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Sleep Apnea is a disorder in which breathing stops and restarts while you’re asleep. These repeated pauses in breathing cause shortness of breath and may cause you to wake up to catch your breath — a survival reflux compensating for the lack of oxygen.
Sleep apnea, or shortness of breath during sleep, occurs for two main reasons. Either obstruction in the airways causes breathing to stop, or the brain fails to control the muscles responsible for breathing.
If you are sleeping next to a person with sleep apnea, you will notice them snoring loudly, pauses in breathing followed by deep breaths, and being restless during sleep.
At first, sleep apnea disturbs the quality of your sleep, but if left untreated, it may lead to severe health problems.Studies show that sleep apnea increases the risk of sudden death by two-fold. This is because sleep apnea can cause cardiovascular problems such as heart failure, arrhythmias, and hypertension.
Reports suggest that around 30 million people in the US have some form of sleep apnea and only 6 million of those are diagnosed cases.
The warning signs of sleep apnea include:
Loud snoring is among the most common signs of sleep apnea in about94% of patients. Snoring occurs when several changes in the airways lead to respiratory obstruction. This obstruction in the airflow causes vibration of the tissues in the throat, resulting in a loud snoring sound.
However, it is important to remember that not all people who snore have sleep apnea. According to the reports, around44% of people snore on a regular basis.
Also, you can have sleep apnea even when you don’t snore at all. Snoring loudly only indicates that you are more likely to have sleep apnea as the root cause.
So, if your partner or a family member tells you that you snore loudly in sleep, followed by pauses in breathing, it is important to consult your healthcare provider.
Shortness of breath during sleep makes you turn your sides unconsciously to find the best possible position for efficient breathing. This continuous effort keeps your body physically active and makes your sleep unpleasant.
In many cases, the shortness of breath becomes so severe that it causes a lack of oxygen and makes a person wake up from sleep to achieve normal breathing.
Thus, sleep apnea disturbs the quality of sleep, causing restlessness despite a person sleeping for the recommended hours i.e. 7-9 hours of sleep for adults.
After an unpleasant sleep, it is no surprise that you feel tired and inactive during the day. Quality sleep helps to relieve the fatigue of the day and prepares your body for the next day. In sleep apnea, your body stays deprived of the quality sleep it needs.
As a result, you feel tired even after a whole night of sleep. You won’t be able to concentrate on your tasks and feel like falling asleep during any work that requires alertness.
There can be several reasons forearly morning headaches, but they are common among people with sleep apnea. Reports suggest that around18% of people with sleep apnea complain about morning headaches.
Morning headaches in sleep apnea are caused by a fall in oxygen levels in the blood during sleep, a condition calledhypoxia.
Unlike migraine headaches, which usually affect one side of the head, morning headaches due to sleep apnea cause pain on both sides of the head. Depending on the severity of the condition, these headaches occur at least15 times a month and can last up to4 hours.
Some other warning signs for sleep apnea include:
There are two types of sleep apnea depending on the cause:
Obstructive sleep apnea, or OSA, occurs when there is a blockage in the airway, obstructing normal breathing. The blockage happens when the muscles in the back of the throat relax and narrow the passage for the air to pass.
In this state, respiratory muscles work harder to overcome the obstruction and maintain the required airflow, causing loud gasps with breathing.
Obstructive sleep apnea is the most common type of sleep apnea. Reports estimate that between5 to 10% of people around the world have obstructive sleep apnea.
Central sleep apnea, or CSA, occurs when the brain can’t send proper nerve signals to control the respiratory muscles. In the absence of adequate nerve supply, respiratory muscles fail to contract and relax efficiently, causing episodes of breathlessness during sleep.
Central sleep apnea is less common than obstructive sleep apnea. According to estimates,less than 1% of the world's population has central sleep apnea.
Causes of sleep apnea are different for obstructive and central sleep apnea.
Obstructive sleep apnea is a result of the narrowing of the airways. Some of thefactors that may lead to the narrowing of airways include:
Central sleep apnea is a result of problems with the coordination between the brain and the muscles responsible for breathing. Some of thefactors responsible for these problems and causing central sleep apnea include:
Sleep apnea is a bigger problem than what many people think of it — unpleasant sleep. Untreated sleep apnea can cause severe dangers to health, which include:
Shortness of breath in sleep apnea causes oxygen deficiency in the blood. Low blood oxygen puts stress on the cardiovascular system and increases blood pressure —pulmonary hypertension.
Studies show that sleep apnea is also associated with coronary artery disease, irregular heart rate, heart attack, stroke, and heart failure. If you already have cardiovascular problems, sleep apnea can worsen the condition by putting extra pressure on it.
Scientific studies show that sleep apnea increases the risk of heart failure by 140%. It also increases the risk of coronary artery disease by 30%.
Based on these reports, it is no surprise that people with sleep apnea havetwice the risk of sudden death by cardiac conditions.
Obstructive sleep apnea and type 2 diabetes are correlated to each other.Research shows that more than half of the people with type 2 diabetes experience the symptoms of obstructive sleep apnea.
Similarly, obstructive sleep apnea is also a contributing factor in causing type 2 diabetes. Shortness of breathing causes a decrease in oxygen levels and an increase in carbon dioxide levels in the blood. Studies show that these changes in blood gasseslead to insulin resistance and can be associated with the development of type 2 diabetes.
Metabolic syndrome is a collective name for conditions that include increased blood pressure, blood sugar, cholesterol, and excess fat accumulation around the waist. People with metabolic syndrome are at a higher risk of developing heart problems, stroke, and type 2 diabetes.
Research shows that the prevalence of metabolic syndrome is significantly high among people with obstructive sleep apnea.
Non-alcoholic fatty liver disease (NAFLD) is a serious liver problem in which excess fat accumulates in the liver. In severe form, NAFLD causes scarring of the liver tissue and may lead to liver failure.
Research shows that sleep apnea can contribute to NAFLD indirectly — other comorbidities in sleep apnea, such as obesity and metabolic syndrome, can cause NAFLD.
There is alsoevidence that even in the absence of other comorbidities, sleep apnea can independently increase the risk of NAFLD. Hypoxia is considered the main factor in the studies about the independent effect of sleep apnea in causing NAFLD.
Erectile dysfunction or impotence is a condition in which men fail to get or keep an erection for long enough to perform sexual intercourse.
Astudy found that about half of the people with sleep apnea had erectile dysfunction. The explanation for this link is low testosterone levels in patients diagnosed with obstructive sleep apnea.Research shows that reduced quality and quantity of sleep in individuals with sleep apnea leads to low testosterone levels.
Alongside the health risks, sleep apnea disturbs the overall quality of life. People with sleep apnea fail to get quality sleep, making them feel fatigued throughout the day. They fail to concentrate on their tasks and feel sleepy while doing so.
Frequent headaches are common in people with sleep apnea because of low blood oxygen. Feeling tired and frequent headaches cause mood swings and irritability.
Reports show that anxiety and depression are more common among people with sleep apnea. People with sleep apnea also experience memory and thinking problems. A recent study shows that there is a 50% increase in memory and thinking problems among people with sleep apnea.
In summary, sleep apnea makes your life unpleasant and makes you less productive in your daily life.
The diagnosis of sleep apnea starts with questions related to your symptoms and sleep schedule. Your doctors will ask you questions like,
If your doctor finds any indication that you are suffering from sleep apnea, he will recommend a sleep study test. There are two types of sleep study tests:
Polysomnography is the most common and valid test for diagnosing obstructive and central sleep apnea. In polysomnography, you must sleep in a controlled environment in the clinic or any other testing facility.
Different sensors record necessary data during sleep, such as breathing rate, heart rate, blood oxygen levels, brain activity, and body movements. An expert will analyze the data to see if the measurements indicate sleep apnea.
Ahome sleep study is not as thorough as polysomnography and can’t be used for diagnosing central sleep apnea. For this study, you sleep in the usual environment at home but with a device that measures necessary information such as breathing rate, heart rate, and blood oxygen.
Your doctor will recommend polysomnography if the home sleep study doesn’t show satisfactory results.
Unfortunately, there is no complete cure for sleep apnea, but you can treat the condition effectively and improve life and health. Depending on the cause, treatment, and lifestyle changes can minimize the symptoms and complications linked to sleep apnea.
If any treatment option works best for you and eliminates the symptoms, it is important to adhere to it to manage the condition and improve quality of life.
The treatment option for sleep apnea depends on the cause and severity of your condition. Some of the most common treatment options for sleep apnea include:
Positive airway pressure devices are special devices that contain a mask you wear on your face. When you inhale, air is pushed into your airways through the mask. This increase in air pressure keeps the airways open and prevents shortness of breath due to any obstruction.
Many types of positive airway pressure devices are available, but all work on the same principle — keeping the upper airway open by air pressure for normal breathing. These devices are effective in both types of sleep apnea. Some common examples are:
You may not feel comfortable using positive airway pressure devices during sleep. In that case, your doctor will recommend oral devices to maximize the airflow in breathing.
These oral devices stay in your mouth and keep the jaw or tongue in a specific position to create more room for airflow. A dentist will help you in finding the right fit for the oral device that works best for you. The two most common oral devices include:
A nerve stimulator is a specialized device that stimulates the hypoglossal nerve, which controls tongue movement. This device is surgically implanted in the chest region, and an electrode is attached to the hypoglossal nerve under the jaw.
The nerve stimulator sends impulses to the nerve via the electrode. These impulses keep the tongue forward and prevent it from blocking the passage to the air.
If you have obstructive sleep apnea and other treatment options fail to help your condition, your doctor may suggest surgery in the upper airway.
Depending on the cause, some surgical options include:
You can’t prevent all the causes of sleep apnea, but lifestyle changes and diet can significantly reduce several risk factors.
Lifestyle changes such as exercise help in weight management and can prevent obesity — obesity is a significant cause of sleep apnea. Smoking and alcohol consumption are associated with central sleep apnea. You must refrain from smoking and alcohol abuse to lower the risk of developing sleep apnea.
Diet can play a role in preventing sleep apnea as a healthy diet can prevent obesity. A study found that people on a plant-based diet had a17% lower risk of developing sleep apnea than those on animal-based foods.
If you are diagnosed with sleep apnea, you must know what are things that can worsen your condition. Here are a few things that you should avoid to lower the risk of sleep apnea symptoms:
Foods that are high in calories and can lead to weight gain are big NO for people with sleep apnea. It is critical to manage a healthy weight, as obesity increases the risk of airway obstruction.
Instead, shift towards a plant-based diet low in calories but high in nutritional value.Studies also support the effectiveness of a plant-based diet in sleep apnea.
Sleeping positions greatly influence the quality of sleep if you have sleep apnea. Some positions can make your sleep apnea symptoms worse, while others can lower them.
Research shows that sleeping on your side is the best position for sleep apnea as this position keeps the airways open. In contrast,research finds that sleeping on the back, also called the supine position, worsens sleep apnea symptoms.
Getting a night of quality sleep is difficult for people with sleep apnea. An irregular sleep schedule will further worsen the sleep experience.
Studies show that going to bed and waking up at the same time each day helps people get a good quality of sleep.
If you manage your sleep apnea with effective treatment options, you can live a healthier life like others without sleep apnea. However, untreated sleep apnea doubles the risk of sudden death.
Severe episodes of sleep apnea cause a lack of oxygen, which contributes to hypertension. Hypertension and irregular heartbeats in sleep apnea increase the risk of brain damage by stroke.
There is little evidence about stress in developing sleep apnea. However, stress can worsen sleep apnea symptoms such as restlessness, fatigue, lack of concentration, and cardiovascular problems.
Sleep apnea is a common sleeping disorder that is much more serious than just snoring or restlessness at night. Studies show the association between untreated sleep apnea and severe health risks such as cardiovascular problems, type 2 diabetes, and liver problems.
Fortunately, several effective treatment options are available depending on the cause of sleep apnea. Diet and lifestyle changes can also help in reducing the risk factors and severity of the symptoms. By addressing the condition properly and on time, a person with sleep apnea can live a normal and healthier life.