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Sleep Apnea

Sleep Apnea


 Sleep Apnea


Sleep apnea is a common condition that may seriously impact your health, increasing your risk for heart disease, stroke and diabetes, among other conditions. Indiana University Health physicians are experts in treating sleep apnea, which will improve your health and quality of sleep.


If you have sleep apnea, you may stop breathing for short periods of time while you sleep. During this period, the amount of oxygen in your blood drops, which affects the cells in your body and prevents them from functioning correctly. Your body often wakes you up multiple times each night as you experience these periods of not breathing, which causes you to become sleep deprived because the sleep you are getting is of such poor quality. People with sleep apnea are at higher risk for accidents, high blood pressure, heart disease, diabetes, stroke, arrhythmias and depression.


There are two types of sleep apnea: obstructive sleep apnea and central sleep apnea. Obstructive sleep apnea, the most common form of the condition (especially in obese patients), results when the upper airway becomes blocked during sleep, although your body continues to try to breathe. Central sleep apnea, on the other hand, is a less common condition in which your brain does not send the signals to your respiratory system to breathe during sleep.


Sleep apnea has a variety of causes, ranging from excess weight and obesity to genetic and physical or anatomical factors. Lifestyle changes, breathing devices, mouth guards and even surgeries may be used to correct your sleep apnea and keep you healthy.


If you are having issues with daytime sleepiness or snoring, talk to your physician about the possibility of sleep apnea. 


Our physicians offer advanced, comprehensive treatment options for sleep apnea that fit your needs and lifestyle. At Indiana University Health, we work with you to make the changes necessary to improve your sleep quality and overall well-being. Our expert physicians understand how difficult it is to go about your daily activities when you are having trouble sleeping and strive to help you rest easy. 


How We Can Help


Sleep Apnea Treatment Information


We provide a variety of services to manage your sleep apnea.


  1. Berlin questionnaire. A Berlin questionnaire is a screening tool used to figure out if you are at risk for having sleep apnea. It assesses your risk by asking about how you sleep, whether you snore and if you have high blood pressure. Take the American Sleep Apnea Association’s Berlin Sleep Questionnaire to learn your risk.
  2. STOP-BANG screening. A STOP-BANG questionnaire is a simple screening to determine your risk for sleep apnea. The letters refer to the eight different questions about snoring, tiredness, observed apneas, blood pressure, BMI, age, neck circumference and gender. Take the STOP-BANG questionnaire from the American Sleep Apnea Association. Calculate your BMI to complete the screening.
  3. Overnight sleep study. During a sleep study, we evaluate your sleeping and breathing patterns while you sleep. For shift workers, we are able to work with your schedule to ensure that you undergo the sleep study during your typical sleep time. We take measurements by attaching cannulas, belts and small metal discs called electrodes, to the skin around your head. We also take video of you sleeping or attach electrodes to other parts of your body to monitor muscle movements. Electrodes allow us to watch your brain and nerve activity so we can map out your sleep pattern. Changes in sleep pattern or breathing may indicate sleep apnea.
  4. Home sleep studies. For some selected patients, sleep studies can be completed at home in the comfort of your own bedroom. You simply pick up sleep monitoring equipment from our facility and return it when you are finished.
  5. Home care consultation. A variety of devices and masks help relieve the symptoms of sleep apnea. Our home care experts work with you to find the ones that fit you best so you can rest comfortably. Our respiratory therapists meet with you personally at one of our Indiana University Health Sleep Apnea Education Centers where we offer a wide selection of equipment and supplies to meet your needs. In a consultation of up to 90 minutes, we use our skill and experience to ensure an excellent fit and teach you how to use your device. We provide thorough follow-up to answer questions, resolve problems and help you use the equipment effectively.  
  6. Continuous positive airway pressure (CPAP). This treatment uses a gentle air flow to keep your breathing passages open while you sleep. Components include a mask that fits over your nose (or nose and mouth) and a machine that blows air through a tube connected to the mask. Some machines have heated humidifiers or other additional features. Your physician prescribes specific settings for your CPAP device so that you receive the proper air pressure. The right CPAP mask for you is comfortable and does not leak too much air or irritate your skin. CPAP is a long-term treatment that you use every time you sleep, even during naps. The machine is typically the size of a tissue box and light enough to bring when traveling. We may be able to link your device to a website that records data about your treatment.
  7. Bilevel positive airway pressure device. This machine works like CPAP with one major difference. Instead of delivering air at a constant pressure, it supplies a higher pressure when you breathe in and a lower pressure when you breathe out. This feature helps if you find it hard to breathe while using CPAP. It is also useful for severe obstructive sleep apnea and for central sleep apnea.
  8. Auto-adjusting positive airway pressure (AutoPAP). This device is like CPAP except that it monitors the resistance in your breathing and adjusts air pressure throughout the night. In this way it maintains the minimum pressure to keep your airways open. AutoPAP helps if you tend to have more trouble during specific times of the night, such as the rapid eye movement (REM) sleep phase. This machine also may be useful if you find CPAP uncomfortable.
  9. Adaptive servo ventilation. Like PAP devices, this treatment for central sleep apnea and complex sleep apnea (combination of obstructive and central sleep apnea) uses a mask connected by tubing to a machine. However, it uses different processes and calculations to keep your breathing stable throughout the night. Adaptive servo ventilation reacts in real time to changes in your breathing rate and the volumes of air that you inhale and exhale.
  10. Oral appliance. Selected patients with obstructive sleep apnea may benefit from an oral appliance that is made by a sleep dentist. This appliance is specially molded to keep your mouth and throat in a position that allows your airways to stay open during sleep. Some patients find these more comfortable than PAP machines, though PAP machines are always the first line of treatment for sleep apnea.
  11. Surgical options. Some surgical treatments are available to reduce the risk of airway obstruction if no other options improve your condition. IU Health Ear, Nose & Throat surgeons can remove tissue in your throat and mouth to open up the airway or move your jaw forward so your airway has a wider opening. All surgeries have risks of bleeding, infection and pain. Be sure to speak with your physician about all your options before undergoing surgery.
  12. Weight loss support. Being overweight can dramatically increase problems associated with sleep apnea. Our physicians provide you with support and resources to lose weight. You may need to visit with a dietitian to create a nutrition plan to help you lose weight in a healthy way. Regular exercise can also lead to weight loss as well as improved sleep quality.
  13. Bariatric Surgery. If you are morbidly obese, one of several bariatric surgeries may be helpful. Gastric band surgery, Roux-en-Y gastric bypass surgery and sleeve gastrectomy are several bariatric surgery weight loss options. Losing excess weight is important in the treatment of sleep apnea and often improves the condition. In some cases of mild or moderate sleep apnea, shedding extra pounds may even be curative.
  14. Referral to specialist. If your sleep apnea is causing other problems, our physicians can refer you to other IU Health experts who can improve your health. If the amount of oxygen in your blood drops during sleep because you stop breathing, it can increase your blood pressure and risk for heart disease. IU Health Heart & Vascular physicians provide expert management of high blood pressure and other cardiovascular conditions.

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