Sleep apnea is often dismissed as “just another sleeping issue”. Little do people know that sleep apnea can have serious repercussions when not treated right away.
What can you expect with sleep apnea? Sleep apnea is a serious sleeping disorder where your breathing randomly stops and starts repeatedly. Expect someone with sleep apnea to snore loudly, and to continue feeling tired despite sleeping for hours.
Let’s look at the most critical aspects surrounding sleep apnea to better understand its causes, symptoms, kinds, and possible treatments available.
What are the Different Types of Sleep Apnea?
Sleep apnea comes in three different types.
- Obstructive Sleep Apnea – This is usually due to your throat muscles relaxing. It is the most common form of sleep apnea.
- Central Sleep Apnea – This is more of a neurological issue where the brain does not send the right signals to the muscles involved in the breathing process.
- Complex Sleep Apnea – This is also called “treatment emergent central sleep apnea”. This is when a person has both central sleep apnea and obstructive sleep apnea.
If you think you have sleep apnea, it is best to see a doctor so that the root cause may be identified. This allows you to really pinpoint what type of treatment is best for you.
What are the Symptoms of Sleep Apnea?
The symptoms of all three forms of sleep apnea often overlap, making it hard to diagnose properly.
Here are the most common symptoms of both kinds of sleep apnea:
- Loud snoring
- Breathing stops a few times while sleeping
- Suddenly gasping for air while sleeping
- Waking up with a dry mouth
- Experiencing headaches in the morning
- Insomnia or difficulty staying asleep for long
- Hypersomnia or feeling excessively sleepy throughout the day
- Lack of focus or difficulty paying attention when awake
- Easily irritated
Note that although snoring is one of the most common symptoms of sleep apnea, some people may exhibit the other symptoms without snoring. So make sure you ask any roommate you have if they notice anything unusual when you sleep to check if there’s a need for you to go to the doctor.
What Causes Sleep Apnea?
Sleep apnea, as discussed earlier, can be caused by two things, depending on what kind of sleep apnea it is. Let’s take a deeper look at each of these causes to really understand how it works and what the risks are.
Obstructive Sleep Apnea
Obstructive sleep apnea occurs when the muscles around the back of your throat relax. These muscles support a number of different parts:
- The soft palate
- The small triangular tissue that hangs from your soft palate
- The sides of your throat’s walls
- The tonsils
- The tongue
So you can probably imagine how much potential blockage occurs when your throat muscles relax. Your airway starts to close up, making it highly difficult to breathe in or out.
When your brain notices that you are having a hard time breathing, it automatically wakes you up so that you can reopen your airways by gasping or snorting. Usually, this happens so briefly that you don’t even notice or remember that you woke up.
This happens a few times every hour throughout the night. This is why people with sleep apnea still feel extremely tired even after an entire night’s sleep.
Central Sleep Apnea
When it comes to central sleep apnea, it’s more of an issue with your central nervous system. For people who have central sleep apnea, their brain sometimes fails to send the right signals to the muscles in charge of breathing.
As a result, the body makes no effort at all to breathe continuously while sleeping. People with this kind of sleep apnea may stop breathing for around 10 seconds at a time.
This is why some people wake up with shortness of breath, as if they just came from doing an extremely streinous activity and not from sleeping. This is also why people with central sleep apnea have difficulty in sleeping restfully for hours at a time. Their brain wakes them up every so often, especially when they are no longer breathing.
What are the Risk Factors that Contribute to Sleep Apnea?
Anybody can have sleep apnea. It doesn’t even matter how old you are. There are, however, certain factors that could increase the risks of you getting any of the two major types of sleep apnea.
Obstructive Sleep Apnea
For obstructive sleep apnea, here are the main factors that could increase the risks:
- Excess fats – When people gain weight, sometimes, the additional fats are deposited around the airways. This can cause the area to shrink, which could cause the airways to be blocked.
- Neck circumference – The thicker your neck is, the narrower your airways could also be.
- Narrow throat – Some people may not have a big neck, but would have a narrow throat. This is often inherited.
- Enlarged tonsils – Sometimes, your tonsils or adenoids become larger or inflamed. When this happens, it can cause your airways to be blocked. This is something that commonly occurs in children.
- Gender – Sleep apnea is more common in men than in women.
- Age – The risk of getting sleep apnea also increases as one gets older.
- Use of sedatives – Any form of sedative (alcohol, medication, etc.) causes the throat muscles to relax, therefore blocking the airways.
- Family history – If other people in your family suffer from sleep apnea as well, the risks of you getting it eventually are also higher.
- Nasal congestion – Any form of nasal congestion can cause sleep apnea. So the risks are higher if you have allergies, or if your anatomy causes your nose to be congested all the time.
- Smoking – Smoking causes inflammation in the airways. This is why smokers are thrice as likely to develop sleep apnea compared to people who have never smoked in their entire life.
Central Sleep Apnea
As for developing central sleep apnea, here are the biggest risk factors:
- Age – People who are middle-aged and older are often more at risk of getting sleep apnea than people who are younger.
- Gender – Men are more likely to have central sleep apnea than women.
- Heart disorders – If you have a heart problem, then you would most likely suffer from sleep apnea as well.
- Narcotic pain medication – Methadone and other similar medicine can cause sleep apnea.
- History of stroke – If you’ve suffered from a stroke in the past, your brain function may be slower or weaker, causing sleep apnea.
What are the Effects of Sleep Apnea?
As a serious medical condition, sleep apnea can cause a number of complications:
- Daytime fatigue
When you suffer from sleep apnea, it is almost impossible to have a good night’s rest. Your brain wakes you up repeatedly throughout the night. And although you may not remember waking up every so often in the morning, you will definitely feel its effects throughout the day.
First of all, you will wake up feeling like you didn’t sleep at all. You may remain tired even if you’ve been in bed the whole night. You may also feel sleepy throughout the day.
Because of the lack of restful sleep, you would also have a hard time focusing on your tasks and paying attention to things. It will be easy for you to be distracted or for your mind to wander off. You may even catch yourself dozing off even if you’re in the middle of something extremely important.
All this lack of rest could lead to irritability, moodiness, and depression. Your performance will noticeably decline, whether it’s in school or work.
- Heart problems and hypertension
Because there is a limited supply of oxygen passing through your airways when you have sleep apnea, your blood oxygen levels dramatically drops. This causes your blood pressure to rise and your cardiovascular system to be strained.
This also causes your heartbeat to be abnormal. These irregular heartbeats can be dangerous, as this can lead to sudden death.
Other effects include potential heart attacks and strokes.
- Diabetes
Type 2 diabetes is yet another complication that one can get from sleep apnea.
Type 2 diabetes is characterized by insulin resistance, which means that the body is unable to use its insulin supply properly. This is the most common form of diabetes.
Although some may think that the high occurrence of type 2 diabetes in sleep apnea patients is also connected to age and weight, studies find that these factors are independent of each other. Sleep apnea promotes insulin resistance and alters glucose metabolism regardless of the patient’s age and weight.
- Metabolic syndrome
Metabolic syndrome is characterized by a number of different conditions, including abnormal cholesterol levels, hypertension, high blood sugar, and widening around the waist area.
Those with metabolic syndrome also face a higher risk of contracting heart disease.
- Liver problems
Those who suffer from sleep apnea often receive abnormal results when taking liver function tests. Their livers also show some scarring, which is a symptom of non-alcoholic fatty liver disease.
- Concerns with surgery and medication
Because people with sleep apnea often have trouble breathing when lying on their backs, they are more likely to have complications while and after going through surgery. This is especially true when they are fully sedated while going through any procedure.
- Relationship issues
Of course, one of the biggest effects of having sleep apnea are strained relationships with people you live with. It’s not uncommon to hear about spouses or partners sleeping in different rooms simply because the other couldn’t get enough sleep from the loud snoring.
This is why sleep apnea has to be addressed right away and should be seen as an issue to be discussed between partners, spouses and roommates, and not a problem to be ignored.
How is Sleep Apnea Diagnosed?
When diagnosed right away, you can find many ways to avoid the complications that sleep apnea can bring.
The initial evaluation will mostly be based not only on your own observation, but also that of the people around you, like your roommate or spouse. From here, the doctor will refer you to a sleep disorder center where you’ll be asked to take some tests.
These tests are usually performed at the sleep center, although some tests could also be done at home. The most common tests are:
Nocturnal Polysomnography
This test requires you to be hooked up to a machine that monitors your brain, heart and lung activity while sleeping. It also looks at your breathing patterns, blood oxygen levels, and any arm and leg movements that you may exhibit as you sleep.
This is usually the most accurate form of testing and can detect different forms of sleep apnea. However, this has to be done at a sleep center where you’ll be asked to stay overnight.
Home Sleep Tests
There are simpler tests that you can take home with you. These monitor your blood oxygen level, heart rate, airflow and breathing. However, these tests usually do not show a clear picture of whether you have sleep apnea or not.
If these home tests show abnormal results, the doctor may still recommend letting you go through nocturnal polysomnography to get a clearer picture of what’s going on in your body while you’re sleeping.
How is Sleep Apnea Treated?
Treatments for sleep apnea may vary, depending on what’s causing it and how bad it is. If yours is a mild case, for example, you may be asked to change your lifestyle. But for worst-case scenarios, doctors may go as far as suggesting surgery.
Here are the different ways that sleep apnea may be treated:
Lifestyle Changes
For mild cases of sleep apnea, the doctor may recommend a few lifestyle changes.
- Losing excess weight that could be weighing your throat muscles down
- Avoiding alcohol, tranquilizers, and sedatives that could overly relax your throat muscles before sleeping
- Sleeping on your side instead of on your back
- Avoiding overfatigue
- Stopping bad habits like smoking
Therapy
Here are a few therapeutic methods that have also been proven to help in treating sleep apnea:
- Continuous positive airway pressure (CPAP) and other airway pressure devices
CPAP is a machine that lets you wear a mask where air pressure is delivered while you sleep. This keeps your airways open and clear of obstructions that could cause snoring and sleep apnea.
Of course, this could be a bit bothersome at the start. You would have to get used to sleeping with a mask over your face. The mask is adjustable though, so you can at least make sure it fits comfortably on your face.
If CPAP does not work for you, you may need a different type of air pressure device. A bilevel positive airway pressure (BPAP) might help. This machine delivers more pressure when inhaling compared to when you’re exhaling.
- Oral appliances
There are also oral appliances that keep your throat open. They are also easier to use than CPAP.
A dentist might be able to help you on this. They could suggest different devices you can try. You may have to go through different appliances before you find the right fit, though. These also aren’t as effective in the long-term as a CPAP. You would have to go back to the dentist every so often to readjust the fit as well.
Surgery
Surgery is usually the final option in case you’ve tried everything and nothing has worked. Here are some of the most common surgeries performed for sleep apnea:
- Tissue removal
This is only recommended for those who have mild to moderate sleep apnea, although there is no assurance that it would work.
The procedure involves removing tissues from the top of the throat and at the back part of the mouth, including the adenoids and tonsils. This ensures that there are minimum blockages in the airway, and that there is minimal vibration as you breathe in and out while sleeping.
- Tissue shrinkage
This is a bit similar to tissue removal, but only involves shrinking the tissues through radiofrequency ablation. There are fewer risks here compared to tissue removal.
- Jaw repositioning
This is more formally known as maxillomandibular advancement. it basically moves your jaw forward, away from the rest of your facial bones. This means that there will be more space around your throat, specifically behind the tongue and soft palate.
- Nerve stimulation
In this procedure, a stimulator is inserted into the hypoglossal nerve. This controls the movement of your tongue.
Once the stimulator is there, it will ideally keep your tongue in a position where it does not cause any obstruction to your airways as you sleep. More research has to be done about this procedure though, and there is no assurance that this would work.
- Tracheostomy
Tracheostomy is a procedure where a new air passageway is created. This is only done when your sleep apnea has reached life-threatening heights.
Basically, the surgeon creates a hole on your neck where a tube is inserted. This tube is where you will breathe through.
Related Questions
Does sleep apnea happen every night?
Sleep apnea is a serious, repetitive and long-term disorder, so you may show the symptoms every single night while you sleep. Symptoms like the short stops in between every breath can also happen repetitively while you sleep, sometimes even up to 400 times each night.
Does sleep apnea shorten life span?
Sleep apnea comes with a number of serious complications like hypertension and diabetes, so it’s usually these complications that could cause your life span to shorten.
