Sleep apnea (AP-ne-ah) is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound. Sleep apnea usually is a chronic (ongoing) condition that disrupts your sleep. When your breathing pauses or becomes shallow, you'll often move out of deep sleep and into light sleep. As a result, the quality of your sleep is poor, which makes you tired during the day. Sleep apnea is a leading cause of excessive daytime sleepiness. Overview Sleep apnea often goes undiagnosed. Doctors usually can't detect the condition during routine office visits. Also, no blood test can help diagnose the condition. Most people who have sleep apnea don't know they have it because it only occurs during sleep. A family member or bed partner might be the first to notice signs of sleep apnea. The most common type of sleep apnea is obstructive sleep apnea. In this condition, the airway collapses or becomes blocked during sleep. This causes shallow breathing or breathing pauses. When you try to breathe, any air that squeezes past the blockage can cause loud snoring. Obstructive sleep apnea is more common in people who are overweight, but it can affect anyone. For example, small children who have enlarged tonsil tissues in their throats may have obstructive sleep apnea. The animation below shows how obstructive sleep apnea occurs. Click the "start" button to play the animation. Written and spoken explanations are provided with each frame. Use the buttons in the lower right corner to pause, restart, or replay the animation, or use the scroll bar below the buttons to move through the frames. The animation shows how the airway can collapse and block air flow to the lungs, causing sleep apnea. Central sleep apnea is a less common type of sleep apnea. This disorder occurs if the area of your brain that controls your breathing doesn't send the correct signals to your breathing muscles. As a result, you'll make no effort to breathe for brief periods. Central sleep apnea can affect anyone. However, it's more common in people who have certain medical conditions or use certain medicines. Central sleep apnea can occur with obstructive sleep apnea or alone. Snoring typically doesn't happen with central sleep apnea. This article mainly focuses on obstructive sleep apnea. Outlook Untreated sleep apnea can: Increase the risk of high blood pressure, heart attack, stroke, obesity, and diabetesexternal link icon Increase the risk of, or worsen, heart failure Make arrhythmias (ah-RITH-me-ahs), or irregular heartbeats, more likely Increase the chance of having work-related or driving accidents Sleep apnea is a chronic condition that requires long-term management. Lifestyle changes, mouthpieces, surgery, and breathing devices can successfully treat sleep apnea in many people. Which allergens commonly cause allergic rhinitis? You probably know that pollens from trees, grasses, and weeds cause allergic rhinitis. Many people have allergies to dust mites, animal dander, cockroaches, and mold as well. Things in the workplace, such as cereal grain, wood dust, chemicals, or lab animals, can also cause allergic rhinitis. If you are allergic to pollens, you may have symptoms only at certain times of the year. If you are allergic to dust mites and indoor allergens, you may have symptoms all the time. How is allergic rhinitis diagnosed? To find out if you have allergies, your doctor will ask about your symptoms and examine you. Knowing what symptoms you have, when you get them, and what makes them worse or better can help your doctor know whether you have allergies or another problem. If you have severe symptoms, you may need to have allergy tests to find out what you are allergic to. Your doctor may do a skin test. In this test your doctor puts a small amount of an allergen into your skin to see if it causes an allergic reaction. Your doctor may order lab tests. These tests look for substances that put you at risk for allergies. How is it treated? There is no cure for allergic rhinitis. One of the best things you can do is to avoid the things that cause your allergies. You may need to clean your house often to get rid of dust, animal dander, or molds. Or you may need to stay indoors when pollen counts are high. Unless you have another health problem, such as asthma, you may take over-the-counter medicines to treat your symptoms at home. If you do have another problem, talk to your doctor first. Others who also should talk to their doctor before starting self-treatment include older adults, children, and women who are pregnant or breast-feeding. If your allergies bother you a lot and you cannot avoid the things you are allergic to, you and your doctor can decide if you should get allergy shots (immunotherapy) to help control your symptoms. For allergy shots to work, you need to know what you are allergic to. Finding the treatment that works best for you may take a little time. Rhinitis, which occurs most commonly as allergic rhinitis, is an inflammation of the nasal membranes that is characterized by sneezing, nasal congestion, nasal itching, and rhinorrhea, in any combination.[2] While allergic rhinitis itself is not life-threatening (unless accompanied by severe asthma or anaphylaxis), morbidity from the condition can be significant. Signs and symptoms History Signs and symptoms of allergic rhinitis include the following: Sneezing Itching: Nose, eyes, ears, palate Rhinorrhea Postnasal drip Congestion Anosmia Headache Earache Tearing Red eyes Eye swelling Fatigue Drowsiness Malaise Complications of this allergic rhinitis include the following: Acute or chronic sinusitis Otitis media Sleep disturbance or apnea Dental problems (overbite): Caused by excessive breathing through the mouth Palatal abnormalities Eustachian tube dysfunction Management The management of allergic rhinitis consists of the following 3 major treatment strategies: Environmental control measures and allergen avoidance: These include keeping exposure to allergens such as pollen, dust mites, and mold to a minimum Pharmacologic management: Patients are often successfully treated with oral antihistamines, decongestants, or both; regular use of an intranasal steroid spray may be more appropriate for patients with chronic symptoms Immunotherapy: This treatment may be considered more strongly with severe disease, poor response to other management options, and the presence of comorbid conditions or complications; immunotherapy is often combined with pharmacotherapy and environmental control Allergy skin tests (immediate hypersensitivity testing): An in vivo method of determining immediate (IgE-mediated) hypersensitivity to specific allergens Radioallergosorbent test (RAST): Indirectly measures the quantity of immunoglobulin E (IgE) serving as an antibody to a particular antigen Total serum IgE: Neither sensitive nor specific for allergic rhinitis, but the results can be helpful in some cases when combined with other factors Total blood eosinophil count: Neither sensitive nor specific for the diagnosis, but, as with total serum IgE, can sometimes be helpful when combined with other factors Imaging studies used in the diagnosis and evaluation of allergic rhinitis include the following: Radiography: Can be helpful for evaluating possible structural abnormalities or to help detect complications or comorbid conditions, such as sinusitis or adenoid hypertrophy Computed tomography scanning: Can be very helpful for evaluating acute or chronic sinusitis Magnetic resonance imaging: Also can be helpful for evaluating sinusitis
