Sleep Apnea

Sleep-Disordered Breathing and Snoring

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As one of the most common sleep disorders, sleep apnea can seriously affect your quality of life. Left untreated, sleep apnea’s hallmark symptoms of snoring and daytime sleepiness can turn into serious issues like high blood pressure, heart arrhythmias, heart attack, and stroke. Duke sleep medicine specialists and other sleep experts work together to diagnose sleep apnea and recommend treatments that can get you back to sound, restful sleep.

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About Sleep Apnea

Sleep apnea is a type of sleep-disordered breathing that causes you to stop breathing (this is called “apnea”) for short periods of time during sleep. These episodes cause what doctors call microarousals, which is when the brain wakes so slightly that you probably don’t even realize it, interrupting sleep repeatedly. There are two kinds of sleep apnea:

  • Obstructive sleep apnea occurs when your airway becomes temporarily narrowed or closed because certain muscles in your airway relax.
  • Central sleep apnea most often occurs when your brain temporarily fails to tell your body to breathe. Other conditions like heart failure can also cause this type of sleep apnea.
Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

When to Seek Care for Sleep Apnea

If you frequently snore, feel tired, sleep restlessly, temporarily stop breathing during sleep, and/or have a headache when you wake up, you should be evaluated for sleep apnea. 

Many people don’t realize they have sleep apnea or how much it’s affecting their daily function until after they are diagnosed and treated and notice how much better they feel.

Snoring is one of the most common symptoms of sleep apnea, but not everyone who snores has sleep apnea and vice versa. Considering that sleep apnea can be serious, even life-threatening, it’s best to be evaluated and find out for sure. Even if it turns out you don’t have sleep apnea, your doctors can help reduce your snoring.

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Tests for Sleep Apnea

The only way to determine whether you have sleep apnea is to undergo an overnight sleep study. Your doctor may recommend an at-home sleep study or an in-lab sleep study. By measuring your oxygen levels, noting your sleep stages, recording brain activity, monitoring your heart rate, and measuring limb movements while you sleep, our sleep disorders team can determine whether you have sleep apnea, what type it is, and how it can best be treated.

Find out more about sleep studies at Duke.

Positive Airway Pressure (PAP) Therapy Options for Sleep Apnea

Positive airway pressure helps prevent your air passage from collapsing during sleep by delivering compressed air (not to be confused with oxygen) through a mask on your nose and/or mouth. This helps prevent apneas, allowing your body to rest more deeply. 

Most PAP therapy machines require electricity, although there are mobile versions that use batteries. Your Duke sleep doctor will likely prescribe a PAP machine that records and wirelessly transmits data back to them about your machine’s use, air pressure, and more. This allows your doctor to make adjustments remotely, and simplifies your follow-up visits.

Continuous positive airway pressure, or CPAP, therapy is the most common and most effective treatment for sleep apnea. CPAP machines deliver a steady stream of pressurized air as you inhale and exhale during sleep. 

Bi-level positive airway pressure, or BiPAP, machines provide higher-pressure air when you inhale and a lower pressure when you exhale. BiPAP therapy may feel more natural and might be easier to adjust to than CPAP, but it’s usually reserved for people who have central sleep apnea, cannot tolerate CPAP therapy, or have more complex sleep apnea.

Adaptive-Servo Ventilation
As one of the newer PAP options available, adaptive-servo ventilation (ASV) adapts in real-time to your breathing patterns. When it detects a change in breathing, it adjusts to promote continued breathing and then returns to support normal breathing patterns. As such, it may be even more comfortable than BiPAP therapy.

Getting Started with PAP Therapy
With any type of PAP therapy, it will take some time for you to adjust. Our team of PAP coordinators help you find a PAP mask that is both comfortable and effective, order supplies, and learn how to use and maintain your machine. You can call or message our coordinators to ask questions from home, or you can make an appointment to talk to them in person to work through any issues.

Positive Airway Pressure (CPAP / BiPAP) Alternatives

Oral Devices
A mandibular advancement device is a customized mouth guard that is created for you by a dentist. The adjustable device helps move your jaw forward slightly, which helps to keep your airway open during sleep. Oral devices are ideal for people with obstructive sleep apnea who cannot tolerate PAP devices.

Sleep Apnea Surgery
Surgery might be appropriate for people who have tried CPAP and other conservative sleep apnea therapies without success.

Sleep Apnea Surgery: Eligibility

Sleep Apnea Surgery: Types

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Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2023–2024.

This page was medically reviewed on 01/08/2024 by