping. Fortunately, I don't feel sleepy during the day. I talked with my doctor about my breathing problems because I think that I might have sleep apnea. She told me that it is common for older adults to have short lapses in breathing and that I probably don't need to have a sleep study to diagnose sleep apnea unless I am having other problems.
Frank, age 63
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have a sleep study
Reasons not to have a sleep study
I want to do everything I can to find out why I'm snoring so much.
I want to just try things at home to reduce snoring.
My snoring is hurting my relationship.
My snoring isn't hurting my relationship.
I'm so tired during the day that I'm sleepy when I should be awake.
I'm not sleepy when I should be awake.
I'm willing to try a treatment like CPAP if I find out that I have sleep apnea.
I'm not willing to do anything more than lifestyle changes for sleep apnea.
My other important reasons:
My other important reasons:
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having a sleep study
NOT having a sleep study
What else do you need to make your decision?
Check the facts
Do all people who snore need a sleep study to see if they have sleep apnea?
- YesSorry, that's not right. If you snore but don't have other symptoms of sleep apnea, you may not need a sleep study. Lifestyle changes may reduce your snoring.
- NoThat's right. If you snore but don't have other symptoms of sleep apnea, you may not need a sleep study. Lifestyle changes may reduce your snoring.
- I'm not sureIt may help to go back and read "Get the Facts." If you snore but don't have other symptoms of sleep apnea, you may not need a sleep study. Lifestyle changes may reduce your snoring.
Is a sleep study the only way to know for sure if you have sleep apnea?
- YesYou're right. A sleep study is the only sure way to find out if you have sleep apnea.
- NoSorry, that's not right. A sleep study is the only sure way to find out if you have sleep apnea.
- I'm not sureIt may help to go back and read "Get the Facts." A sleep study is the only sure way to find out if you have sleep apnea.
Can sleep apnea lead to any other health problems?
- YesYou're right. Sleep apnea has been linked with problems such as high blood pressure, heart failure, and depression.
- NoThat's not right. Sleep apnea has been linked with problems such as high blood pressure, heart failure, and depression.
- I'm not sureIt may help to go back and read "Key points to remember." Sleep apnea has been linked with problems such as high blood pressure, heart failure, and depression.
Decide what's next
Do you understand the options available to you?
Are you clear about which benefits and side effects matter most to you?
Do you have enough support and advice from others to make a choice?
How sure do you feel right now about your decision?
Use the following space to list questions, concerns, and next steps.
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
|Primary Medical Reviewer||Anne C. Poinier, MD - Internal Medicine|
|Specialist Medical Reviewer||Mark A. Rasmus, MD - Pulmonology, Critical Care Medicine, Sleep Medicine|
- Kushida CA, et al. (2006). Practice parameters for the indications for polysomnography and related procedures: An update for 2005. Sleep, 28(4): 499–521.
- Giles TL, et al. (2006). Continuous positive airways pressure for obstructive sleep apnoea in adults. Cochrane Database of Systematic Reviews (3).
- Hensley M, Ray C (2008). Sleep apnoea, search date May 2008. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
- Pepperell JC, et al. (2002). Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: A randomised study. Lancet, 359(9302): 204–210.
- Barbe F, et al. (2010). Long-term effect of continuous positive airway pressure in hypertensive patients with sleep apnea. American Journal of Respiratory and Critical Care Medicine, 181(7): 718–726.
- Norman D, et al. (2006). Effects of continuous positive airway pressure versus supplemental oxygen on 24-hour ambulatory blood pressure. Hypertension, 47(5): 840–845.
- Milleron O, et al. (2004). Benefits of obstructive sleep apnoea treatment in coronary artery disease: A long-term follow-up study. European Heart Journal, 25(9): 728–734.
Last Updated:June 17, 2011