Sleep apnea
Overview & Facts
Obstructive sleep apnea is a common and serious sleep disorder that causes you to stop breathing during sleep. The airway repeatedly becomes blocked, limiting the amount of air that reaches your lungs. When this happens, you may snore loudly or make choking noises as you try to breathe. Your brain and body becomes oxygen deprived, and you may wake up. This may happen a few times a night, or in more severe cases, several hundred times a night.
In many cases, an apnea, or temporary pause in breathing, is caused by the tissue in the back of the throat collapsing. The muscles of the upper airway relax when you fall asleep. If you sleep on your back, gravity can cause the tongue to fall back. This narrows the airway, which reduces the amount of air that can reach your lungs. The narrowed airway causes snoring by making the tissue in the back of the throat vibrate as you breathe.
Sleep apnea can make you wake up in the morning feeling tired or unrefreshed although you have had a full night of sleep. During the day, you may feel fatigued, have difficulty concentrating, or you may even unintentionally fall asleep. This is because your body is waking up numerous times throughout the night, even though you might not be conscious of each awakening.
There are many people with sleep apnea who have not been diagnosed or received treatment. A sleep medicine physician can diagnose obstructive sleep apnea using an in-lab sleep study or a home sleep test. Sleep apnea is manageable using Continuous Positive Airway Pressure (CPAP), the front-line treatment for sleep apnea, oral appliance therapy, or surgery.
Obstructive sleep apnea in adults is considered a sleep-related breathing disorder. Causes and symptoms differ for Obstructive Sleep Apnea in Children and Central Sleep Apnea.
Symptoms
The symptom most commonly associated with sleep apnea is snoring. Not everyone who snores has sleep apnea. If snoring is paired with choking or gasping sounds, it is likely to be sleep apnea. Daytime fatigue is another common symptom.
The symptoms of sleep apnea include:
- Loud or frequent snoring
- Choking or gasping while you sleep
- Pauses in breathing
- Morning headaches
- Excessive daytime sleepiness
- Insomnia due to difficulty staying asleep
- Waking up with dry mouth or a sore throat
- Frequent need to urinate during the night
- Trouble concentrating
- Memory or learning problems
- Moodiness, irritability or depression
Risk Factors
A common misconception is that sleep apnea only affects older, overweight men. This widely-held assumption is wrong: anyone can have sleep apnea, regardless of gender, age or body type.
If you have any of the following traits you may be at increased risk:
Am I at risk?
The Epworth Sleepiness Scale is often used tell if you have daytime fatigue, a symptom of sleep apnea.
Physician’s Visit
Your pulmonologist will need to know your symptoms, and whether they began when you gained weight or stopped exercising. If you can, ask a partner or roommate or relative if they have ever heard you snore loudly or make choking noises in your sleep.
You may also need to keep a sleep diary for two weeks. This includes information about what time you went to bed each night, when you woke up in the morning and how many times you woke up each night. This will help the doctor see your sleep patterns, which could contain clues about how to diagnose and correct your sleep problem.
Your pulmonologist will also try to determine if there is something else that is causing your sleep problems or making the symptoms worse, such as:
- Another sleep disorder
- A medical condition
- Medication use
- A mental health disorder
- Substance abuse
A Message to Our Sleep Apnea Patients About Zepbound Coverage
We understand how frustrating the insurance approval process for Zepbound can be — for patients and providers alike. Please know that our team works hard to obtain approvals for every patient who may benefit from this medication.
Unfortunately, insurance coverage for Zepbound varies widely between plans. Some insurance companies do not cover weight-loss medications at all, while others have specific requirements that may differ from the manufacturer’s guidelines or from what we are initially told.
These requirements can include:
- Specific BMI criteria
- Additional medical conditions
- Participation in weight-management programs
- Trial and failure of other medications
- Employer plan exclusions
Even when all medical criteria are met, coverage is ultimately determined by your individual insurance plan. While we are happy to support patients in their medical weight-management journey, our practice is not a dedicated weight-loss clinic.
We do our best to complete prior authorizations, submit required documentation, and advocate for our patients whenever possible within the scope of our practice and staffing resources. If a medication is denied, we will do our best to assist with the appeal process when appropriate.
Thank you for trusting us with your care.