Understanding Sleep Apnea and Its Symptoms
Sleep apnea is a serious sleep disorder where a person’s breathing repeatedly stops and starts during sleep. The most noticeable symptom is loud snoring, though not everyone who snores has sleep apnea. Obstructive Sleep Apnea (OSA), the most common form, involves the throat muscles intermittently relaxing and blocking the airway during sleep. Central Sleep Apnea, which is less common, doesn’t involve blockage of the airway; instead, the brain fails to send the appropriate signals to the muscles that control breathing. Lastly, Complex Sleep Apnea Syndrome is when someone has both obstructive and central sleep apnea.
Primary Indicators of Sleep Apnea
People often do not know they have sleep apnea because it occurs during sleep. It is usually identified by a family member or bed partner. Symptoms include:
- Excessive Daytime Sleepiness: You might find yourself feeling extremely drowsy during the day, falling asleep during routine activities, or struggling to stay awake while driving.
- Loud Snoring: Snoring loud enough to disturb the sleep of others or yourself is a common sign of sleep apnea. However, not all snorers have sleep apnea, and not all sleep apnea patients snore.
- Observed Episodes of Breathing Cessation: A partner might notice periods during the night where you stop breathing altogether, which is a telltale sign of sleep apnea.
- Awakening With a Dry Mouth or Sore Throat: Awakening in the morning with a dry mouth or sore throat is often due to breathing through the mouth during sleep, which can be a result of airway obstruction.
- Morning Headache: Frequent morning headaches can also be a symptom due to the lack of oxygen and disturbed sleep.
- Difficulty Concentrating: Sleep apnea can lead to poor sleep quality, which can cause trouble with attention, concentration, and memory.
- Mood Disturbances: Irritability or depression can result from the chronic sleep disturbance associated with sleep apnea.
- Insomnia or Difficulty Staying Asleep: You may experience insomnia or wake up frequently during the night due to the inability to breathe properly.
- Nocturia: Waking up during the night to urinate (nocturia) can be associated with sleep apnea.
- Decreased Libido: A reduction in sexual desire can sometimes be linked to sleep apnea.
It’s important to note that some people with sleep apnea may not experience daytime sleepiness.
Differentiating Between Types of Sleep Apnea
Obstructive Sleep Apnea (OSA)
In obstructive sleep apnea, the airway at the back of the throat becomes physically blocked due to various reasons such as excess weight, a large tongue, tonsillitis, or anatomical differences. The blockage can cause multiple awakenings throughout the night, though the person may not fully wake up or remember these disturbances. Because of these frequent interruptions in breathing, the brain and the rest of the body may not get enough oxygen, leading to other health issues over time.
Central Sleep Apnea (CSA)
In central sleep apnea, the problem lies within the central nervous system. Unlike OSA, the airway is not blocked; instead, the brain fails to signal the muscles to breathe due to instability in the respiratory control center. Snoring is typically less common in central sleep apnea compared to obstructive sleep apnea. The most prominent symptoms are shortness of breath and chronic fatigue.
Complex Sleep Apnea Syndrome (CompSAS)
This syndrome, also known as treatment-emergent central sleep apnea, includes symptoms of both obstructive and central sleep apnea. Patients with CompSAS often develop central sleep apnea when they are receiving treatment for OSA through Continuous Positive Airway Pressure (CPAP) machines.
The Impact of Sleep Apnea on Health
Sleep apnea does more than just disrupt sleep; it can lead to a number of health problems if left untreated:
- High Blood Pressure: The stress of waking up often can increase blood pressure, and the lack of oxygen can add to it.
- Heart Disease: People with OSA are more likely to suffer from heart attacks and atrial fibrillation due to the sudden drops in blood oxygen levels during sleep.
- Type 2 Diabetes: Sleep apnea is common among people with type 2 diabetes because of its association with obesity and insulin resistance.
- Metabolic Syndrome: This disorder, which includes high blood pressure, abnormal cholesterol levels, high blood sugar, and an increased waist circumference, is linked to a higher risk of heart disease.
- Complications With Medications and Surgery: People with sleep apnea may be more likely to experience complications following major surgery because they’re prone to breathing problems, especially when sedated and lying on their backs.
- Liver Problems: Nonalcoholic fatty liver disease could be more likely due to the effects of sleep apnea.
- Sleep-Deprived Partners: Loud snoring can keep anyone sharing the room awake, leading to relationship stress and separate bedrooms.
Factors that Affect Sleep Apnea
Several factors can increase the risk of developing sleep apnea:
- Excess Weight: Obesity greatly increases the risk of sleep apnea. Fat deposits around your upper airway can obstruct breathing.
- Neck Circumference: A thicker neck may narrow the airway, making it more likely to be obstructed.
- A Narrowed Airway: You might have a naturally narrow throat, or enlarged tonsils or adenoids.
- Being Male: Men are more likely to have sleep apnea than women, though the risk for women increases if they are overweight or postmenopausal.
- Age: Sleep apnea is more common in older adults.
- Family History: A family history of sleep apnea could increase your risk.
- Use of Alcohol, Sedatives, or Tranquilizers: These substances can relax the muscles in your throat, which can worsen obstructive sleep apnea.
- Smoking: Smokers are more likely to have obstructive sleep apnea than are people who’ve never smoked. Smoking can increase inflammation and fluid retention in your upper airway.
- Nasal Congestion: If you have difficulty breathing through your nose due to an anatomical problem or allergies, you’re more likely to develop obstructive sleep apnea.
- Medical Conditions: Congestive heart failure, high blood pressure, and type 2 diabetes may increase the risk of obstructive sleep apnea. Polycystic ovary syndrome, hormonal disorders, prior strokes, and chronic lung diseases such as asthma can also make it more likely.
Diagnosis and Treatment of Sleep Apnea
If you notice signs of sleep apnea, it’s important to consult a doctor who may refer you to a sleep disorder center. A sleep specialist can help you decide on your need for sleep testing. Tests to detect sleep apnea include nocturnal polysomnography — where you’re connected to equipment that monitors your heart, lung, and brain activity, breathing patterns, arm and leg movements, and blood oxygen levels while you sleep — and home sleep tests, which are simplified tests used to diagnose sleep apnea by measuring airflow, breathing patterns, and blood oxygen levels.
The treatment of sleep apnea may involve lifestyle changes, such as losing weight or quitting smoking, and CPAP therapy, which uses a machine to deliver air pressure through a mask while you sleep. Other options include using a different airway pressure device, wearing a mouthpiece or oral device, or undergoing surgery to remove tissue and expand the airway.
Finishing Thoughts
Sleep apnea is not just about loud snoring and poor sleep. It’s linked with several serious health conditions, and recognizing its symptoms can be crucial for your long-term well-being. Whether through lifestyle changes, medical devices, or surgery, treatment can greatly improve the quality of life and health outcomes for those suffering from this condition. Always consult healthcare professionals if you believe you or a loved one may have sleep apnea, and take proactive steps towards a healthier, restful night’s sleep.
