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silently respond. I snore, and occasionally I stop breathing for a few seconds. At least I’m getting some sleep . (That’s more than I could say about a lot of them!) “But now I’m noticing that I’m really tired a lot, particularly during the afternoon and at the end of the day. I need to take lots of naps, and I’ve even caught myself falling asleep at the wheel. That’s crazy. Maybe this sleep stuff is more serious than I thought.” —Kyle, a twenty-something professional The Greek word “apnea” means “without breath.” People with sleep apnea lit- erally stop breathing—are without breath—repeatedly during their sleep. In some cases, this happens literally hundreds of times per night and often for thirty seconds or longer! These periods of not breathing often wake the per- son from deep sleep, the kind of sleep that restores us. How can anyone get any rest with all those interruptions? In the world of sleep disorders, there are basically two main types of sleep apnea: obstructive apnea and central apnea. Fully nine out of ten people with sleep apnea have obstructive apnea. It is also the type of sleep apnea affected by obesity, so we’ll limit our discussion to obstructive apnea. If you have obstructive apnea, something is blocking your trachea (the passageway, commonly referred to as the windpipe, that brings air in and out of your body) while you sleep. Normally when a person sleeps, his throat muscles stay sufficiently tense to keep the airway open. A person suffering from sleep apnea, however, experiences a relaxation of the throat muscles while he sleeps. This relaxation allows a blockage to form in the passageway. Many things, such as your tongue, tonsils, uvula (that dangly thing in the back of your throat), soft tissue in the back of the throat, the relaxed throat muscles themselves, or fatty tissue can cause such a blockage. Whatever the culprit, the sleeper keeps trying to breathe, but he can’t get enough air because something is in the way. After usually twenty to thirty seconds, the sleeper is disturbed enough to rouse, throat muscles contract, and the throat reopens. Normal air exchange resumes, the individual falls back to sleep, throat muscles relax again allowing the blockage to move back into place, and the cycle repeats.

Aching and Exhausted: Osteoarthritis and Sleep Apnea / 75