What Is Sleep Apnea?
Impact of Sleep Apnea in the US
According to the American Academy of Sleep Medicine, over 30 million people in the US suffer from sleep apnea, a serious sleep disorder caused by temporarily relaxed throat muscles that block the upper airways. This blockage results in breathing that repeatedly starts and stops throughout the night with a characteristic breath pattern of gasps and loud snoring most associated with the disease. Sleep apnea often goes undiagnosed, and its serious comorbidities contribute to one of this nation's most prevalent health concerns.
The Cardiovascular Risks of Obstructive Sleep Apnea
There are three types of sleep apnea. The most common type, known as Obstructive Sleep Apnea, has serious cardiovascular comorbidities resulting from how our bodies react to the blocked airways that occur during sleep. When breathing stops and starts throughout the night, oxygen levels in the blood drop. Our bodies respond by releasing the stress hormone epinephrine. This response elevates the heart rate and can lead to high blood pressure. Overall heart function decreases because it becomes less efficient at pumping blood and because of the pressure changes taking place in the chest. This puts sleep apnea sufferers at higher risk for cardiovascular disease and heart attacks.
Diabetes and Sleep Apnea: A Serious Comorbidity
For those with undiagnosed or untreated OSA, diabetes is another serious comorbidity. The depletion of blood oxygen levels also has a negative effect on blood sugar levels and insulin resistance. For patients with Type 2 diabetes, there is already an inability to regulate the amount of sugar or glucose in the blood. When insulin can't do its job in getting glucose to the cells where it is used for energy, insulin resistance results. Healthline reports that these changes are not limited to only during the night. Obstructive Sleep Apnea changes how the body responds to insulin and influences glucose levels throughout the day.
The second type of sleep apnea, Central Sleep Apnea, is a result of a malfunction in the central nervous system and is most common in those who suffer from neuromuscular disease, stroke, or other heart, kidney, or lung diseases. Central Sleep Apnea occurs when the brain doesn't tell the muscles to enact breathing during sleep. People with Central Sleep Apnea may complain of insomnia but also can exhibit the same gasping or choking sounds that are common in Obstructive Sleep Apnea. The third type of sleep apnea is called Complex Sleep Apnea, and it occurs in the rare instance where a patient has the symptoms of both Obstructive Sleep Apnea and Central Sleep Apnea.
Recognizing Sleep Apnea Symptoms and Atypical Signs
Sleep apnea symptoms can often be attributed to other medical conditions, so they may not stand out initially. But the reoccurring combination of heavy snoring with restless sleep, waking up with a sore throat, dry mouth, or headache, and daytime fatigue with lack of focus are all symptomatic of sleep apnea. In children, sleep apnea symptoms can easily be mistaken for other issues. The next day sleepiness that can occur after a night of repeated periods of waking up could be misinterpreted as laziness or lack of motivation. Similarly, children's learning and behavioral issues and overall poor school performance can also be attributed to sleep apnea. Some of the more unique and unusual symptoms include unusual sleeping positions, such as sleeping on the hands and knees or with a hyperextended neck. Bedwetting, another common condition in children, can also be attributed to sleep apnea.
The Road to Diagnosis and Treatment Options
The first step on the sleep apnea diagnosis journey is to see your physician. Doctors screen for sleep apnea first by doing a thorough medical exam and reviewing family medical history to rule out any other medical conditions that could cause your symptoms. Medications can affect sleep, and even traveling to a high altitude destination of over 6,000 feet can cause reduced oxygen levels that can present sleep apnea symptoms. While both men and women can have sleep apnea, the disease is disproportionally associated with men, particularly those who need to lose weight. A thick neck or enlarged tonsils are also common in those with sleep apnea. It is important to discuss medical history with your doctor since many of the most serious comorbidities of sleep apnea are bidirectional. For example, people with diabetes and cardiovascular conditions are more likely to have sleep apnea, while having sleep apnea can also contribute to developing these conditions.
In order to get more detailed information, your doctor may request a sleep study. While most cases can undergo home testing, some severe cases will require a visit to a sleep center for a sleep study, where you will spend the night hooked up to a probe on your finger and electrodes around your chest and abdomen. An on-site sleep specialist will get information from this equipment to measure blood oxygen levels, study muscle movements and watch for heart and brain activity during the sleep cycle. The testing results will be sent to your primary physician for final diagnosis.
The number of sleep apnea events per hour will help to determine the severity of the sleep apnea. Treatment options will vary on how severe the condition is, but for the mildest cases, lifestyle changes may be enough to ease the symptoms. Stopping smoking, taking care of allergies, and losing weight can help in those instances. For more severe cases, A CPAP (Continuous Positive Airway Pressure) device may be the best way to help control sleep apnea and prevent further comorbidities. CPAP machines are the gold standard in the treatment of Obstructive Sleep Apnea. They work by taking in the room's air, filtering and pressurizing it, and then delivering it through a hose attached to a mask you wear during sleep. The continuous flow of air gently keeps your tongue and soft palate from relaxing and blocking your airway. This air pressure keeps the airway open, allowing your body to get the oxygen it needs for optimal function and facilitates improved sleep quality.
Sleep apnea is a prevalent sleep health issue with serious comorbidities. If you are experiencing symptoms associated with sleep apnea, the best first step is to see your doctor and then, once diagnosed, seek treatment. Whether through lifestyle changes, using a CPAP device, or an oral appliance, treating sleep apnea will lead to a good night's sleep and better overall health.