Imagine this: You are sleeping perfectly when something suddenly wakes you up in the middle of the night. You feel terrified as you struggle to breathe. No matter how hard you try, you can't do it. Several seconds pass by… followed by many more. You are just lying there losing your breath, coughing, and choking. Soon, your partner wakes up and rushes you to the nearest hospital in a complete state of panic. For you, this may sound like a story, but for one out of every fifteen people, this is sleep apnea; a condition that frequently hits them in their sleep.
Even though the disease sounds extremely severe, it often goes undiagnosed. Why? Because most people do not know about what they are dealing with.
Keep reading to learn more about sleep apnea, its causes, types, and treatment.
What is Sleep Apnea?
For most people, snoring is just a joke or something they feel too shameful to discuss with others. If you feel that you snore too loud and are tired most of the day, despite sleeping properly, it might be because of sleep apnea.
Sleep apnea is a serious breathing disorder in which your breathing is constantly interrupted during sleep. The person who suffers from this disease is not usually aware of it since it happens during sleep. In sleep apnea, you may have short breathing pauses multiple times per night. These repeated durations of breathlessness can significantly disturb your sleep rhythm, reduce your concentration, and deprive you of energy during the daytime.
Types of Sleep Apnea
Sleep apnea can be broadly categorized into three types:
Obstructive Sleep Apnea
This type of sleep apnea refers to the condition in which there is a physical hindrance to your airway structures. It normally leads to temporary disruptions in normal breathing patterns.
Central Sleep Apnea
Central sleep apnea is caused by faults in the brain. The brain is unable to control the respiratory muscles properly leading to shallow breathing which is slower than usual.
Mixed Sleep Apnea
In some people, there is an anatomical blockage of the airway together with a faulty control of the respiratory muscles. Such type of sleep apnea is called mixed sleep apnea since it carries the features of the other two types together.
What Causes Sleep Apnea?
Sleep apnea occurs when your airway is blocked or collapsed during sleep. Multiple factors can contribute to this blockage such as:
Obesity
Obesity is among the leading causes of sleep apnea. It is also an important risk factor in more than half of the diagnosed cases as well. Excessive weight gain can anatomically reduce the circumference of the airway, causing interruptions in breathing. According to research, a ten percent increase in weight can increase the risk of acquiring sleep apnea by six times. (1)
Anatomical Features
In some people, the position or size of various neck structures, including the tonsils, tongue, jaw, and the neck, is such that it obstructs the entry and exit of air in the body. These anatomical features are natural and present by birth.
Substance Abuse
Consuming too many sedatives and alcohol can over-relax the muscles of respiration. As a result, they are unable to perform their designated function and lead to trouble during breathing.
Smoking
People with a smoking history or those who are active smokers are much more likely to experience obstructive sleep apnea as compared to non-smokers. (2)
Nasal Congestion
People whose noses are often congested rely on their mouths to breathe. Such people are at higher risk of developing sleep apnea at some point in their lives.
A Positive Family History
People having at least one close relative with a history of sleep apnea are at a higher risk of developing it.
Hormonal Issues
People with hormonal disorders such as acromegaly (too much growth hormone) or hypothyroidism (too little thyroid hormone) are at an increased risk of developing sleep apnea, particularly the obstructive type. This is because these conditions promote obesity and may cause the tissues around the airways to swell up. (3) (4)
Sleeping Posture
Certain sleep postures such as sleeping on the back can increase the risk of tissue collapse around the neck, leading to airway obstruction. (5)
How Do You Know if Someone has Sleep Apnea?
It is usually next to impossible for a person to know if they suffer from sleep apnea or not since they are asleep when the problem occurs. However, certain clues may lead to suspicion. These clues include: (6)
Sleepiness
No matter how much sleep you have had, you will always feel tired when you wake up and may even doze off while driving.
Gasping
You may find yourself choking and gasping for every breath of air whenever you wake up from sleep.
Loud Snoring
You may snore so loud that it disturbs your partner's sleep.
Difficulty Sleeping
You might develop insomnia and may have to wait for hours before finally falling asleep. This symptom is more pronounced in women.
Morning Symptoms
You may suffer from dryness in the throat, morning headaches, irritability, or sore throat as soon as you wake up every morning.
Cognitive Deterioration
You may develop anxiety, depression, and problems with memory.
Long-term Effects of Sleep Apnea
If left untreated, sleep apnea can have rather serious effects on your body which may include:
- Increased risk of getting into automobile accidents.
- Increased risk of acquiring metabolic syndrome, hypertension, stroke, and glaucoma.
- Mood changes.
- Impaired cognition leading to deterioration in personal and professional lives.
- Chronic restlessness and fatigue.
- Deteriorated quality of life.
- Increased risk of early mortality.
Diagnosing Sleep Apnea
If you always feel tired, energy-deprived, and burnt out during the day, it is better to consult a doctor to rule out any possibility of sleep apnea. The doctor may start the investigation with a set of questions such as:
- What is your normal sleep schedule throughout the week?
- Do you know if you snore or not?
- How long do you take to fall asleep on a normal day?
- Are you using any sedatives?
- Do you smoke/drink alcohol? What is the frequency?
- Have you ever woken up with a feeling of panic?
- How much sleep are you getting per day according to you?
- Does anyone in your family suffer from a sleep-related problem?
Based on these questions, the doctor will assess your chances of having sleep apnea. If there is a high suspicion, you might be referred for a nocturnal polysomnography or sleep study. (7) This test requires you to sleep in an appropriate facility overnight as the professionals monitor you. During this test, they monitor and assess your oxygen levels, heart rate, brain waves, and the movements of your limbs. Based on all these factors combined, a diagnosis is made by the relevant physician.
Sometimes, a Home Sleep Apnea Testing may also be prescribed.
Treating Sleep Apnea
Physicians often use a three-way approach to manage sleep apnea in most patients. This approach includes lifestyle changes, bedtime tips, and medical treatment.
Lifestyle Changes
Adopting the following lifestyle changes may significantly improve the symptoms of sleep apnea in most people:
Weight Loss
Obese people tend to have extra tissue on the back of their throat which can block their airway and cause sleep apnea. Losing weight can, therefore, be helpful for such people.
Quit Smoking, Alcohol, and Sedatives
Factors like smoking, alcohol, and sedatives all relax the muscles of your throat and make breathing more difficult. (8) (9) Quitting them all can have significant improvement in most patients.
Regular Exercise
Exercising on a regular basis can improve your quality of sleep and reduce your risk of experiencing the discomforting symptoms of sleep apnea. Aerobic exercise, in particular, can be of great help in this context. Moreover, experts also recommend yoga to improve breathing.
Maintenance of a Proper Sleep Cycle
To avoid sleep apnea, you must get lots of sleep. And to make sure you get enough sleep, the best way is to make a sleep schedule and stick to it.
Bedtime Tips
Some tips to follow before going to sleep are:
- Sleep on your side instead of sleeping on your back.
- Use pillows or elevate the head of the bed to prop up your head and open your airway muscles throughout the night.
- Use a saline spray, nasal dilators, or breathing strips to maximize air entry through the nostrils.
- Chew gum more frequently to tighten the muscles that keep your mouth shut.
- Perform tongue and throat exercises to strengthen the airway muscles.
Medical Treatment
If lifestyle management and bedtime tips fail to treat the symptoms of sleep apnea, your physician may choose one of the following treatment modalities after assessing your case:
- Breathing devices
- Continuous Positive Airway Pressure or CPAP
- Implants
- Surgery
In a Nutshell
Sleep apnea can be extremely discomforting and scary for many people, and can severely affect the quality of life. However, remember that it is not an incurable problem. With proper diagnosis and individualized plan tailored to your needs, you can recover from this problem and sleep without the fear of being breathless once again.
