18 million Americans suffer from it. It can lead to both physical and psychological problems. Perhaps you, as many do, have it and aren’t even aware of it.

Sleep apnea is a sleep disorder that is characterized by snoring and pauses in breathing at night, waking the person momentarily before they fall back asleep. This disruption of sleep can occur several times a night, 5 to 30 times or more in just one hour. A person, both adults and children alike, can suffer from this disorder for years, even decades, before realizing it.

Studies have shown that sleep apnea can lead to problems like irritability, daytime fatigue, depression, hypertension, heart attack, and stroke, but recent studies have shown that the risks are actually more serious than, well, a heart attack. And while obesity can lead to this disorder, the disorder itself can lead to obesity.

The authors of a review posted in The Lancet Diabetes & Endocrinology journal wrote, “Metabolic health … is largely dependent on behavioral factors such as dietary habits and physical activity. In the past few years, sleep loss as a disorder characterizing the 24-hour lifestyle of modern societies has increasingly been shown to represent an additional behavioral factor adversely affecting metabolic health.”

Other risks have been brought to light as well. Earlier this month, Vincent Yi-Fong Su and Kun-Ta Chou from Taipei Veterans General Hospital in Taiwan spoke of results from their research, which followed 34,100 patients for 11 years.

“Our findings show that sleep apnea is an independent risk factor for incident pneumonia,” they said. “Our results also demonstrated an exposure-response relation in patients with more severe sleep apnea may have a higher risk of pneumonia than patients with sleep apnea of milder severity.”

Heart disease, dementia, diabetes … the negative effects continue to mount up. However, along with the worrisome research comes some hope.

Continuous positive airway pressure devices, or CPAP machines, are currently the most common treatment out there. They consist of a plastic facial mask, which the patient wears at night, connected by a flexible tube to a small bedside machine. Using air pressure, it keeps the patient’s airways open during sleep.

“We know that obstructive sleep apnea is a potential cause of high blood pressure, and we know that CPAP use is associated with reductions in blood pressure in people with hypertension,” says sleep specialist Vishesh K. Kapur, MD. “And now there is reasonable evidence that this treatment can prevent high blood pressure in patients who don’t already have it.”

Modern CPAP machines also come with a built-in humidifier to help prevent dryness in the throat/nasal passages.

But the CPAP machine, which kind of makes you look like a character out of Star Wars, isn’t the only form of treatment. Dr. Ryan Soose, director of the Division of Sleep Surgery at the University of Pittsburgh Medical Center, is studying a new implantable device.

Inspire is a form of upper airway stimulation therapy. The pacemaker-like device is placed just under the skin of the right upper chest, connected to an electrode that stimulates the nerve of the tongue, thus preventing the narrowing of the throat while sleeping.

“The patient has a remote control to turn it on and off when they want to use it,” Dr. Soose said.

Kathy Gaberson, a patient who wore a CPAP machine for five years, tried the new device. Though she felt a slight tingling in her throat when it was turned on, she got the best night’s sleep that she’s had in years.

“I woke up in the morning refreshed,” she said.

Mild sleep apnea can also be treated by sleep hygiene, such as avoiding caffeine and stimulants before bed.

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