You wake up tired every morning, even though you were in bed for almost eight hours. You have a headache, and your mouth is dry. Worst of all, your sleeping partner is grumpy, complaining about your loud snoring all night. What’s going on? You’re doing everything you can to get the right amount of sleep, but it just doesn’t seem to be working.
If this sounds familiar, you may be suffering from sleep apnea, a potentially dangerous sleep disorder in which you stop breathing for short periods during the night. According to the National Sleep Foundation, more than 18 million adults have sleep apnea, many of whom don’t even realize it. Untreated sleep apnea can lead to serious complications, including heart attack, so it’s important to talk with your doctor if you suspect a problem.
What Is Sleep Apnea?
Generally speaking, sleep apnea is a disorder in which your upper airway is blocked while you are sleeping, causing you to repeatedly stop and start breathing. This can happen hundreds of times a night, briefly waking you every time. These momentary wake-ups are so quick that they usually go unnoticed, but each one disrupts your sleep cycle and prevents you from getting deep, restful sleep. As a result, you wake up tired and groggy and struggle with fatigue throughout the day.
Although sleep apnea is often referred to as a general condition, there are actually three different types:
Obstructive sleep apnea
The most common type of sleep apnea, obstructive sleep apnea occurs when the throat muscles relax and obstruct the airway, preventing the flow of air. With this type of sleep apnea, you may gasp for air or choke, but you don’t typically wake up.
Central sleep apnea
With central sleep apnea, the part of your brain that controls your breathing fails to work properly while you are asleep. The signals your brain sends to the muscles that control breathing are disrupted, causing you to briefly stop breathing. Central sleep apnea is more likely to wake you and make it more difficult to get back to sleep; you’re also likely to wake up with shortness of breath.
Complex sleep apnea
The rarest form of sleep apnea, complex sleep apnea means that you have both obstructive and central sleep apnea. It’s also known as treatment-emergent central sleep apnea.
What Causes Sleep Apnea?
Several factors contribute to the risk of developing sleep apnea, including age, race, and genetics. African Americans, Pacific Islanders, and Hispanics over the age of 40 have the highest risk, particularly if the condition runs in their families. That being said, younger people, women, and other races also get sleep apnea, but their risk is more closely tied to physical and lifestyle factors.
What are the physical factors that put people at risk of developing apnea? An unusually large uvula (located in the back of the throat), large tonsils, or a large tongue can increase the risk for sleep apnea, as well as having an overbite, small jaw, or recessed chin. A large neck size – more than 17 inches for a man and 16 inches for a woman – is also a factor. Ongoing nasal congestion due to an anatomical issue like a deviated septum or untreated allergies can lead to apnea as well.
Beyond demographics or physical characteristics, though, lifestyle factors are the most common cause of sleep apnea, in particular being overweight. Being obese not only increases your neck size but it also increases the number of fat deposits around your neck, which contribute to obstructed breathing. Other lifestyle choices that can increase apnea risk include smoking, drinking excessive amounts of alcohol, and using narcotic pain relievers.
Do You Have Sleep Apnea?
Only a doctor can definitively diagnose sleep apnea, but if you have any of the following symptoms, you should discuss the issue with your doctor. Some of the most common signs of a sleep disorder include:
- Waking up tired
- Daytime fatigue, even when you think you are getting enough sleep. Excessive drowsiness throughout the day, an uncontrollable desire to sleep, or excessive napping indicate you aren’t getting restful sleep.
- Problems with mood, including irritability and depression
- Cognitive difficulties, such as inability to concentrate, focus, or pay attention
- Morning headaches
- Waking up with a dry mouth
- Sexual dysfunction and decreased libido
- Waking up repeatedly during the night to use the bathroom
- Loud, constant snoring
- Problems with your partner, who may also be sleep deprived due to your snoring and/or waking up gasping
- Waking up gasping for air, choking, or being short of breath
Keep in mind that having any of these symptoms doesn’t automatically mean that you have sleep apnea, as many are also associated with other illnesses or conditions. In addition, you can have sleep apnea even if you don’t experience most of these symptoms, which is why it’s vital that you consult your doctor about a formal diagnosis.
Most people learn that they potentially have sleep apnea by talking with their sleep partner. If you’re experiencing symptoms, ask your partner if they have noticed you struggling to breathe while you sleep, or if you’re choking, gasping, or having similar problems. If so, make an appointment with your doctor to discuss whether you need a sleep study. Your provider will order a sleep study after reviewing your symptoms and any medications you take. During the sleep study, you’ll spend the night in a sleep center where doctors will monitor how you sleep and certain vital signs, including your sleep state, muscle activity, heart rate, respiratory effort, airflow, and blood oxygen levels. The results of the study will determine whether you have apnea, or if another issue is causing your sleep problems.
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Why Sleep Apnea Requires Treatment
Sleep apnea shouldn’t be ignored, as it can lead to significant health problems if left untreated, including but not limited to perpetual fatigue. Sleep apnea increases inflammation throughout the body, which can contribute to a host of complications, such as:
- Cardiovascular disease, including uncontrollable high blood pressure, heart failure, stroke, increased risk of heart attack, and atherosclerosis (hardening of the arteries)
- Metabolic syndrome and disorders, including Type 2 diabetes, insulin resistance, and glucose intolerance
- Chronic kidney disease
- Liver problems, including reduced liver function and nonalcoholic fatty liver disease
- Asthma
- Atrial fibrillation, or irregular heartbeat
- Cognitive function problems, including dementia in adults and learning disabilities in children
- Complications during surgery
- Pregnancy complications, including premature birth and low birth weight
- Relationship problems due to disrupted sleep patterns
With so many potential complications, sleep apnea is a serious condition. Discuss any symptoms with your doctor to determine the best course of treatment.
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Treating Sleep Apnea
In many cases, the first steps in treating sleep apnea are lifestyle changes. Losing weight, quitting smoking, and following a healthy diet with adequate exercise can all go a long way toward preventing and treating sleep apnea. Avoiding alcohol before bedtime and maintaining good sleep habits can also help reduce the risk of complications.
Many sleep apnea patients are also prescribed devices to help them sleep better. The most common device is the Continuous Positive Airway Pressure (CPAP) machine, which delivers a consistent amount of pressure to your airways so they do not collapse and inhibit breathing. CPAP machines are available in multiple configurations with different types of masks, so you are sure to find a machine that works for you. If CPAP therapy simply doesn’t work for you, your doctor may recommend a BPAP (Bilevel Positive Airway Pressure) machine, which adjusts pressure as you inhale and exhale, or an oral appliance that helps position your jaw while you sleep to keep your airway open.
Some cases of sleep apnea are best treated with surgery, but this is often seen as a last resort. The most common surgical procedures are tissue removal (which includes the tonsils and adenoids), tissue shrinkage, jaw repositioning, and in extreme cases where all other treatments have failed, the creation of a new airway (tracheostomy.) For some people, weight loss surgery can decrease the symptoms of sleep apnea, helping them lose the extra weight that’s contributing to their condition.
Sleep apnea is common, but it should never be ignored. Continued disruption to your sleep can have significant effects on your well-being, and depriving your body of oxygen during episodes of suspended breathing can have long-lasting health effects. Pay attention to the signs and call your doctor if you are having trouble sleeping.