What is Sleep Apnea?
Sleep Apnea is a common but serious sleep disorder. The disorder is caused by repetitive periods when airflow is interrupted during sleep due to a narrowing or closure to the throat. A complete blockage of airflow is an apnea, and a partial interruption is a hypopnea. Each apnea or hypopnea can result in drops in oxygen levels and brief awakenings or sleep disturbances.
Typical symptoms of Sleep Apnea are snoring, snorting or gasping during sleep, unrefreshed sleep, and daytime sleepiness. These multiple breathing interruptions may prevent you from sleeping well, leaving you feeling extra tired during the day.
The disorder can also stress your heart and other organs due to the recurrent drops in oxygen levels, which can cause abnormalities in blood pressure, levels of hormones, inflammation, and other changes.
There are many possible consequences of sleep apnea, and different people can experience different problems. Some people may experience daytime fatigue or sleepiness, problems thinking and concentrating, and mood problems. Untreated sleep apnea may increase the risk of motor vehicle crashes or work-related accidents, poor control of blood pressure, diabetes, heart disease, stroke, and liver problems.
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Types of Sleep Apnea
Obstructive Sleep Apnea: The most common type of sleep apnea. It occurs when the soft tissues in the back of the throat relaxes during sleep and blocks the airway, often causing you to snore loudly. Since sleep apnea only occurs while you are asleep, you may not know you have a problem until a bed partner or roommate complains about your snoring.
Central Sleep Apnea: A much less common type of sleep apnea but is more common in people with heart failure or who have had a stroke. There are also rare genetic disorders and diseases of the brain and muscles that cause central sleep apnea. In central sleep apnea, breathing can be interrupted when the brain fails to signal the muscles that control breathing.
Complex Sleep Apnea: Is characterized by the existence of both “Central” Apneas and “Obstructive” Apneas. This can have multiple causes. More information on this disorder can be found here.
Who is at Risk?
Anyone can have sleep apnea, regardless of age, sex or body type. However, having any of the following factors may put you at increased risk:
Being older: Sleep apnea can occur at any age, including during childhood. Prevalence is very high in older adults, for whom over 25% may have at least mild levels of sleep apnea.
Excess Weight: Being overweight is one of the strongest risk factors for sleep apnea. Your risk of sleep apnea increases with the amount of excess body weight and can decrease by losing weight. Sleep apnea may also cause weight gain.
Gender: Sleep apnea is more common in men than women. The reasons are not clear, but may relate to differences in anatomy of the airway as well as hormone differences. Sleep apnea risks increase sharply for post-menopausal women. Sleep apnea can also differ in men and women, with women tending to have more severe sleep apnea in REM sleep but milder sleep apnea in Non-REM sleep, and often have shorter apneas. More on gender differences can be found here.
Neck Circumference: Men with a neck circumference of 17 inches or more and women with a neck circumference of 16 inches or more are more likely to develop sleep apnea.
Family History: Your risk of developing sleep apnea can be 50% greater if a parent or sibling also has sleep apnea. This may be a result of either inherited genetic traits or similar lifestyles.
Pregnancy: Sleep apnea increases during pregnancy, particularly during the third trimester or with extra weight gain.
Smoking: Smoking is associated with a higher risk of snoring also increasing the risk of developing sleep apnea.
Alcohol: Drinking alcohol before sleep can cause the upper airways to relax and collapse during sleep, leading to apneas.
Muscle-Relaxant Medication: Medication such as sedative hypnotic drugs and opiates can make sleep apnea worse in some patients.
Symptoms
The following is a list of common symptoms or signs of sleep apnea. Some people have several and others have only one or two of these symptoms. Sleep apnea is not always recognized, so if you have any of these symptoms or problems it may be helpful to discuss your risk of sleep apnea with your doctor.
Loud or frequent snoring
Restless sleep
Episodes in which you stop breathing during sleep — either waking you up or reported by a person who observed you.
Gasping for air during sleep
Daytime tiredness or exhaustion
Waking up feeling unrefreshed
Poorly controlled blood pressure
Waking with a dry mouth
Morning headache
Difficulty staying asleep
Excessive daytime sleepiness
Difficulty paying attention or trouble concentrating
Related Health Issues
High Blood Pressure: When your oxygen drops and you wake up often during the night, your body responds by sending signals to your brain, heart, and other organs. One effect is to raise blood pressure. Blood pressure levels that increase during sleep can also be sustained during the awake hours that follow. People who get help for Sleep Apnea can often see their blood pressure improve. Some people may be able to cut back on their blood pressure medications, but you should never stop or change your dose without talking to your doctor first.
Type 2 Diabetes: 80% of people with Type 2 diabetes also have obstructive sleep apnea. Being overweight raises the risk for both sleep apnea and Type 2 diabetes. Lack of sleep can keep your body from using insulin properly which leads to diabetes.
Weight Gain: When you are tired all the time, it is harder to resist carbs and sweets or to exercise as you should. Increasing weight is the single biggest contributor to the development of Sleep Apnea. Weight Loss can substantially improve Sleep Apnea.
Heart Disease/Stroke: Sleep apnea can increase your risk of heart disease by 30% and risk of stroke by 60%. Atrial fibrillation is also common in people with sleep apnea. Untreated sleep apnea can reduce the effectiveness of treatments for atrial fibrillation. In fact, many cardiologists test their patients who have atrial fibrillation for sleep apnea and make sure sleep apnea is treated as part of the plan for their treatment.
Cognitive Problems: Sleep apnea can cause both disturbed sleep and low oxygen levels during sleep—both of which may lead to problems with brain health and may increase risk for developing dementia.
