You’ve heard of sleep apnea, but can you explain exactly what it is? Do you worry that you may have it? It is an extremely common condition, an estimated 24% of men and 9% of women are affected.
The most common type of sleep apnea, called Obstructive Sleep Apnea, affects 18 million Americans; however, an estimated 80-90% go undiagnosed, (NIH: National Heart, Lung and Blood Institute – Sleep Apnea) During sleep, the soft tissue structures in the back of the throat, the soft palate, tonsils, uvula and tongue, collapse, restricting airflow. It disrupts sleep quality and causes a reduction in oxygen levels.
Left untreated, this combination of disturbed sleep and oxygen deprivation may lead to hypertension, heart disease, mood disruption, diabetes and memory difficulties. Day to day, affected individuals deal with fatigue and drowsy driving putting themselves and others at risk. A quick review of the signs and symptoms, as well as the risk factors associated with sleep apnea can help you decide whether a consultation with your physician is a necessary step in improving your health. (sleepfoundation.org/sleep-problems-list/how-spot-sleep-apnea-early/)
Risk Factors for Developing Sleep Apnea
- Excess Weight – BMI of 25 or more.
- Large Neck Circumference – Neck size of 17 inches or more for men, 16 inches for women. More soft tissue can narrow the airway.
- Middle Age – Sleep apnea can occur at any age, but is most common between young adulthood and middle age.
- Being Male – Men are 2-3 times more likely to have sleep apnea than are women. Women increase their risk after menopause.
- Smoking – Smokers are 3 times more likely to develop sleep apnea.
- Nasal Congestion – If nose breathing is difficult, regardless of the cause, sleep apnea is more likely.
- Excessive Alcohol Use – Alcohol disrupts the natural sequence and length of sleep states. Alcohol also increases the time between when you stop breathing and when the brain “wakes up” to stimulate breathing again.
- Family History – Sleep apnea may result from inherited traits and conditions.
Some of these risks factors are unavoidable, such as age and gender. However, others can be modifiable. Over 50% of people with sleep apnea are overweight, per The National Sleep Foundation. Losing weight and stopping smoking are two lifestyle changes with huge implications for resolving sleep apnea without the use of drugs or surgery. Moderate or heavy alcohol use can trigger sleep apnea in people who don’t otherwise have it.
Conditions That May Predispose You to Sleep Apnea
- Heart Disease, Stroke, Congestive Heart Failure
- Use of Alcohol, Opiods, Barbiturates
While knowing your risk factors is imperative, there are 10 common signs of sleep apnea. The presence of risk factors or any of these 10 signs should direct you to a conversation with your health care provider.
10 Surprising Signs That You May Have Sleep Apnea
1. Loud Snoring
Snoring refers to the snorting or grunting noise made when a person is sleeping. Snoring to the point of disrupting a bed partner, that is consistent or worsening, may be a sign of sleep apnea. However, not all snorers have sleep apnea, and not all people with sleep apnea snore.
2. Fatigue During the Day
Hypersomnia or Excessive Daytime Sleepiness, EDS, is an overwhelming daytime fatigue despite adequate time spent in bed. While you may have gotten your recommended 7-9 hours of sleep, you don’t wake up feeling well-rested because your sleep quality was poor. The frequent disruptions in sleep, whether you recall them or not, have not allowed you to achieve the deeper levels of sleep necessary for vital body functions. Research has demonstrated that driver fatigue is associated with 16-20% motor vehicle accidents. This fatigue is directly related to sleep apnea as well as excessive workload and other sleep disorders. (ncbi.nlm.nih.gov/pubmed/12394158/)
3. Morning Headaches
The lack of oxygen to the brain causes vascular headaches because the body responds by widening the blood vessels. These are one of the most commonly reported symptoms of sleep apnea as a person may not be aware if they snore or stop breathing during the night.
4. Restless Sleep
The human body is an amazing compensator. Sleep apnea is a life-threatening problem; therefore, subconsciously it tries to avoid being at risk through avoidance of falling asleep. It is difficult to recognize restless sleep as again, it impacts the quality, not the quantity of sleep.
5. Attention, Concentration or Memory Problems
The brain requires rest and oxygen to function optimally. In the case of sleep apnea, neither is occurring on a recurrent basis.
6. Mood Swings
The lack of quality sleep, regardless of quantity, can lead to irritability, increased anxiety and even depression. This is often a symptom of prolonged, untreated sleep apnea.
7. Waking Up Choking, Gasping or With Shortness of Breath
The need for oxygen is basic. The brain may wake a person up when they stop breathing, with an immediate gasp formed to maximize their intake of oxygen quickly.
8. Stopping Breathing While Sleeping
This sign of sleep apnea requires a bed partner or some sort of monitoring, such as video. A strong sign of sleep apnea is breathing that is interrupted during sleep. This sign can occur hundreds of times each night. Many times this silence from not breathing is followed by a loud gasp as the body reflexively tries to gather oxygen.
Insomnia refers to the persistent and habitual inability to fall and stay asleep. While everyone experiences insomnia periodically, insomnia due to sleep apnea is persistent and does not improve with other efforts to improve sleep hygiene.
10. Waking Up With a Sore or Dry Throat
Dry mouth and sore throat are symptoms of inadequate amounts of moisturizing saliva. This occurs as people with obstructive sleep apnea tend to open their mouth in an attempt to improve their breathing. The saliva that is produced, quickly dries up, resulting in a sore, scratchy throat with cracked lips.
Recognizing the risks and identifying the signs of sleep apnea is only the first step. Discussion of these factors with your primary physician is typically the best place to start. They themselves may order a sleep study that can be used to diagnose sleep apnea.
Versions of newer sleep studies can even be performed in the comfort of your own home. Based upon your symptoms and risks factors, you may be referred to a neurologist or sleep specialist who in turn may order the sleep study or other tests such as an EEG (electroencephalogram), ECG (Electrocardiogram) or EOG (Electro-oculogram). Sleep apnea is an easily treated condition that has serious health implications. A consultation may save your life.