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Focus on sleep - treatment for apnea

Researchers are not sure why apnea occurs. Attempts to correct the disorder through surgical widening of the nasal passages have largely failed, indicating the problem is less of an anatomical than neurological nature.

Alan Solko, 64, of Queens, used to snore so loudly that his wife couldn't bear sleeping with him and visitors could hear him "all the way down the hall," he said recently. "I felt nothing. I just snored. I slept very well. But I kept my wife up all night," he said.

One of the most common, most dangerous and most easily treated sleep disorders is apnea. Million of Americans stop breathing for up to two minutes at a time in their sleep and suffer related respiratory and heart problems, according to the American Sleep Disorders Association.

After seven years of ever-louder nocturnal snoring, Solko sought help at the Stony Brook University Hospital sleep laboratory. "I didn't know until I slept in the test at the hospital that I was stopping breathing three hundred times or more a night. That scared the hell out of me. It meant I could die in my sleep," Solko said.

Solko was given a CPAP device (controlled positive airways pressure) to use while sleeping, "and it's like a miracle," he said. "You have a mask that you put over your face when you sleep, and this machine just pumps ordinary air through your nostrils."

CPAP has revolutionized treatment for apnea, experts say. But many insurance carriers and Medicare do not fully cover the price of CPAP. That financial burden can deter some patients from seeking treatment.

There are changes in the respiratory control of breathing. And one kind of change is a reduction of respiratory drive. And during REM [rapid eye movement] sleep there is a tremendous amount of change that seems to impact respiratory drive.

In REM sleep, the heart and breathing rates may vary dramatically, then fall sharply during deep sleep. Some scientists believe apnea is a condition in which the brain mechanisms responsible for controlling changes in breathing rates somehow go awry.

Nearly all apnea sufferers are men, which forces scientists to seek some male factor in the brain that affects breathing. So far, no such tie has been found, but many in the field believe it may be linked to the same factors that put men at greater risks for heart attacks.

The mortal danger of sleep apnea is particularly dramatic among infants. Up to 50 percent of all prematurely born babies suffer apnea, requiring constant monitoring and respiratory support.

Next: Helping yourself to get relief from sleep apnea