Your Complete, Science-Backed Guide to Sleep Apnea
With sleep disorders affecting around 70 million people in the US, it’s possible you or someone you know struggle with one without realizing it.
To many people, sleep disorders sound more like an annoyance than a legitimate issue. But many conditions, such as sleep apnea, illustrate the seriousness of sleep disorders, and why it’s important to begin treatment as soon as possible.
What actually is sleep apnea?
Sleep apnea is a sleep disorder that happens when a person repeatedly stops breathing while they sleep. These gaps can affect your quality of sleep and the amount of oxygen your brain receives, which can have serious health consequences.
There are three types of sleep apnea:
- Obstructive sleep apnea, or OSA, occurs when a person’s airway is blocked, often when tissue at the back of the throat collapses while he or she is sleeping.
- Central sleep apnea, or CSA, occurs when the brain doesn’t tell the body to breathe. CSA relates to issues within the central nervous system.
- Complex sleep apnea or mixed sleep apnea occurs when a person is affected by both OSA and CSA at the same time.
Who is at risk of developing sleep apnea?
Sleep apnea affects around 25% of men and 10% of women. It affects people regardless of their age, including babies, children, and adults over the age of 50.
While it can affect anyone, certain factors pose a higher risk:
- Being male
- Being overweight or obese
- A family history of sleep apnea
- A narrowed airway, either due to genetics, large tonsils, adenoids, or a large neck circumference
- Older age
- Smoking and/or using alcohol, sedatives, or tranquilizers
- Nasal congestion
- Other medical conditions, such as type 2 diabetes, high blood pressure, Parkinson's disease, hormonal disorders, or chronic lung diseases
CSA, specifically, is more common in people with an underlying health condition, such as neuromuscular disease or lung disease, and in people who have had a stroke.
What are the risks of sleep apnea?
Untreated sleep apnea can have mild to serious consequences.
- Daytime fatigue: Since sleep apnea prevents you from sleeping continuously through the night, you will likely feel tired and irritated the day after.
- High blood pressure: Drops in oxygen levels while you’re sleeping can put stress on your heart and increase your blood pressure.
- Heart problems: Drops in oxygen levels can also increase your risk of abnormal heartbeats, heart attacks, and strokes.
- Type 2 diabetes: Sleep apnea increases your risk of insulin resistance and type 2 diabetes.
- Issues with surgery: People with OSA may experience more issues after surgery since they are more likely to experience breathing problems.
- Liver complications: People with sleep apnea are more likely to show signs of scarring on their liver and receive abnormal results on liver function tests.
What are the symptoms of sleep apnea?
People with OSA often think they’re sleeping fine, and their partners are the ones who first notice something is wrong. Symptoms of OSA include:
- Snoring
- Feeling sleepy or tired during the day
- Feeling restless while sleeping
- Suddenly and/or frequently awakening while gasping or choking
- Having a dry mouth or sore throat when waking up
- Irritability, forgetfulness, and problems concentrating
- A frequent need to urinate at night
- Headaches
People with CSA often find themselves repeatedly waking up at night or experiencing insomnia. Some may gasp or choke when they awaken. In children, symptoms may be less obvious and include:
- Poor performance in school and/or a learning or behavioral disorders, such as ADHD
- Often tired or sleepy in the day
- Difficulty breathing through the mouth and swallowing in the day
- Odd sleeping positions, such as hyper-extending the neck
- Sweating profusely at night
- Wetting the bed
What is the difference between sleep apnea and snoring?
While snoring is an important indicator of sleep apnea, not everyone who snores has the disorder. Regular snoring and sleep apnea-related snoring occur when tissues at the back of your throat vibrate.
However, regular snoring, also called primary snoring, has many other causes, such as your sleeping position or a nose or throat condition. People with sleep apnea also:
- Snore a lot louder than people without sleep apnea
- Pause for several seconds (over 10 seconds) while they breathe
- Gasp, choke, or take shallow breaths
- Are restless while they sleep
How do I get diagnosed with sleep apnea?
While the diagnostic process for sleep apnea can vary, there are some general procedures your doctor will likely follow. They’ll want to rule out other possible reasons for your symptoms, such as medications, other medical conditions, or travel.
Medical history: Your doctor will look at your family’s history of sleep disorders to assess your risk. They will also look at your health and see if you show signs of untreated sleep apnea, such as another health condition.
Physical examination: Your doctor will perform a physical examination, also to assess your risk of sleep apnea. Certain characteristics, such as large tonsils or the diameter of your upper airway, can indicate signs of sleep apnea or other conditions. Your doctor may also check other organs, such as your lungs and heart, to see if you suffer from any complications related to untreated sleep apnea.
Sleep study: Your doctor might refer you to a sleep specialist for a test that examines factors related to sleep apnea. These include the level of oxygen in your blood while you sleep and the level of activity in the muscles that control your breathing.
Your doctor may order other tests to rule out other conditions. For example, blood tests can indicate hormone levels and whether or not you have an endocrine disorder that is causing your sleep issues.
Your doctor can diagnose you with mild, moderate, or severe sleep apnea, depending on how many times lapses in breathing happen.
- Patients with mild sleep apnea experience between 5 and 14 apnea events in an hour
- Patients with moderate sleep apnea experience between 15 and 29 apnea events in an hour
- Patients with severe sleep apnea experience 30 or more apnea events in an hour
What are the treatment options for sleep apnea?
There are several different treatment options for sleep apnea, depending on how severe your situation is. Mild cases may require lifestyle changes, such as losing weight, changing your sleeping position, and avoiding cigarettes. For more severe cases, your doctor may suggest:
- Positive airway pressure therapy: Patients with OSA can wear a mask while they sleep that lightly forces air through the nose and/or mouth. The mask adjusts air pressure to keep the airway open.
- Oral devices: Patients with mild to moderate OSA can use certain oral devices or dental appliances to physically keep their airways open while they sleep
- Supplemental oxygen: Patients with CSA can use devices to deliver oxygen to their lungs while they sleep.
- Treating other issues: Patients with CSA may have the disorder due to an underlying condition. Treating that condition may also reduce symptoms of CSA.
- Adaptive servo-ventilation (ASV): Patients with complex sleep apnea can use an ASV, a device that learns their breathing pattern and prevents pauses in their breathing.
If you think you or someone you know has sleep apnea, check in with your doctor to discuss your concerns. Due to the potentially serious consequences of untreated sleep apnea, it’s a good idea to know what’s going on and begin treatment as soon as possible.
Disclaimer: This article is an information resource only and is not to be used for diagnostic or treatment purposes. You should always consult your health care provider before making any health care decisions.
