apneic

Sleep apnea is a common disorder that causes your breathing to stop or get very shallow. Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour.

The most common type is obstructive sleep apnea. It causes your airway to collapse or become blocked during sleep. Normal breathing starts again with a snort or choking sound. People with sleep apnea often snore loudly. However, not everyone who snores has sleep apnea.

You are more at risk for sleep apnea if you are overweight, male, or have a family history or small airways. Children with enlarged tonsils or adenoids may also get it.

Doctors diagnose sleep apnea based on medical and family histories, a physical exam, and sleep study results.

When your sleep is interrupted throughout the night, you can be drowsy during the day. People with sleep apnea are at higher risk for car crashes, work-related accidents, and other medical problems. If you have it, it is important to get treatment. Lifestyle changes, mouthpieces, surgery, and breathing devices can treat sleep apnea in many people.

NIH: National Heart, Lung, and Blood Institute

Heart disease is the leading cause of the death in the United States. It is also a major cause of disability. But you can take steps to improve your health and help prevent heart disease. The first step is understanding your risk of heart disease. Your risk depends on many factors, some of which are changeable and others that are not. Learning about them and working on the things that you can change can lower your risk of heart disease.

There are some risk factors for heart disease that you cannot change:

• Your age. Your risk of heart disease increases as you get older. The risk is higher in:
  • Men age 45 and older
  • Women age 55 and older
• Your sex. Some risk factors may affect heart disease risk differently in women than in men. For example:
  • The hormone estrogen provides women some protection against heart disease
  • Diabetes raises the risk of heart disease more in women than in men.
• Your race or ethnicity. Certain groups have higher risks than others. For example:
  • African Americans are more likely than Whites to die of heart disease, while Hispanic Americans are less likely to die of it
  • Asian Americans as a group have lower rates of heart disease than other groups, but South Asian Americans have higher rates
• Your family history. You have a greater risk if you have a close family member who had heart disease at an early age, for example if:
  • Your father or brother was diagnosed before age 55
  • Your mother or sister was diagnosed before age 65

There are many heart disease risk factors that you can change. If you make these changes, you don't just help protect your heart. You can also improve your overall health and well-being.

You may have a lot of changes to make. If you need to, you can make the changes gradually, one at a time. What's most important is that you make them. Depending on your lifestyle, these changes could include:

• Controlling your blood pressure.High blood pressure is a major risk factor for heart disease. It is important to get your blood pressure checked regularly - at least once a year for most adults, and more often if you have high blood pressure. You can also take steps, including lifestyle changes, to prevent or control high blood pressure.
• Keeping your cholesterol and triglyceride levels under control:
  • High levels of cholesterol can clog your arteries and raise your risk of coronary artery disease and heart attack. Lifestyle changes and medicines (if needed) can lower your cholesterol.
  • Triglycerides are another type of fat in the blood. High levels of triglyceride may also raise the risk of coronary artery disease, especially in women.
• Staying at a healthy weight. Being overweight or having obesity can increase your risk of heart disease. This is mostly because they are linked to other heart disease risk factors, including high blood cholesterol and triglyceride levels, high blood pressure, and diabetes. Controlling your weight can lower these risks.
• Eating a healthy diet. Try to limit saturated fats, foods high in sodium (salt), and added sugars. Instead, eat plenty of fresh fruit, vegetables, and whole grains. The DASH diet is an example of an eating plan that can help you to lower your blood pressure and cholesterol, two things that can lower your risk of heart disease.
• Getting regular physical activity. Regular physical activity has many benefits, including strengthening your heart and improving your circulation. It can also help you maintain a healthy weight and lower cholesterol and blood pressure. All of these can lower your risk of heart disease.
• Limiting alcohol. Drinking too much alcohol can raise your blood pressure. It also adds extra calories, which may cause weight gain. Both of those raise your risk of heart disease. It's best not to drink, but if you do:
  • Have no more than 2 drinks per day if you are a man.
  • Have no more than 1 drink per day if you are a woman.
• Not smoking. Cigarette smoking raises your blood pressure and puts you at higher risk of heart attack and stroke.
  • If you do not smoke, don't start.
  • If you do smoke, quitting will lower your risk of heart disease. You can talk with your health care provider for help in finding the best way for you to quit.
• Managing stress.Stress is linked to heart disease in many ways. It can raise your blood pressure. Extreme stress can be a "trigger" for a heart attack. Also, some common ways of coping with stress, such as overeating, heavy drinking, and smoking, are bad for your heart. Some ways to help manage your stress include exercise, listening to music, focusing on something calm or peaceful, and meditating.
• Managing diabetes. Having diabetes doubles your risk of diabetic heart disease. That is because over time, high blood glucose (blood sugar) from diabetes can damage your blood vessels and the nerves that control your heart and blood vessels. So, it is important to get tested for diabetes, and if you have it, to keep it under control.
• Getting enough sleep. If you don't get enough sleep, you raise your risk of high blood pressure, obesity, and diabetes. Those three things can raise your risk of heart disease. To improve your sleep:
  • If you are an adult, try to get 7 to 9 hours of sleep per night.
  • Make sure that you have good sleep habits, such as keeping a regular sleep schedule and creating a good sleeping environment in your bedroom.
  • If you have frequent sleep problems, contact your health care provider. One problem, sleep apnea, causes people to briefly stop breathing many times during sleep. This interferes with your ability to get a good rest and can raise your risk of heart disease. If you think you might have sleep apnea, ask your provider about having a sleep study. And if you do have sleep apnea, make sure that you get treatment for it.

Snoring is the sound you make when your breathing is blocked while you are asleep. The sound is caused by tissues at the top of your airway that strike each other and vibrate. Snoring is common, especially among older people and people who are overweight.

When severe, snoring can cause frequent awakenings at night and daytime sleepiness. It can disrupt your bed partner's sleep. Snoring can also be a sign of a serious sleep disorder called sleep apnea. You should see your health care provider if you are often tired during the day, don't feel that you sleep well, or wake up gasping.

To reduce snoring:

• Lose weight if you are overweight. It may help, but thin people can snore, too.
• Cut down or avoid alcohol and other sedatives at bedtime
• Don't sleep flat on your back

NIH: National Institute on Aging

Adenoids are a patch of tissue that is high up in the throat, just behind the nose. They, along with the tonsils, are part of the lymphatic system. The lymphatic system clears away infection and keeps body fluids in balance. The adenoids and tonsils work by trapping germs coming in through the mouth and nose.

Adenoids usually start to shrink after about age 5. By the teenage years, they are almost completely gone. By then, the body has other ways to fight germs.

Enlarged adenoids are adenoids that are swollen. It is a common problem in children.

Your child's adenoids can be enlarged, or swollen, for different reasons. It may just be that your child had enlarged adenoids at birth. Adenoids can also become enlarged when they are trying to fight off an infection. They might stay enlarged even after the infection is gone.

Enlarged adenoids can make it hard to breathe through the nose. Your child might end up breathing only through the mouth. This may cause:

• A dry mouth, which can also lead to bad breath
• Cracked lips
• A runny nose

Other problems that enlarged adenoids can cause include:

• Loud breathing
• Snoring
• Restless sleep
• Sleep apnea, a disorder that causes you to repeatedly stop breathing during sleep
• Ear infections

To find out if your child has enlarged adenoids, the health care provider will:

• Ask about your child's medical history, including asking about your child's symptoms
• Check your child's ears, throat, and mouth
• Feel your child's neck

Since the adenoids are higher up than the throat, the provider cannot see them just by looking through your child's mouth. To check the size of your child's adenoids, your provider may use:

• A special mirror in the mouth
• A long, flexible tube with a light (an endoscope)
• An x-ray

The treatment depends on what is causing the problem. If the symptoms are not too bad, your child may not need treatment. If treatment is needed, your child may get nasal spray to reduce the swelling or antibiotics if the provider thinks that there is a bacterial infection.

In some cases, your child may need an adenoidectomy.

An adenoidectomy is surgery to remove the adenoids. The provider may recommend this surgery if:

• Your child has repeated infections of the adenoids. Sometimes the infections can also cause ear infections and fluid buildup in the middle ear.
• Taking antibiotics doesn't get rid of a bacterial infection of the adenoids.
• The enlarged adenoids block the airways.

If there is also a problem with the tonsils, your child will probably have a tonsillectomy (removal of the tonsils) at the same time that the adenoids are removed.

After having the surgery, your child usually goes home the same day. Your child will probably have some throat pain, bad breath, and a runny nose. It can take several days to feel all better.

Obesity is a disease that means having too much body fat. It is different from being overweight, which means weighing too much. Both terms mean that your weight is greater than what's considered healthy for your height.

Body Mass Index (BMI) measures how much you weigh compared to how tall you are. An adult who has a BMI of 30 or more is considered to have obesity. Severe obesity is having a BMI of 40 or higher. Obesity increases your risk for many other diseases and health problems, especially if the extra body fat is carried around the waist.

Obesity happens over time from taking in more calories (through food and drinks) than used up from physical activity and daily living. Your body stores the extra calories as fat. The right balance between calories and activity is different for everyone.

There are many different factors that can affect your body weight. Certain medicines or medical conditions may affect your weight. Other factors include your:

• Genetic makeup
• Eating habits
• Sex
• Race or ethnicity
• Physical activity level

To find out if you have obesity, your health care provider may:

• Ask about your health history, which may include reviewing your weight history, weight-loss efforts, and how physically active you are.
• Do a physical exam, which may include checking your height, weight, and vital signs, as well as listening to your heart and lungs.
• Order blood tests or other imaging tests, which may include checking any known health problems, as well as for other weight-related diseases and health conditions.
• Calculate your BMI, to check your risk for certain diseases. The higher your BMI, the higher your risk. BMI does not distinguish between fat, muscle, and bone mass. It may also overestimate body fat in athletes or those with a muscular build, or underestimate body fat in older persons, or others who have lost muscle.
• Check your waist size, since a large waistline, with more body fat around your abdomen (belly) rather than your hips, increases your risk for weight-related health problems.

Having a larger body size can make your heart work harder, put extra pressure on your joints, and may increase your risk for many health conditions, including:

• Type 2 diabetes.
• Heart disease.
• High blood pressure.
• Stroke.
• Metabolic syndrome.
• Osteoarthritis.
• Sleep apnea.
• Pregnancy problems.
• Fertility problems.
• Some cancers.

If you have obesity, losing even 5 to 10% of your weight can delay or prevent some of these diseases. For example, that means losing 10 to 20 pounds if you weigh 200 pounds.

Treatment plans for obesity may depend on your overall weight, other health conditions, and your willingness to participate in a weight-loss plan.

Your provider can tell you what a healthy weight is for you, help you set goals, and give you tips on how to lose weight. They may refer you to other providers that specialize in nutrition or weight loss to help you make realistic goals and provide support.

Possible treatments may include:

• Dietary changes and exercise goals to help you learn how to adopt healthy nutrition, exercise, and lifestyle changes to lose weight safely and keep it off long term.
• Counseling or support groups can give you encouragement and help you understand what's behind weight changes.
• Weight-loss medicines to treat obesity.
• Weight loss procedures or surgery if you have severe obesity or serious obesity-related health problems and have not been able to lose enough weight.

A healthy lifestyle that includes healthy eating patterns and regular physical activity can help you lose weight and lower your chance of developing complications related to obesity.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Almost 1 of every 10 infants born in the United States are premature, or preemies. A premature birth is when a baby is born before 37 completed weeks of pregnancy. A full-term pregnancy is 40 weeks.

Important growth and development happen throughout pregnancy - especially in the final months and weeks. Because they are born too early, preemies weigh much less than full-term babies. They may have health problems because their organs did not have enough time to develop. Problems that a baby born too early may have include:

• Breathing problems
• Feeding difficulties
• Cerebral palsy
• Developmental delay
• Vision problems
• Hearing problems

Preemies need special medical care in a neonatal intensive care unit, or NICU. They stay there until their organ systems can work on their own.

Centers for Disease Control and Prevention

While you are sleeping your brain and body functions are still active. Sleep is a natural process that helps your body restore energy, supports learning and memory, and keeps you healthy.

It's not just the number of hours of sleep you get that matters. The quality of your sleep is also important. During the night, your brain cycles through different stages of non-rapid eye movement (non-REM) sleep and rapid eye movement (REM) sleep. If your sleep is often interrupted, you may not get enough time in certain stages of sleep. Poor-quality sleep does more than make you feel tired. It can affect your physical and mental health, thinking, and daily functioning.

Sleep disorders are conditions that disturb your normal sleep patterns. There are many types of sleep disorders. Some general types include:

• Insomnia, which is trouble falling asleep or staying asleep.
• Sleep-related breathing disorders such as sleep apnea, a condition in which you stop breathing for 10 seconds or more during sleep.
• Sleep-related movement disorders such as restless leg syndrome (RLS), which involves tingling or prickling sensations in your legs, and a strong urge to move them.
• Hypersomnia, which is extreme daytime sleepiness. This includes narcolepsy.
• Circadian rhythm sleep-wake disorders, which are problems falling asleep or waking up at the right times. This may be due to shift work or jet lag.
• Parasomnia, which is unusual behaviors during sleep or while falling asleep or waking up. This may include sleepwalking, talking, or eating during sleep.

Some people who feel tired during the day have a true sleep disorder, while others simply don't get enough sleep. The amount of sleep you need depends on your age, lifestyle, health, and sleep patterns. Most adults need about 7-9 hours each night.

There are different causes for different sleep disorders. They may include:

• Other health conditions, such as heart disease, lung disease, nerve disorders, or pain
• Mental illnesses, including depression and anxiety
• Medicines
• Genetics

Sometimes the cause is unknown.

Other factors that may contribute to sleep problems include:

• Using caffeine or alcohol
• Having an irregular schedule, such as working the night shift
• Aging, since older adults may sleep less, spend less time in deep sleep, and wake easily

The symptoms of sleep disorders depend on the specific disorder. Some signs that you may have a sleep disorder include that:

• You regularly take more than 30 minutes to fall asleep.
• You regularly wake up several times and then have trouble falling back to sleep, or you wake up too early in the morning.
• You often feel sleepy during the day, take frequent naps, or fall asleep at the wrong times during the day.
• Your bed partner says that when you sleep, you snore loudly, snort, gasp, make choking sounds, or stop breathing for short periods.
• You have creeping or tingling sensations in your legs or arms that are relieved by moving or massaging them, especially in the evening and when trying to fall asleep.
• Your bed partner notices that your legs or arms jerk often during sleep.
• You have vivid, dreamlike experiences while falling asleep or dozing.
• You have episodes of sudden muscle weakness triggered by strong emotions.
• You feel as though you cannot move or speak for a brief time when you first wake up.

To diagnose a sleep disorder, your health care provider will review your medical and sleep history and do a physical exam. You may also have a sleep study (polysomnogram). Most sleep studies monitor and record data about your body during a full night of sleep. The data includes:

• Brain wave activity
• Eye movements
• Breathing rate
• Blood pressure
• Heart rate and electrical activity in the heart and other muscles

Other types of sleep studies may check how quickly you fall asleep during daytime naps or how well you can stay awake during the day.

Treatments for sleep disorders depend on which disorder you have. They may include:

• Practicing good sleep habits and other lifestyle changes, such as eating a healthy diet and getting regular exercise
• Reducing anxiety about sleep with cognitive behavioral therapy or relaxation techniques
• Using a CPAP (continuous positive airway pressure) machine for sleep apnea
• Using bright light therapy (in the morning)
• Taking sleep aid medicines, or natural products such as melatonin

Always check with your provider before taking any medicine or supplement. Most sleep aid medicines are generally for short-term use.

An arrhythmia is a problem with the rate or rhythm of your heartbeat. Your heart beats too quickly, too slowly, or with an irregular pattern. Changes in the electrical signals that control your heartbeat cause arrhythmias.

• When your heart beats faster than normal, it's called tachycardia.
• When your heart beats too slowly, it's called bradycardia.
• When the signal to beat comes too early, it's called a premature or extra heartbeat. It may feel like your heart skipped a beat.

There are many types of arrhythmias. Arrhythmias may affect the upper or lower chamber of your heart. The most common type of arrhythmia is atrial fibrillation, which causes an irregular and fast heartbeat.

Some arrhythmias are harmless, such as when your heart rate speeds up during exercise and slows down when you sleep. But if you have a frequent irregular rhythm, it may mean your heart isn't pumping enough blood into your body. Getting treatment and following a heart-healthy lifestyle can help control arrhythmias. It may also help prevent heart damage that can trigger some heart arrhythmias.

Many factors can affect your heart's rhythm, such as having had a heart attack, smoking, congenital heart defects, and stress. Other factors that could increase your risk for some types of arrhythmias could include if you:

• Have a family history of arrhythmias.
• Have certain health conditions, which can include heart and blood vessel diseases, lung diseases, kidney diseases, obesity, and sleep apnea.
• Are an older adult.
• Have had recent surgery for your heart, lungs, or throat.
• Take certain medicines for other health conditions.
• Use illegal drugs.

If you have risk factors, some situations that make your heart work harder, raise your blood pressure, or cause strong emotional stress may trigger an arrhythmia.

You may not have any noticeable symptoms of an arrhythmia. Your provider may find an arrhythmia during your routine checkup. Symptoms of an arrhythmia can include:

• Fast or slow heartbeat
• Skipping, fluttering, or pounding heartbeats
• Chest pain or discomfort
• Dizziness or fainting
• Shortness of breath
• Sweating
• Tiredness or weakness

Seek emergency medical care if you have chest pain, shortness of breath, or think you are having a heart attack.

To find out if you have an arrhythmia, your health care provider may order an electrocardiogram (EKG). This test records your heart's electrical activity and is the most common for finding an arrhythmia. Your provider may also:

• Ask about your medical history, including your symptoms and lifestyle habits.
• Do a physical exam, which includes checking your heartbeat and pulse.
• Order blood tests and other heart tests.
• Check your legs or feet for swelling.
• Look for signs of other health conditions that could cause an arrythmia, such as thyroid disease.

Treatment may include medicines, an implantable cardioverter-defibrillator (ICD) or pacemaker, or sometimes surgery. Your provider may also recommend avoiding activities that may trigger your arrhythmia.

The goal of treatment is to restore a normal heart rhythm. If not treated, arrhythmias can damage your heart, brain, and other organs and could be life-threatening.

To help prevent an arrhythmia, your provider may suggest that you make heart-healthy lifestyle changes and treat health conditions that may cause arrhythmias.

NIH: National Heart, Lung, and Blood Institute

Atrial fibrillation, also known as AFib or AF, is one of the most common types of arrhythmias. Arrhythmias are problems with the rate or rhythm of your heartbeat. They can cause your heart to beat too slowly, too fast, or in an irregular way.

If you have AFib, your heart beats irregularly and sometimes much faster than normal. Also, your heart's upper and lower chambers do not work together as they should. When this happens, the lower chambers do not fill completely or pump enough blood to your lungs and body. This can cause symptoms such as dizziness, fatigue, and a pounding heartbeat.

AFib may happen in brief episodes, or it may be a permanent condition. It's very important to treat it, since AFib can put you at risk for stroke and other heart conditions.

AFib is most often caused by changes to the heart's tissue or the electrical signaling that helps the heartbeat. These changes can happen due to different conditions and factors, such as high blood pressure, coronary artery disease, congenital heart defects, infections, and aging. Sometimes the cause is unknown.

Anyone can develop AFib, but there are certain things that raise your risk for it:

• Aging. The risk of atrial fibrillation increases as you get older, especially when you are over age 65.
• Family history and genetics. AFib can run in families. So can heart disease, which raises your risk of AFib.
• Some lifestyle choices. Your risk is higher if you drink a lot of alcohol, use certain illegal drugs such as cocaine and methamphetamines, or smoke.
• Having certain health conditions, such as:
  • High blood pressure
  • Diabetes
  • Heart failure
  • Heart valve diseases
  • Obesity
  • Hyperthyroidism
  • Chronic kidney disease
  • COPD and other lung diseases
  • Sleep apnea
• Race. AFib is more common in people with European ancestry.
• Recent surgery. You may be at risk of atrial fibrillation in the early days and weeks after surgery on your heart, lungs, or esophagus.

Some people who have AFib don't have any symptoms and don't know they have it. If you do have symptoms, you may only notice them once in a while. Or you may have symptoms that are more frequent. And in some cases, the symptoms might be severe. If you have heart disease, you are more likely to notice your symptoms. And those symptoms could get worse if your heart disease gets worse.

The symptoms of AFib can include:

• Extreme fatigue, which is the most common symptom
• Heart palpitations (the feeling that your heart is skipping a beat, fluttering, pounding, or beating too hard or too fast)
• Trouble breathing, especially when lying down or when exercising
• Chest pain
• Dizziness or fainting
• Low blood pressure

If AFib is not treated, it can lead to serious health problems (complications) such as:

• Stroke
• Heart failure
• Blood clots
• Sudden cardiac arrest (SCA)
• Cognitive impairment and dementia

To help prevent these problems, it's important to contact your health care provider if you are having symptoms. If you do have AFib, the sooner you are diagnosed and treated, the better.

To find out if you have AFib, your provider:

• Will ask about your medical history, including your symptoms, lifestyle, and any other health conditions you may have
• Will ask about your family history, to find out if you have relatives who have or had AFib
• Will do a physical exam
• May order blood tests
• Will likely order heart tests, such as an electrocardiogram (also called an EKG or ECG) and echocardiogram
• May ask you to wear a heart monitor device that records your heart's electrical activity

The treatments for AFib may include:

• Blood thinner medicines that help prevent blood clots from forming.
• Medicines to control your heart's rhythm and rate.
• Following heart-healthy lifestyle changes, such as:
  • Following a heart-healthy eating plan that limits saturated fats, salt, and cholesterol. An example is the DASH eating plan.
  • Limiting or avoiding alcohol, because it can increase your heart rate.
  • Aiming for a healthy weight.
  • Getting regular physical activity.
  • Managing stress.
  • Quitting smoking.
• Procedures such as:
  • Electrical cardioversion, which restores your heart rhythm using low-energy shocks to your heart.
  • Catheter ablation, which scars the tissue that is causing the arrhythmia. The scar tissue blocks the abnormal heart signals.
• Surgeries such as:
  • Surgery to put in a pacemaker to help control the arrhythmia.
  • A Maze procedure, which creates scar tissue in a maze-like pattern in certain parts of the heart.
  • Left atrial appendage closure, a surgery on a small sac in the muscle wall of your left atrium (the upper left chamber of your heart). It helps prevent blood clots and can reduce your risk of stroke. This surgery is for people who are not able to take blood thinners.

There are steps you can take to help lower your risk of atrial fibrillation, such as:

• Making heart-healthy lifestyle changes:
  • Following a heart-healthy eating plan
  • Limiting or avoiding alcohol
  • Aiming for a healthy weight
  • Getting regular physical activity
  • Managing stress
  • Not smoking
• Avoiding illegal drugs, such as cocaine and methamphetamines
• Taking antiarrhythmic medicine (medicine to treat arrhythmia) if you are having heart surgery
• Treating any health conditions that could raise your risk of AFib

NIH: National Heart, Lung, and Blood Institute

When you're short of breath, it's hard or uncomfortable for you to take in the oxygen your body needs. You may feel as if you're not getting enough air. Sometimes you can have mild breathing problems because of a stuffy nose or intense exercise. But shortness of breath can also be a sign of a serious disease.

Many conditions can make you feel short of breath:

• Lung conditions such as asthma, emphysema, or pneumonia
• Problems with your trachea or bronchi, which are part of your airway system
• Heart disease can make you feel breathless if your heart cannot pump enough blood to supply oxygen to your body
• Anxiety and panic attacks
• Allergies

If you often have trouble breathing, it is important to find out the cause.