If you suffer from excessive daytime sleepiness in combination with loud, persistent snoring, you may be one of the over 18 million Americans that suffer from sleep apnea (National Sleep Foundation, n.d.). Sleep apnea occurs when breathing stops for brief periods during sleep.
Obstructive sleep apnea is caused by relaxation of the tongue and throat which then temporarily blocks the airway. When oxygen levels get too low, sufferers partially wake up, the muscles regain tone, and the airway opens. As soon as you return to deep sleep, however, the throat relaxes and the cycle begins again. This apnea cycle can occur 20–60 times per hour, seriously decreasing the restorative value of prolonged deep sleep.
Apnea can also occur as a result of the brain’s failure to properly regulate breathing during sleep. This form, called central sleep apnea, is less common but follows a very similar pattern. The brain fails to cue muscles to initiate breathing, oxygen levels decrease, the body wakes partially to address the issue, breathing is restarted, the sufferer falls back asleep and the cycle repeats.
Sleep apnea is not only disruptive, it is also associated with snoring and sleep noises that may disturb your sleeping partner, as well as increased risk of heart disease, stroke, and motor vehicle accidents.
Risk Factors
Sleep apnea is almost twice as common in men as in women, striking respectively 4 and 2% of the population (Alchanatis et al., 2012).
Additional risk factors include:
- Obesity
- Genetic predisposition
- Age (sleep apnea is more common in people over 40)
- A large neck (greater than 17in in men and 16in in women)
- Smoking and alcohol use
- Physiological factors (small upper airway, recessed chin, small jaw, large overbite)
Symptoms
Sleep apnea is associated with a range of symptoms. If you are suffering from daytime tiredness, frequent urges to nap, irritability, reduced memory and cognitive acuity, difficulty waking up, frequent nighttime waking, headaches, choking during sleep, unusual breathing patterns, disruptive snoring, or lack of sex drive, you may be experiencing the negative impact of sleep apnea.
Dangers
Beyond the discomfort of the symptoms listed above, sleep apnea is also associated with an increased risk of cardiovascular disease, stroke, and motor vehicle accidents. Researchers have found that the cardiovascular stress caused by oxygen deprivation in sleep apnea increases the risk of hypertension, cardiovascular disease, stroke, and congestive heart failure (Leung & Bradley, 2001).
The daytime drowsiness that results from sleep apnea can also be dangerous if you are driving or operating machinery. Researchers have found that drivers suffering from sleep apnea perform worse than drivers with a blood alcohol content above legal levels (Powell et al., 1999).
Disrupted sleep is damaging to all aspects of health, but sleep apnea is particularly dangerous to your cardiovascular health and your ability to safely perform daily tasks such as driving. There is no cure for sleep apnea but it can be treated so if you think you are suffering from sleep apnea it is important to visit your doctor as soon as possible.
Visiting a Health Professional
If you find that your symptoms are effecting your health, it may be time to visit a health care professional. Before you go it is important to be prepared. Recording your sleep patterns, feelings, and behaviors - both before bed and in the morning after you wake–will help your doctor diagnose your sleep disturbance more effectively.
To ensure that your doctor has a full understanding of your situation, you should also provide your medical history, a full list of any medications and supplements that you are taking, and any other information you have gathered about your sleep. It can also be very helpful to have another member of your household come along. They may have noticed things like snoring or sleep noises that you are not aware of yourself.
Treatment
Your health professional may suggest a range of treatments including lifestyle changes such as:
- Losing weight
- Avoiding alcohol and sedatives
- Sleeping on your side or stomach rather than on your back
- Stopping smoking
If lifestyle changes are not successful in managing your sleep apnea, your doctor may also suggest medical treatments. The most common treatment is continuous positive airway pressure (CPAP) which involves wearing an oxygen mask while you sleep so that air can be blown gently into your airways to keep them open.
As with bruxism, dental appliances can also provide relief from apnea. These appliances keep the airway open by adjusting the position of your jaw and tongue.
If none of the milder treatments are helpful, you may be advised to undergo surgery. Surgery removing tissue from the throat area creates a larger airway which is less easily obstructed by relaxation during sleep. Surgery does carry risks however, and successful cessation of symptoms cannot be guaranteed. As a result, you may want to try other treatments and lifestyle changes before you turn to surgery.
Related Article: Bruxism and Sleep Apnea
Staying Healthy and Rested
Sleep apnea can be very damaging not only to your physical health but also to your psychological well-being. If you are suffering from any of the symptoms listed above, or if you are finding yourself dozing off at inopportune times, it may be worthwhile to visit your doctor and seek treatment. Left untreated, sleep apnea can leave you tired, irritable, and at a greater risk of cardiovascular disease, stroke, hypertension, and motor vehicle accidents.
Though there is no cure, in most cases, sleep apnea can be managed successfully, and treatment can help you return to a normal quality of life.
References:
Alchanatis, M. MacFarlane, J. & Schiza, S. (2012). Sleep apnea. Sleep Disorders, 2012. doi:10.1155/2012/308978
Leung, R.S.T., & Bradley, T.D. (2001). Sleep apnea and cardiovascular disease. Am J Respir Crit Care Med, 164, 2147–2165.
National Sleep foundation. (n.d.). Sleep apnea and Sleep. sleepfoudnation.org. Retrieved from http://sleepfoundation.org/sleep-disorders-problems/obstructive-sleep-apnea-and-sleep/
Powell NB et al. (1999). A comparative model: reaction time performance in sleep-disordered breathing versus alcohol-impaired controls. Laryngoscope, 109(10):1648–54.