Sleep Apnea: Symptoms, Risks and Lifestyle Changes – Turmerry

Sleep Apnea: Symptoms, Causes, and Treatments

Last Updated January 6, 2023

Did anyone ever tell you that you snore? Did you ever wake up with a feeling of panic or jolt awake? Do you know what the scariest part is? You might not even know you have this pervasive problem called sleep apnea.

Sleep apnea occurs when upper airway muscles relax during your sleep and pinch off the airway, which prevents you from getting enough air.

what is sleep apnea

What is sleep apnea?

Sleep apnea is known to be a sleep disorder that can lead to many health conditions. Untreated sleep apnea can cause loud snoring, daytime tiredness, and severe problems like high blood pressure or even heart trouble.

You need to understand that this condition is different from regular or primary snoring. Primary snoring by an individual can be caused by their sleeping style (especially back sleeping) and nose or throat conditions. At the same time, primary snoring and sleep apnea happen when the upper airway becomes blocked many times during sleep due to irregular relaxing of throat muscles.

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People with sleep apnea tend to:

  • Have trouble breathing, shallow breathing, gasping, or choke
  • Have poor sleep, daytime tiredness
  • Snore louder than individuals with regular snoring
  • Daytime fatigue
  • Stop breathing (for over 10 seconds)
  • Be restless

sleep apnea - all you need to know

What are the different types of sleep apnea?

Sleep apnea can be mainly divided into these types :

  • Obstructive sleep apnea
  • Central sleep apnea
  • Complex sleep apnea

Obstructive sleep apnea

Obstructive sleep apnea is the most common type, and it occurs when there is repeated blockage of the upper airway (completely or partially). Anything that could narrow your airways, such as obesity, enlarged tonsils, or changes in your hormone levels, all of these can result in an increased risk for obstructive sleep apnea.

When a person with suspected obstructive sleep apnea is having an apneic episode, their diaphragm and chest muscles work harder as there is an increase in pressure to open the airway; their breathing usually resumes, followed by a loud gasp or body jerk. When this happens, they stop breathing.

The episodes of sleep apnea can disturb your healthy sleep, reduce the flow of oxygen to vital organs, and can cause heart rhythm irregularities.

Central sleep apnea

Central sleep apnea is a condition where the airway does not become blocked. Instead, your brain fails to signal the muscles to breathe because of the issues of instability in your respiratory control center, which results in an inability to fall asleep. Central apnea syndrome is related to the functioning of the central nervous system.

Central sleep apnea occurs most often in individuals with neuromuscular diseases such as amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), those who have suffered a stroke, and people with heart failure or other forms of lung, kidney, or heart disease.

Complex sleep apnea

Complex sleep apnea is known as the combination of both obstructive sleep apnea and central sleep apnea. Doctors also call this condition treatment-emergent central sleep apnea.

What are the symptoms of sleep apnea?

The symptoms of sleep apnea include abnormal nighttime breathing, breathlessness, restlessness, and daytime tiredness, which is the effect of reduced sleep quality.

Frequent symptoms of obstructive sleep apnea include:

  • Loud snoring, gasping or choking sounds while sleeping
  • Daytime fatigue
  • Headaches in the morning that long for several hours after waking up
  • Waking up with a dry mouth 
  • Restless sleep with body jerks while sleeping
  • Frequent urination at night
  • Signs of irritability or frustration
  • Cognitive impairments such as lack of focus, forgetfulness
  • Sexual dysfunction
  • Night sweats

A person with obstructive sleep apnea may not be aware of certain symptoms right away, but their sleeping partner, roommate, or family member may notice them. For example, when abnormal breathing and loud snoring may come to the individual's attention only after they are observed by their bed partner.

Obstructive sleep apnea cannot be diagnosed just by these symptoms alone since many of these symptoms can also result from other health problems.

Symptoms of central sleep apnea

Central sleep Apnea causes dysfunction in the central nervous system. There are also symptoms of :

  • Abnormal breathing patterns such as unusually slow breathing, then rapidly fast and pauses during sleep.
  • Excessive daytime sleepiness
  • Frequently waking up at night.
  • Sudden uneasiness, the feeling of breathlessness, and chest pain at night.
  • Difficulty in concentrating
  • Severe headaches in the morning
  • Trouble swallowing

Symptoms of sleep apnea in children:

  • Poor performance in school
  • Excessive tiredness, sluggishness, or sleepiness. Others usually mistake this symptom as laziness in the classroom.
  • Bed wetting 
  • Learning and behavioral disorders in children
  • Increased irritability
  • Children who have enlarged tonsils or adenoids may also get it.
  • Unusual sleeping position of children, like sleeping on their hands and knees.

Causes of sleep apnea

The cause of breathing disorders differs in the case of obstructive sleep apnea and central sleep apnea.

Causes of obstructive sleep apnea

In people with obstructive sleep apnea, the muscles in the back of the neck relax during sleep, reducing the space for air to pass through. Snoring occurs when the airways narrow, and when the airways are blocked, a person is not getting enough oxygen. Lack of oxygen causes partial or complete awakening to restore airflow. These breathing disorders repeatedly occur during sleep.

Causes of central sleep apnea

Central sleep apnea occurs because of problems with your brain's communication with the muscles responsible for breathing. In people with Central sleep apnea syndrome, a part of the brain called the brainstem fails to correctly recognize carbon dioxide levels in the body during sleep, and there are increased risk of neurological disorders. This leads to frequent apneic episodes of breathing that are slower and shallower than they should be.

What are other sleep disorders?

There are sleep disorders other than central sleep apnea and obstructive sleep apnea. This includes restless legs syndrome, insomnia, circadian rhythm disorders, parasomnias, or narcolepsy.

How is sleep apnea diagnosed?

There is a lot of confusion and tension among people when they want to know whether they have sleep apnea or not. It is always better to seek a medical expert to diagnose this condition of restless sleep. Doctors diagnose sleep apnea patients based on medical and family histories, physical exams, and sleep study results. There are people who have mild sleep apnea, and there are conditions with severe sleep apnea. The doctor will diagnose accordingly to each patient's given condition.

If you think you or your loved ones have these above-mentioned symptoms, then it is suggested that you go and meet a doctor. Additionally, if your doctor suspects you have sleep apnea, you may be asked to undergo a sleep evaluation with a sleep specialist or be prescribed sleep medication.

  • Polysomnogram is the testing method which is an overnight sleep study(American Sleep Apnea Association). It is a physical exam performed in a laboratory with a trained technologist who supervises the test throughout.
  • During this test in the sleep clinic, a variety of body activities is recorded, such as eye movements, signaling activity of the brain, muscle functioning, heart rate, airflow breathing pattern, and blood oxygen levels. 
  • After the study is done, the number of times breathing is disrupted during sleep is calculated, and the severity of sleep apnea is assessed.
  • In adults, home sleep apnea testing (HST) can sometimes be done instead of testing in a sleep laboratory. This is a modified type of sleep analysis that can be conducted in the comfort of your home. It records comparatively fewer body functions than PSG, including airflow, respiratory effort, blood oxygen levels, and snoring, to confirm the diagnosis stage of moderate to severe obstructive sleep apnea.

how is sleep apnea diagnosed?

Treatments for sleep apnea

Undiagnosed sleep apnea will result in various health issues like difficulty breathing and neurological disorders; there is a higher risk of atrial fibrillation.

Conservative treatment

In mild cases of OSA, conservative therapy may be an effective treatment method.

  • Overweight individuals may benefit from weight loss. Even a 10% decrease in body weight can reduce sleep-disordered breathing in most patients. However, losing weight can be difficult with undiagnosed obstructive sleep apnea syndrome because of the increased appetite and metabolic changes that can occur with OSA.
  • Individuals with obstructive sleep apnea should avoid alcohol and certain sleeping pills, which increase the likelihood of airway collapse during sleep and prolong apnea periods.
  • Some patients with mild obstructive sleep apnea experience pause in breathing only when they sleep on their backs. In these cases, using a wedge pillow or other devices to help them sleep in the side position can help.
  • People who have sinus problems or nasal congestion should consider using nasal sprays or breathing strips, as this would help reduce snoring and improve the airflow for more comfortable nighttime breathing. It is important for patients with sleep disorders to avoid sleep deprivation.

Mechanical therapy

Positive airway pressure (PAP) therapy is one of the preferred initial treatments for most individuals with obstructive sleep apnea.

In PAP therapy, patients wear a mask over their noses and/or mouth. An air blower gently pushes air through the nose or mouth. The air pressure is adjusted to be just enough, which prevents the upper airway tissues from collapsing during sleep. PAP therapy prevents airway closure during use, but episodes of apnea return when PAP is stopped or used incorrectly. Depending on the specific needs of the patients, There are various styles and types of positive airway pressure devices designed. Styles and types include:

  • CPAP (Continuous Positive Airway Pressure) is one of the most widely used PAP devices. The machine is set to one pressure.
  • Bi-Level PAP uses one pressure when you inhale (inhale) and a lower pressure when you exhale (exhalation). There is a criterion that must be met before the health insurance will cover the two-tier. This usually means that the CPAP (Continuous Positive Airway Pressure) machine must first be tried without success, and those results must be documented before for a bi-level.
  • Auto (continuous positive airway pressure )CPAP or Auto Bi-Level PAP uses a wide range of pressures that self-regulate during use depending on the pressure requirements detected by the machine.
  • Adaptive servo-ventilation (ASV) is a type of noninvasive ventilation used in patients with central sleep apnea that keeps the airway open and delivers forced breaths when necessary.

Mandibular advance devices

These are devices designed for patients suffering from mild to moderate obstructive sleep apnea. Advanced devices such as dental appliances or oral mandibular advancement appliances can be made to help in preventing the tongue from blocking the throat or moving the mandible forward. These are the devices that help keep the airway open during sleep. A sleep examiner and dentist (with experience in oral appliances for this purpose) should work together to determine if this treatment is best for you.

Hypoglossal nerve stimulator

The stimulator is implanted under the skin, to the right side of the chest, with the electrodes under the skin to the hypoglossal nerve and to the intercostal muscles (between the two ribs) in the chest. The device is turned on before going to bed using the remote control. With each breath you take, the hypoglossal nerve is stimulated, the tongue moves forward from the airway, and the airway opens.

Surgery

Surgical procedures can help individuals with obstructive sleep apnea and other individuals who snore but do not have sleep apnea. Outpatient procedures are among the many types of surgery performed. The surgery is for people with excessive or deformed tissue that prevents airflow through the nose or throat, as in people with a deviated septum, significantly enlarged tonsils, or a small lower jaw with an overbite that causes an abnormally narrow throat. These procedures are usually performed after sleep apnea fails to respond to the conservative measures and a trial of CPAP (Continuous Positive Airway Pressure). Types of surgery include:

  • Somnoplasty is an invasive treatment that uses radio frequency energy to reduce soft tissue in the upper airways.
  • Tonsillectomy is known as a surgical procedure that removes the tonsil tissue at the back of the throat, and this is considered a common cause of obstruction in children with sleep apnea.
  • Uvulopalatopharyngoplasty (UPPP) is a procedure in which the soft tissue at the back of the throat and palate is removed, thereby increasing the width of the airway at the throat opening.
  • Mandibular/maxillary shift surgery is the surgical correction of certain types of facial abnormalities or throat obstructions that contributes to obstructive sleep apnea. This is an invasive procedure that is suggested for patients with severe OSA with abnormalities of the head and face.
  • Rhinoplasty is a cosmetic procedure that involves the correction of nasal obstructions and changing the shape of the nose to correct breathing problems.

Complications of sleep apnea

complications of sleep apnea

Now that we know sleep apnea is a serious medical condition, the complications may include the following:

DAILY FATIGUE

The repeated awakenings associated with sleep apnea prevent normal, restorative sleep, causing severe daytime sleepiness, fatigue, and irritability in an individual. You may have trouble concentrating and find yourself falling asleep at your office, watching TV, or even while driving. Individuals with sleep apnea are at an increased risk of vehicle accidents and workplace accidents. You may also feel moody, short-tempered, or depressed. Children and adolescents with sleep apnea may perform poorly in school or have behavioral problems.

HIGH BLOOD PRESSURE OR HEART PROBLEMS.

The case with sleep apnea patients is that there is a sudden drop in blood oxygen levels, increased blood pressure, and stress in the cardiovascular system. OSA increases the risk of high blood pressure (hypertension).

OBSTRUCTIVE SLEEP APNEA.

OSA can also increase the risk of recurrent heart attacks, strokes, and abnormal heartbeats, such as atrial fibrillation. If you suffer from heart disease, multiple episodes of lack of oxygen in the blood can lead to sudden death when you stop breathing from an irregular heartbeat.

DIABETES.

If you have sleep apnea and type 2 diabetes, it increases the risk of developing insulin resistance. Diabetes is also associated with other sleep-related symptoms, such as snoring and excessive daytime sleepiness.

METABOLIC SYNDROME

Metabolic syndrome is a disorder that includes high blood pressure, abnormal cholesterol levels, increased waist circumference, and high blood sugar and is considered to be associated with a higher risk of heart disease.

COMPLICATIONS WITH DRUGS AND SURGERY.

Obstructive sleep apnea is also a problem with some medications and general anesthesia. People having sleep apnea may be more likely to have complications after major surgery because they are prone to breathing problems, especially when sedating and lying on their backs. Before surgery, tell your doctor about your sleep apnea and how it is being treated.

LIVER PROBLEMS.

People who have sleep apnea disorder are more likely to have abnormal liver test results, and there are chances that their livers are likely to show symptoms of scarring (nonalcoholic fatty liver disease).

SLEEPY PARTNERS.

If you have untreated sleep apnea, snoring can prevent anyone sleeping near you from getting a good night's rest. However, It is not uncommon for the partner to have to go to the other room or to another floor of the house to sleep.

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Are you living with sleep apnea?

If you are somebody who is living with sleep apnea, you need not worry much. Below are some practical steps that can help people who have sleep apnea cope with this condition of apnea and the health effects of sleep apnea.

  • Work closely with your doctor

It is suggested to stay in touch with your primary care doctor or sleep specialist and report any persistent symptoms, problems with treatment, or other concerns that may require the modification of your sleep apnea management plan. Try to explain your condition clearly to your doctor without trying to hide anything that could lead to improving your condition.

  • Take proper care of your treatment devices

Whether you use a PAP device or a mouthpiece, you must take proper care of them by cleaning and maintenance of health and hygiene. This will help you get the most from your treatment and avoid unwanted side effects.

  • Avoid any activity involving high risk

People who have sleep apnea should be aware of the risks of daytime fatigue. In particular, people with untreated sleep apnea should avoid activities such as driving or operating heavy machinery when tired, as this would expose them to a higher risk. Try to engage yourself with activities that keep you focused, and try to calm yourself when you are getting tensed.

  • Consider changing your sleeping position

Although the effect of change in sleeping position has not been rigorously studied, special products that avoid sleeping on your back may help relieve the symptoms of obstructive sleep apnea in some people and help them have a healthy sleep. There are several sleeping positions that will cause body pain and discomfort while sleeping, and it is always better to sleep in a position that would ease your breathing.

  • Sleep environment

One of the most important factors that you have to look at is your sleep environment, and if you have a disturbing sleep environment, it will hinder you from falling asleep, ensure that to have a sound sleep, you have a good environment. Try to keep the devices away, and have a routine and a strict principle of not using any devices before 30 minutes of going to sleep. This could help in concentrating better as some people have an impulse to use devices even while they are asleep.

How your lifestyle changes will help treat sleep apnea?

lifestyle changes to treat sleep apnea.

Sleep apnea occurs in people who are generally negligent towards their health and lifestyle. Many of us are stressed in our day-to-day life, and we tend to ignore our healthy sleep. Now it is very important to understand your body and cater to its needs before the health conditions get severe. Those who tend to ignore the signs and symptoms in the early stages face a hard time in the later stages.

People with Obstructive sleep apnea and central sleep apnea are suggested to

1. Eat healthy and exercise regularly.

Having a healthy diet and exercising regularly can do wonders for your health. The odds of your sleep apnea increase when you're not physically active. Regular movements in your body not only raise your energy level but also boost your oxygen levels, helps you shed fat around your upper airway, and help you feel less sleepy. So try to work out at least 30 minutes a day, five days a week, as this would help improve your sleep quality.

2. Try to quit drinking and smoking.

The consumption of alcohol and smoking can worsen your sleep apnea, as there are studies that suggest that people who usually drink a lot of alcohol tend to put on weight. If you are somebody who has a hard time quitting alcohol, you can control your alcohol intake by taking considerable measures and strictly ensuring that you do not drink 3-4 hours prior to bedtime.

Smoking cigarettes is harmful to your health because of the toxic chemicals present in them. Smoking will only cause poor quality and might as well result in other severe health complications.

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Can you take sleep medicine to treat sleep apnea?

Yes, you can take medicines for the treatment of sleep apnea only if it is prescribed by a doctor. It is strongly advised to refrain from taking any sleeping pills, opioids, or any sort of strong painkiller without the doctor's prescription, as these can slow down your breathing rate, relax the breathing muscles even more, and pose a threat to your life.

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Disclaimer: What is said in this article has been referenced from multiple sources and is intended only for educational and informational purposes. Please note that no content in this article is a substitute for professional advice from a qualified doctor or healthcare provider. Always consult an experienced doctor with any concerns you may have regarding a health condition or treatment, and never disregard any medical suggestions or delay in seeking treatment because of something you read here.

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