What is sleep apnea, what are the symptoms, and how to take action

Sleep apnea is a sleep disorder that affects millions of people worldwide. Often mistaken for insomnia or poor sleep, sleep apnea is characterized by frequent interruptions in breathing during sleep, leading to daytime fatigue and other symptoms.

There are two types of sleep apnea: obstructive sleep apnea, which is caused by physical factors, and central sleep apnea, which is a neurological glitch. This blog post will explore the symptoms, risk factors, diagnosis, treatment options for sleep apnea, and lifestyle changes that can help manage this condition.

What is sleep apnea?

Sleep apnea is a sleep disorder that is different from insomnia or poor sleep. One thing the two sleep disorders have in common is daytime fatigue. Most people who experience sleep apnea initially complain of being very tired during the day or even falling asleep unintentionally. Sleep apnea can be underdiagnosed or missed altogether because daytime fatigue and low energy overlap with insomnia.

Sleep apnea means we repeatedly stop breathing for a few seconds while sleeping, and, as we mentioned, there are two types: 

• Obstructive sleep apnea (OSA) is the most common and caused by a physical "block" or pressure that causes the airway to collapse temporarily, and air cannot travel from your nose into your lungs and back. The blockage can be tissue from a large neck, larger adenoids or tonsils, a misaligned jaw, or overweight.
• Central sleep apnea is a neurological "glitch" and is not caused by physical factors like obstructive sleep apnea. Central sleep apnea occurs in about 1% of the general population and is more common with other medical or neurological disorders.

Sleep apnea is usually worse when you lay on your back because gravity pushes down your airway. When an apnea event happens, your breathing briefly pauses, your brain activates the body to breathe, and a brief (and often undetected) awakening happens.

Snoring can often follow because the body tries to "push" air through the collapsed airway. You can imagine the amount of fatigue that results if these mini-awakenings happen multiple times per hour throughout the night. Because you are unaware of these awakenings, you wake up tired and dragging the next day.

Symptoms and risk factors

The most common symptom of sleep apnea is daytime fatigue because people are not aware they are waking up frequently.

Other symptoms of sleep apnea include:

• Snoring
• A partner/friend noticing pauses or stops in your breathing patterns at night
• Waking up with a dry mouth
• Headaches
• Frequent nighttime urination
• Irritability
• Difficulty concentrating during the daytime
• Falling asleep during the daytime by accident

Risk factors that increase the chances o developing sleep apnea include:

• High blood pressure
• Older age
• Male or postmenopausal women
• Large neck circumference (larger than 17 inches around)
• Being overweight
• Family history of sleep apnea
• Nasal congestion

Women are less frequently diagnosed with sleep apnea than men with similar symptoms. When they present to medical professionals, their fatigue is more likely to be explained as anxiety or depression. Depression and anxiety can happen along with sleep apnea and also worsen it. Sleep apnea is also overlooked in muscular younger people with a large neck circumference or high body mass index (BMI) but not excess weight. Though often connected, sleep apnea and anxiety or depression should be diagnosed and treated as separate medical disorders.

How is sleep apnea diagnosed and treated?

The first step to diagnosing sleep apnea is talking to your doctor about your symptoms and getting a sleep study. Because sleep apnea causes mini awakenings, behavioral strategies will not treat it. Improving your lifestyle and sleep hygiene can help immensely, but someone with sleep apnea will continue to feel significant daytime sleepiness until appropriately treated.

A sleep study is required to diagnose and determine the severity of sleep apnea. Home sleep studies are becoming more popular but have limitations and do not capture sleep stages. They can still be an excellent first step, though, to get the basic information about your breathing patterns.

Overnight sleep studies completed in sleep labs are another option. They provide more information about your sleep (e.g., how long you are in each sleep stage and limb movements) but are not always accessible. Sometimes, people get anxious about spending the night in a lab and prefer to use the in-home test.

The number of this times your body "wakes up" to take a breath within one hour determines the severity of your sleep apnea. The treatment options depend on your sleep apnea severity.

Positional therapy and mouth appliances can treat mild sleep apnea. Myofunctional exercises can also help mild sleep apnea but need to be completed regularly. A continuous positive airway pressure (CPAP) machine is the recommended treatment if you are diagnosed with moderate to severe apnea.

A lot of people are unaware they have sleep apnea. That is understandable. However, not treating sleep apnea can worsen sleep, mood, and other health issues, making it an integral part of your overall wellness. And the good news is that it can be treated! 

Lifestyle changes that can help manage sleep apnea

• Reduce or consider eliminating alcohol or smoking
• Decrease weight
• Use pillows or other props to stay on your side while you sleep
• Reduce water/liquids before bed
• Manage allergies or any causes of nasal congestion

Growing awareness around sleep apnea

Sleep apnea is a common yet often underdiagnosed sleep disorder that can significantly impact a person's quality of life. Recognizing sleep apnea symptoms and risk factors is crucial in seeking proper diagnosis and treatment. Whether through lifestyle changes, positional therapy, mouth appliances, or a CPAP machine, various treatment options are available. By managing this condition effectively, individuals can experience improved sleep, increased energy levels, and enhanced overall well-being.

If you suspect you have sleep apnea, consult your healthcare provider to discuss your symptoms, explore the best course of action for your needs, and start getting the rest you need.