Sleep apnea is a potentially serious disorder. During sleep, you repeatedly stop breathing for short periods of time, which can lead to heart problems and other complications. Up to 7% of the population suffers from this unusual condition, and it is more common in men. In America, 18 million people are affected by it.
How do you know if you have sleep apnea?
People usually experience excessive tiredness even after – what they perceive to be – a full night’s sleep. Sleep apnea causes the upper airways to shut off and the oxygen supply gets cut. This makes the person wake up to resume the breathing cycle. Constant sleep interruptions result in feelings of fatigue during the day.
Other people’s sleep gets interrupted too, as those affected by sleep apnea snore, gasp and choke very audibly.
The three main warning signs are:
- Loud and persistent snoring.
- Choking episodes during sleep.
- Sleepiness during the day, which can be accompanied by a morning headache.
Often, breathing pauses are observed by the person’s sleeping partner. In severe cases, the sufferers can wake up hundreds of times per night and gasp for air.
Complete apnea means that the breathing stops for a ten-second period. During partial apnea, ventilation is briefly reduced by at least 50%.
Due to poor quality of sleep, people can experience difficulty concentrating, moodiness and irritability and reduced libido. Breathing interruptions also influence hormone function. When sleep apnea is extreme, a hormone that controls urine production in the kidneys gets affected and people start waking up at night to go to the toilet. This frequent desperate need to urinate during the night is called nocturia.
You don’t necessarily suffer from sleep apnea if:
- You snore.
Not every snorer has difficulty breathing. Robert L. Owens, MD, of the Sleep Disorders Research Program at Brigham and Women’s Hospital in Boston, explains that most people who snore don’t have sleep apnea (and in this regard you can refer to my previous article about 7 ways to stop snoring naturally). But, most people with apnea snore and this is the most common sign of the condition.
- You feel sleepy during the day.
It’s normal to sometimes feel the need for a power nap, so don’t worry about that. Excessive sleepiness means that you just doze off in the middle of a conversation or a meal. Daytime sleepiness can be assessed using the Epworth Sleepiness Scale. This scale measures how likely you are to fall asleep during everyday life situations, e.g. in a car, when watching TV, when sitting down after lunch. If the score is above 10, further investigations are needed.
Risk Factors
Everyone can get affected, regardless of age, gender or race. However, certain factors might put you at greater risk of developing the condition:
- Increased body mass index – obesity is an important risk factor. Fat deposits around the neck can disrupt breathing and put extra pressure on the airways. That said, slim people also develop sleep apnea, so not everyone with this condition is overweight.
- Neck circumference – people with thicker necks seem to have a bigger predisposition. This could be due to having narrower airways. Circumference of more than 48 centimeters means a high risk, while a measurement of below 37 centimeters means a low risk for sleep apnea.
- Certain characteristics and abnormalities that narrow the airways – some people have a narrower throat or they develop abnormalities that can make breathing harder, for example, enlarged tonsils, deformities of the nose, thickening or lengthening of the soft palate. Also, if you have difficulty breathing through your nose, you may develop sleep apnea. This can be due to allergies or for anatomical reasons. People with sleep apnea tend to breathe through their mouth and sleep with their mouths open. Consequently, they wake up with dry mouth and gummy front teeth.
- Being Male – men have a greater risk of developing sleep apnea. They are twice as likely to suffer from it compared to women. Women increase their risk after menopause, and if they have other risk factors, such as being overweight.
- Being over 60 – sleep apnea gets more common as people get older.
- Family history – if you have a relative with sleep apnea, it’s more likely to develop the condition. This might be due to the anatomical characteristics that run in the family.
- Use of alcohol and certain drugs – if you drink alcohol or take sedatives or tranquilizers before going to bed, this can increase your chances of having breathing problems. These substances relax the muscles in your throat and make them floppy. They also inhibit the breathing center in your brain.
- Smoking – smoking can increase the amount of phlegm and fluids in your lungs and airways and make breathing more difficult. Smokers are three times more likely to suffer than non-smokers. If you quit smoking, the risk reduces. if you are a smoker, you can find here 5 scientifically proven ways to quit smoking.
If you suspect that you might have sleep apnea, you should go and see your doctor, so that the condition can be investigated and treated. Sleep apnea has been linked to some serious conditions, such as heart failure, stroke and metabolic disorders, so it needs to be properly looked at.
For diagnosing, a set of investigations is performed on the patient while (s)he sleeps. The examination is known as polysomnography and involves various recordings of the person’s brain activity, eye movements and muscle movements.
Treatment
If the most likely cause of the condition is the person’s lifestyle, this needs to be addressed first. Weight loss and smoking cessation are advocated. Also, alcohol should be avoided before going to bed.
Treatment options include the use of a pneumatic splint (CPAP), surgery and intra-oral devices. The most clinical support is given to CPAP, which is considered the gold standard for treating sleep apnea. A nasal or facial mask is worn overnight and a flow generator delivers gentle air pressure that keeps the airways open. It makes the person breathe through the nose rather than through the mouth.
Most people require life-long therapy if the severity of the condition impacts on their daily activities and reduces the quality of life.
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