Signs of Sleep Apnea

Woman sleeping

Sleep apnea is a possibly serious sleeping disorder that causes you to experience pauses in your breath as you sleep. These stops in breathing are frequent throughout your sleep when you have sleep apnea. Often, the most common symptoms of an individual with sleep apnea are daytime sleepiness and loud snoring.

The frequent stops in breathing are either caused by a blockage in your airways or impaired communication between the brain and the muscles controlling your breathing. Sleep apnea can affect your sleep quality, which will boil over into your life.

Experiencing these stops in breathing while you’re sleeping results in a lack of sufficient oxygen, which activates a survival reflex, waking you up enough to resume breathing. These little wakes at night prevent you from having a restful sleep even though you’re unaware of it.

If you think you may have sleep apnea, professionals recommend you work with a doctor as it may result in serious health consequences.

What are the types of sleep apnea and their causes?

Sleep apnea causes a cycle involving your breath repeatedly starting and stopping while you sleep. Most people with sleep apnea are unaware of this problem. However, if someone has complained of your loud snoring and you feel sleepy even after a full night of sleep, you may suffer from sleep apnea.

There are two types of sleep apnea:

Obstructive sleep apnea

(OSA) occurs when something blocks your airways. It is the most common type of sleep apnea. When sleeping, the throat muscles relax and block the airways, reducing airflow into the lungs. When air doesn’t pass through as usual, the person wakes up and engages these muscles. It’s common for them to take gasps of air or deep breaths that sound like choking sounds.

When you can’t breathe, the brain senses it, so you wake up momentarily to re-open your airways. Often, waking up when you have OSA is so brief you won’t remember it. Usually, the lack of airflow and breathing pattern may repeat itself between 5 and 30 times each hour all night. This pattern can make it difficult to enter the deep, restful phases of sleep that your body requires.

Since OSA is the most common type of sleep apnea, it’s estimated to affect approximately 10–30% of adults in the United States. OSA is also more common among older adult males, even though it can affect children too {1}. Additionally, there are more people with obstructive sleep apnea who are undiagnosed.

Central sleep apnea

Central sleep apnea (CSA) occurs when there’s a communication problem between the brain and muscles that control breathing {2}. Typically, your brain controls your breathing even when you’re asleep. However, in CSA, your brain doesn’t send signals to keep your breathing muscles working.

As a result, your breathing becomes shallow, and eventually, you experience pauses in breathing. The prevalence of CSA is relatively low. According to statistics, less than 1% of the population has central sleep apnea {3}.

When you have CSA, you may rouse from sleep with shortness of breath or have difficulty falling or staying asleep.

Who does sleep apnea affect?

Sleep apnea can affect anyone, including children. However, certain risk factors increase your chances of sleep apnea.

Risk factors of obstructive sleep apnea

Some of the factors that increase the risk of developing OSA include:

• Neck circumference: People who have thicker necks may also have narrower airways.
• Overweight: Too much weight, like obesity, increases the risks of OSA due to the fat deposits around your upper airway, which can obstruct your breathing.
• Sex: Men are two to three times more likely to suffer from sleep apnea when compared to women. However, the chances of women suffering from sleep apnea increase if they’re overweight and past menopause.
• Use of tranquillizers, sedatives, and alcohol: The use of these substances relaxes the muscles at the back of your throat, which can worsen OSA.
• Age: Sleep apnea affects more older adults than younger individuals.
• A narrowed airway: Some people inherit a narrow airway. Additionally, tonsils, or adenoids, can enlarge and block airways, especially in children.
• Smoking: Smoking elevates inflammation and fluid retention in the upper airways. People who smoke are three times more likely to suffer from OSA.
• Nasal congestion: If you already have trouble breathing normally, whether it’s due to an anatomical issue or allergies, then you’re at a higher chance of developing sleep apnea.
• Family history: If you have some family members with sleep apnea, it increases your chance of developing one.
• Medical conditions: Type 2 diabetes, congestive heart failure, and high blood pressure increase your chances of developing OSA. Some other conditions that may increase the risk of OSA include hormonal disorders, Polycystic ovary syndrome, prior stroke, and lung diseases like asthma.

Risk factors of central sleep apnea

Some factors that can heighten your chances of developing central sleep apnea include:

• Age: Older and middle-aged people have a higher chance of CSA.
• Heart disorders: If you have congestive heart failure, it increases your chance of developing this sleep disorder.
• Stroke: Having a stroke heightens your chances of having CSA.
• Sex: More men compared to women suffer from CSA.
• High altitude: Being at a high altitude is associated with CSA because there’s decreased oxygen availability.

Symptoms of sleep apnea

Woman yawning

The signs of OSA and CSA often overlap. The overlap can make it challenging to determine which type you have. The most common symptoms of both types of sleep apneas include;

• Waking up with a dry mouth
• Irritability
• Loud snoring
• Episodes where you cease breathing (someone else has to report this to you)
• Gasping for air during sleep
• Morning headache
• Difficulty staying asleep
• Difficulty paying attention
• Sexual dysfunction

Sleep apnea in children and toddlers.

There are different ways in which sleep apnea can manifest in children and toddlers. These include:

• Loud snoring
• Heartburn or night sweats
• Bedwetting
• Sleeping in weird positions
• Frequent leg movements when sleeping
• Trouble focusing in school and performing poorly.

Can sleep apnea be cured?

There are many ways to survive with sleep apnea, depending on its severity. None of the methods used to treat sleep apnea cure it. Unfortunately, there’s no cure for sleep apnea. The techniques used to manage sleep apnea help prevent the occurrence of apnea and ultimately reduce its severity.

Sleep apnea treatments are used as a part of a nightly routine. Using the various treatments for sleep apnea can eventually help eliminate or reduce the effect of sleep apnea on your life.

Possible ways to treat sleep apnea include:

• Conservative (non-medical) treatments.
• Medications (central sleep apnea only).
• Oral appliances
• Nerve stimulators.
• Positive airway pressure and adaptive ventilation devices.
• Surgery.

Conservative treatments

These non-medical methods can help reduce sleep apnea to a point where it stops or is less severe. They include;

• Sleeping position and tools: Sleep on your back increases the chances of sleep apnea. However, sleeping on the side is wiser. Items such as special support pillows can help support the position in which you sleep.
• Weight loss: For people with obesity or excess weight and sleep apnea, a 10% decrease in body weight can significantly improve sleep apnea.
• Underlying conditions: Treatment of underlying conditions such as heart failure can improve CSA.
• Adhesive strips and nasal sprays: These and similar over-the-counter sleep products improve breathing, making airflow through your nose easier. These forms of sleep apnea treatment help mild sleep apnea and reduce snoring.
• Changes in medication: Your doctor can decrease or stop your use of opioid pain medications, and this can improve central sleep apnea.

Medications

There are medications available that can help central sleep apnea. These medications include sleep-promoting and respiratory-stimulating drugs. Even though these are available, most need to be formally approved or accepted for use. You can get the best help through a specialist like a sleep pharmacist or sleep doctor.

Oral appliances

OAS is caused by muscle tissues at the back of the neck pressing downward on your windpipe. Oral devices can hold your jaw and tongue in a position that helps prevent the tissues from blocking your windpipe {4}. Professionals like sleep specialists work with dentists to create these devices for those who need them.

Nerve stimulators

There’s a nerve located under your tongue that stimulates its movement. Devices are made to stimulate this nerve so that your tongue moves forward whenever you breathe in. This nerve stimulator prevents your tongue from relaxing and blocking your windpipe when you’re asleep.

An electrode is placed on this nerve, and it connects to a device implanted on your chest beneath your skin. It only operates when you turn it on. So you can do Thai when going to sleep and turn it off when you wake up.

Positive airway pressure

Positive airway pressure (PAP) is a treatment method offered to most, if not all, people with obstructive sleep apnea. This form of therapy helps keep the airways open using pressurized air from a machine. This air goes through a hose and mask worn on the face.

When pressurized air is pushed down your windpipe, it stays open, and you can breathe. There are different types of PAP, but they all have the same technique of using pressurized air. The most known and used PAP device is continuous Positive Airway Pressure (CPAP).

A CPAP device continuously sends air set at the same pressure level to keep it open. As you breathe, CPAP increases the air pressure in your airways and lungs. This keeps the surrounding tissues from pressuring your airway shut.

Surgery

Different surgeries are done on one’s nose, windpipe, and throat. The impact of these surgeries is unknown as they vary from one person to the next. These surgeries include:

• Uvulopalatopharyngoplasty (UPPP)- The removal of the uvula, soft palate, and pharynx
• Somnoplasty- The use of radiofrequency (RF) to reduce soft tissue on the upper side of your windpipe.
• Tonsillectomy/adenoidectomy- Removal of tonsil and adenoids
• Nasal surgery includes septoplasty, which is the straightening of the soft tissue in your nose.
• Jaw surgery- For people with sleep apnea due to structural issues

Can I prevent sleep apnea?

Some lifestyle factors and home remedies can help you manage sleep apnea. These include:

• Exercise: Aerobic exercise or strength training can help with sleep apnea. Regular exercise increases your heart strength and energy levels. Additionally, exercise like yoga enables you to encourage energy flow and increase respiratory strength.
• Weight loss: Losing weight can improve the quality of your life and health and keep your airways clear, relieving constriction that causes sleep OSA.
• Avoid sleeping on your back: Sleeping on your side or stomach reduces the chances of sleep apnea occurrence. Lying with your belly up can cause your tongue and soft palate to block your airways at the back of the throat.
• Avoid drugs: Alcohol, cigarettes, some types of anxiety medicine, and sleeping pills can worsen sleepiness and OSA.

Sleep apnea complications

Often, the various treatment methods for sleep apnea help prevent serious complications. However, if left untreated, the condition can have far-reaching effects on one’s health, well-being, and quality of life.

Because sleep apnea reduces oxygen levels in the body, it affects your sleep quality, making it poor. Even when sleep apnea does cause severe complications, it leaves you feeling constantly tired throughout the day. Some complications that can arise from sleep apnea include:

• Metabolic disorders, including type 2 diabetes
• Accidents like car accidents because of drowsy driving
• Cognitive issues like impaired memory and low concentration levels.
• Cardiovascular diseases
• Non-alcoholic fatty liver disease
• Anaetheis related complications during surgery
• Mood distracts and like high risk of depression and irritability

Often, these are the complications that may arise when one has obstructive sleep apnea that goes untreated. In CSA, the complications that may occur largely depend on the medical condition causing sleep apnea symptoms.

Living with sleep apnea

There are several ways you can take care of yourself when suffering from sleep apnea.

• Find a professional and work closely with them: A sleep specialist will help you manage your symptoms in case anything arises and advise you on steps to take, among other factors. A professional will help you adjust any treatments for your sleep apnea if they’re not working or if new symptoms arise.
• Manage your lifestyle to the best of your ability: Changing lifestyle factors, such as physical activities and diet, may become a challenge. However, a professional may help you through issues.
• Care for your treatment devices: Caring for your oral devices or CPAP can be essential in case you want to avoid unwanted side effects.
• Please stick to your treatment plan: It becomes a habit when you adhere closely to it. Therefore, this prevents you from suffering from severe complications from sleep apnea.
• Stay away from high-risk activities: If you’re feeling drowsy during the day, avoid driving, operating heavy machinery, or any other tasks that can highly impact your life when done with little concentration. This is especially common for those with untreated sleep apnea.
• Inform your doctors about sleep apnea: When you are seeing new doctors who aren’t aware of your sleep apnea, mention it in case you’re undergoing surgery or getting new meds.

Final thoughts

Sleep apnea can remarkably interfere with your life if left untreated. Many symptoms can help you determine whether you have sleep apnea. Additionally, if your doctor diagnoses it, you can find many alternative methods of treatment that help you manage this condition. Even though there’s no treatment, there are ways to manage it and prevent the complications of sleep apnea.

References

1. Kline, L. R., Collop, N., & Finlay, G. (2017). Clinical presentation and diagnosis of obstructive sleep apnea in adults. Uptodate.com [Internet].
2. Strohl, K. P. (2020, September). Sleep apnea. Merck Manual Consumer Version., Retrieved May 31, 2022, from https://www.merckmanuals.com/home/lung-and-airway-disorders/sleep-apnea/sleep-apnea
3. Becker, K. (2020, August 25). Central sleep apnea syndromes. Medscape., Retrieved May 31, 2022, from https://emedicine.medscape.com/article/304967-overview
4. Cistulli, P. A. (2022, March 31). Oral appliances in the treatment of obstructive sleep apnea in adults. In N. Collop (Ed.). UpToDate., Retrieved May 31, 2022, from https://www.uptodate.com/contents/oral-appliances-in-the-treatment-of-obstructive-sleep-apnea-in-adults