Sleep apnea is a common condition but can be dangerous and even deadly if left untreated.
Snoring may be the stuff of comedy (“My husband snores so loudly that…”), but when snoring is a symptom of sleep apnea, it’s no joke. Sleep apnea is a condition that affects breathing during sleep. If you have sleep apnea, your breathing becomes very shallow or even pauses completely for brief periods. This means your brain isn’t getting the oxygen it should, and your body isn’t getting the sleep it needs, either.
The most common type of sleep apnea is called obstructive sleep apnea (OSA). When we sleep, our muscles relax, including the muscles in our throat. With OSA, the throat muscles relax too much, causing the airway to narrow or close.
An estimated 30 million Americans are affected by sleep apnea, and it does get more common as people age. In fact, a study of over 1,000 Medicare recipients in Michigan found that more than half were at high risk of developing OSA. Sleep apnea in seniors may be a result of decreasing muscle tone, including the muscles in the throat. Other risk factors for sleep apnea include excess weight, smoking, having a thick neck or narrow throat, family history, use of alcohol or sedatives, and certain medical conditions, including high blood pressure, type 2 diabetes, and congestive heart failure.
If you suffer from OSA, you’re in good company. Last month, the White House announced that President Biden was using a CPAP machine (more on CPAPs below) to treat his sleep apnea.
Symptoms of sleep apnea
If you have sleep apnea, you may not even be aware of it. Often it’s the person you’re sleeping with who notices these episodes. That person may notice
- Loud snoring
- Pauses in breathing that can last 10 seconds or more
- Snorting and gasping as breathing resumes
Episodes of OSA can happen as often as 30 times an hour – or hundreds of times a night. Because OSA prevents you from getting deep, restorative sleep, you may feel drowsy during the day, even if you think you slept a full eight hours. Chronic sleep deprivation can cause problems with memory and concentration, forgetfulness, and irritability. In fact, it’s sometimes these complaints that lead to a visit with the doctor – and an eventual diagnosis.
It’s important to note that not all snoring is due to sleep apnea, and not everyone with sleep apnea snores. Doctors diagnose OSA by taking a medical history, doing a physical exam, and sometimes recommending tests to rule out other conditions that may cause similar symptoms. They might also recommend a special test, i.e., a sleep study, which can be done either in a sleep lab or with a portable device at home.
Treatment for sleep apnea
There are various treatments for sleep apnea. Sometimes a specific cause can be pinpointed, such as a blockage in the nose or congestive heart failure. When that’s the case, treatment for these conditions can sometimes put an end to OSA.
For mild cases of OSA, simple lifestyle changes can sometimes make a big difference. Your doctor might recommend that you:
- Lose weight
- Stop smoking
- Avoid sleeping on your back
- Stop drinking alcohol
- Start exercising regularly
- Stop or change certain medications
If these changes don’t help, further steps might be necessary. The gold standard for OSA treatment is a breathing machine called a CPAP, which stands for continuous positive airway pressure. While you sleep, you wear a face mask hooked up to a small air compressor. It delivers a steady stream of air pressure to keep your breathing passages open.
The CPAP machine isn’t for everyone. People with arthritis or vision loss, for instance, may struggle to use the machine correctly. And one recent study found CPAP was less effective when used by people over age 80. (Anecdotally, however, doctors report that plenty of patients over 80 have their apnea greatly improved using the CPAP.)
Non-CPAP options include mouthpieces that position your jaw to keep your airway open. And in severe cases, surgical treatment can help if tonsils or other tissue are causing the airway obstruction, or if the jaw needs to be repositioned permanently.
Finally, there are other types of breathing machines besides the CPAP, including machines that send a gentle pulse to your tongue. The pulse prompts your tongue to move forward and open the airway. This usually requires an outpatient surgical procedure to insert the device.
Complications of sleep apnea
If you suspect you might have OSA, it’s important to get a proper diagnosis and treatment right away. Left untreated, OSA can lead to more serious health problems. It’s thought, for instance, to put people at higher risk of developing atrial fibrillation (a heart rhythm problem), heart disease, stroke, diabetes, glaucoma, and neurologic disease.
People who rarely get enough sleep are also at greater risk of falls and depression and may have trouble managing their other health problems well. Research also shows that OSA may be linked to cognitive impairment and even dementia. “[Sleep apnea] is a relatively common, often undiagnosed, often under-treated, probable cause of cognitive decline in many individuals,” Dale Bredesen, MD, neuroscience researcher and neurodegenerative disease expert, told Prevention.com.
Of course, one big benefit of getting OSA treated is simply getting a good night’s sleep and waking up feeling well rested. And isn’t that something we all want?
Medicare and sleep apnea
Medicare can help cover the costs of both sleep apnea diagnosis and treatment. A sleep study will be covered when it’s ordered by a doctor. Medicare will also cover most of the cost of CPAP machines and replacement supplies. The CPAP is covered as durable medical equipment (DME) provided a doctor has deemed it medically necessary.
Under certain circumstances, Medicare will also cover alternative treatments to CPAP, including dental appliances, other devices, and surgery. Medicare Advantage may offer additional coverage for sleep apnea, as well as exercise benefits like SilverSneakers that can improve the quality of your sleep!
Check out our easy-to-use Find a Plan tool, and rest easy knowing you have the right Medicare plan for your needs.
- ClearMatch Medicare: Sleep and Weight Gain: What’s the Connection?
- ClearMatch Medicare: Find a Medicare Plan
- American Medical Association: What Doctors Wish Patients Knew About Sleep Apnea
- Journal of the American Geriatrics Society: Recognition and Diagnosis of Obstructive Sleep Apnea in Older Americans
- Mayo Clinic: Sleep Apnea
- University of Missouri School of Medicine: Common Sleep Apnea Treatment May Not Benefit Patients Older Than 80
- Prevention: Sleep Apnea May Increase Risk for Alzheimer’s Disease and Stroke, Study Shows