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What are the risk factors for sleep apnea?

There are several factors that may predispose a person towards sleep apnea.

Gender. More men than women appear to have sleep apnea. Sleep apnea may be under-diagnosed in women. In general, older women have the same incidence as men their own age. A range of studies has reported apnea or hypopnea in between 9% and 24% of men and 4% to 15% of women.

Age. Sleep apnea affects people of all ages. Although it is most common in older adults, it has been reported in between 1.6% to 3.4% of children. Some experts believe that sleep disorder breathing may occur in as many as 11% of children. Interestingly, one study suggested that although prevalence of sleep apnea increases with age, its health consequences decline. In the study, apnea posed more of a threat to a person's health before age 45 than afterward.

Ethnicity. African Americans face a higher risk for sleep apnea than any other ethnic group in the United States.

Geography. According to one study, although urban dwellers are more likely to report disturbed sleep, particularly as a result of stress, rural dwellers have a significantly higher risk for apnea.

Obesity. Obesity, particularly having fat around the abdomen (the so-called apple shape), is a particular risk factor for sleep apnea, even in adolescents and children. (It should be noted, however, that many people with sleep-disordered breathing, particularly women and small children, are not obese.)

Immune abnormalities. High levels of certain immune factors are present in people with sleep apnea, including tumor necrosis factor alpha (TNF-alpha) and interleukin 6 (IL-6). Elevated levels of TNF-alpha can cause fatigue, shortness of breath, and weakness in the heart's pumping action. IL-6 and TNF-alpha may both play a role in obesity as well.

Body position. Body position greatly affects the number and severity of episodes of obstructive sleep apnea, with at least twice as many apneas occurring when a person lies face upward than when the person lies on his or her side. This may be due to the effects of gravity, which cause the throat to narrow when a person lies on the back.

Other medical conditions. Individuals with severe heartburn (Gastroesophageal reflux disease, or GERD) appear to be at higher risk for sleep apnea. Sleep apnea is also associated with higher rates of heart failure.

Smoking. Smokers are at higher risk for apnea, with heavy smokers (more than 2 packs a day) having a risk 40 times greater than nonsmokers.

Alcohol. Alcohol use has been associated with apnea, although studies are mixed.

Family history . Family history of OSA, although no genetic pattern has been proven

Obesity or excessive weight gain is a primary risk factor. Additional tissue in the throat narrows the airway, which is then more easily blocked when the muscles are relaxed. Age and gender are also significant factors in sleep apnea. Aging is usually accompanied by a loss of muscle mass and if the muscles near the airways are more lax, it is easier for them to become blocked. Men seem more likely to experience sleep apnea, although it may be underdiagnosed in women.

More information on sleep apnea

What is sleep apnea? - Sleep apnea is a disorder in which a person stops breathing during the night. Sleep apnea means cessation of breath characterized by repetitive episodes of upper airway obstruction.
What types of sleep apnea are there? - There are three types of sleep apnea, including obstructive sleep apnea (OSA), central sleep apnea, mixed sleep apnea.
What is obstructive sleep apnea? - Obstructive sleep apnea is a disorder in which complete or partial obstruction of the airway during sleep causes loud snoring, oxyhemoglobin desaturations and frequent arousals.
What causes obstructive sleep apnea? - Obstructive sleep apnea is caused by repetitive upper airway obstruction during sleep as a result of narrowing of the respiratory passages.
What're the symptoms of obstructive sleep apnea? - Symptoms of obstructive sleep apnea include loud snoring, Daytime sleepiness, memory changes, depression, and irritability.
What is central sleep apnea? - Central sleep apnea is a sleep breathing disorder that occurs when the brain fails to send the appropriate signals to the breathing muscles to initiate respirations.
What causes central sleep apnea? - Conditions that can cause sentral sleep apnea include bulbar poliomyelitis, encephalitis affecting the brainstem, neurodegenerative illnesses.
What're the symptoms of central sleep apnea? - Symptoms of central sleep apnea include extreme exhaustion and sleepiness during daylight hours, early morning headaches, lack of concentration, and memory loss.
What are the risk factors for sleep apnea? - There are several factors that may predispose a person towards sleep apnea, including gender, age, ethnicity, geography, obesity, immune abnormalities.
What are the complications of sleep apnea? - Sleep apnea is a potentially life-threatening condition because there are interruptions in breathing during sleep.
How is sleep apnea diagnosed? - A sleep test, called polysomnography is done to diagnose sleep apnea. Confirmation of the diagnosis requires making measurements while the person sleeps.
What's the treatment to stop sleep apnea? - Treatment for sleep apnea is determined based on the individual's specific circumstances and can include behavioral changes, physical therapy and surgery.
What surgeries are available to cure sleep apnea? - Surgeries to stop sleep apnea include uvulopalatopharyngoplasty, laser-assisted uvulopalatoplasty, tracheostomy, radiofrequency ablation.
What about the CPAP therapy for sleep apnea? - The most effective treatment for sleep apnea is nasal continuous positive airflow pressure (CPAP) therapy.
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