When you think of someone with sleep apnea, the image that comes to mind might be of a large, middle-aged, overweight man with wobbly jowls, snoring away loudly in bed. While this probably is the stereotypical picture of sleep apnea, it is possible to be a slim, young woman sleeping silently or even a small child who is suffering from this sleep disorder.
Sleep apnea describes a disorder involving pauses in breathing during sleep. As breathing is sort of important, these frequent breaks in breathing can lead to some significant health problems. There are three types of sleep apnea:
- Obstructive sleep apnea (OSA). This is the most common type of sleep apnea, affecting an estimated 22-25 million Americans. During OSA, the soft tissues around the throat collapse, blocking off the airways
- Central sleep apnea. Central sleep apnea is not a problem of the airways but originates in the brain centers responsible for signaling the muscles involved in breathing
- Complex sleep apnea syndrome. When both OSA and central sleep apnea are present, a person is considered to have complex sleep apnea syndrome
A Little Snort Here, A Bit of Snoring There – OSA Isn’t So Bad, Is It?
If you think the worst consequence of OSA is a bad night’s sleep for anyone within earshot of your snoring, think again! In the US, the annual economic impact of undiagnosed sleep apnea in adults is estimated to be around $149.6 billion. This number includes those dollars lost from reduced productivity, those associated with covering workplace accidents, and those involved in dealing with motor vehicle accidents. That’s a lot of dollars.
But finances aside, OSA is known to be linked with a number of severe and potentially life-threatening complications. Just to name a few, these can include an increased risk of:
- Hypertension (high blood pressure)
- Cardiovascular disease, including heart attack, heart failure, and stroke
- Type 2 diabetes
- Abnormal liver function
- Chronic kidney disease
- Cognitive and behavioral disorders, including dementia and learning disability
As it turns out, a little snorting and snoring can be pretty bad after all.
Top 10 Signs of Sleep Apnea
Approximately 75% of severe OSA cases in the US are thought to be undiagnosed. That’s a lot of people at an increased risk of an early demise from those complications listed above, and they don’t even realize it.
The most conclusive way of diagnosing sleep apnea is through your doctor. Identifying OSA may involve a sleep specialist at a sleep disorder center, or with an otolaryngologist (ENT doctor). But how do you know you need to see a doctor for suspected sleep apnea in the first place? Here are 10 signs and symptoms that might alert you to get some help.
- Loud and frequent snoring. Although snoring is commonly present during OSA, it is not diagnostic of sleep apnea. A person may snore but not have OSA or conversely, someone can have OSA but snore very little.
- A dry mouth or throat in the morning. People with OSA often end up breathing through their mouth during sleep, which can dehydrate the mouth and throat. Counterintuitively, waking with a wet patch of drool on your pillow can also signal OSA if you sleep with your mouth open to breathe at night.
- Fatigue and sleepiness during the day. The frequent waking during the night (whether you’re conscious of it or not) as your body tries to jumpstart your breathing again, unsurprisingly results in a poor night’s rest. This can translate to drowsiness while driving or poor concentration at work or school.
- Depression and other mood disorders. Chronic poor quality sleep and OSA are both strongly linked to mental illnesses, including depression, anxiety, and panic attacks. Low emotional wellbeing can manifest as no longer enjoying the things that you used to, low energy, poor concentration, and changes to appetite.
- Frequently needing to urinate during the night. Some people just drink a little too much water before bed, causing them to wake to use the bathroom overnight. However, OSA can also increase your need to urinate. It is thought that the disruptions to sleep inhibit the production of a hormone that prevents you from needing to pee at night.
- Teeth grinding or clenching. Grinding the teeth or clenching the jaw typically happens unconsciously. In people with OSA, it may occur during sleep to try and help tense the airway muscles and keep the jaw in position. In this regard, it has the potential to support breathing during sleep, but can lead to dental issues such as tooth damage.
- Poorly controlled hypertension. As OSA is a known risk factor for high blood pressure, it may be worth investigating if you have hypertension that is difficult to manage through the usual means of medications and lifestyle modifications.
- Heartburn or reflux. If you tend to get acid reflux at night and know you have gastro-esophageal reflux disease (GERD) during the day, this may be an indication that you also have sleep apnea. During sleep apnea, the narrowing of your airways can result in the stomach contents being sucked into the esophagus (the tube that connects your mouth to your stomach) through negative pressure. If the muscles that usually close off your esophagus from your stomach are weak, this can lead to heartburn.
- Abnormal sleep behaviors. Curiously, unusual activities during sleep such as walking, talking, or even eating, can point towards sleep apnea. This is because the disturbance to normal sleep caused by OSA puts the brain in a mixed state of between being awake and being asleep.
- Your partner tells you that you choke, gasp, or snort in your sleep. Many people with OSA don’t realize their breathing is interrupted, as they don’t rouse fully from sleep during these episodes. You’re more likely to have a (rather irritable) bed- or room-sharing partner report that you appear to stop breathing for a few seconds, only to start up again with a loud snort or gasp.
Obstructive sleep apnea can be treated. Milder cases may be managed with lifestyle modifications, such as losing weight, while more severe situations can be treated with medical devices to support the airways or with surgery. Because of the extensive list of health risks that come with undiagnosed and untreated sleep apnea, if you think you might have it, it’s important to get yourself checked. Yes, even if you aren’t a large, overweight, middle-aged man with wobbly jowls!