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What is Sleep Apnea?  Sleep-Disordered Breathing Explained

What is Sleep Apnea? Sleep-Disordered Breathing Explained

Guide to understanding sleep apnea

Does sleep apnea hinder you and your loved ones from a good nights rest? This guide will give you important information and tips to help you manage your sleep apnea.

Image: Shutterstock/Tommaso79

What Is Sleep Apnea? 

Sleep apnea is a serious health condition, where sufferers’ breathing stops and starts repeatedly. People who frequently wake up short of breath, feel uncommonly tired throughout the day, or snore loudly may have sleep apnea and should consult a medical professional.

Types of Sleep Apnea

There are three types of sleep apnea that individuals can suffer from. 

Obstructive sleep apnea, the most common type, is caused by throat muscles that become too relaxed, causing your airway to constrict. You don’t breathe in as much air, and your brain wakes you up so you can take a deeper breath. 

Central sleep apnea occurs when there’s a disconnect between your brain and your breathing muscles. You may either have trouble falling asleep or wake up frequently. Finally, complex sleep apnea syndrome is a combination of both types in one individual.

Complex sleep apnea syndrome is the combination of both obstructive sleep apnea and central sleep apnea.

Sleep apnea isn’t limited to just adults. The American Sleep Apnea Association estimates that between 1% and 4% of children also suffer from this condition, while the Sleep Foundation believes it could be as high as 20%. It’s more likely to occur in kids from ages two to eight.

Image: Shutterstock/Alila Medical Media

Fast Facts About Sleep Apnea

  • More than 22 million Americans live with sleep apnea. The most prevalent symptoms include heavy snoring, feeling overly tired during the day, and waking up out of breath throughout the night.
  • Sleep apnea is more likely to be present in men than in women, and it’s also more common among African American and Hispanic men. Besides gender, other risk factors include obesity and being 40 years or older.
  • Suffering from sleep apnea without seeking treatment can be dangerous. For starters, the lack of quality sleep can increase the risk of falling asleep behind the wheel and getting into an accident. Over the long-term, sleep apnea can also contribute to cardiovascular disease (including high blood pressure). Headaches, gaining weight, and memory issues can also result from untreated sleep apnea. 

Sleep Apnea Symptoms

There are multiple signs and symptoms that may indicate you’re suffering from sleep apnea:

  • Snoring (loudly or on a regular basis)
  • Waking up gasping for breath
  • Frequently waking up to go to the bathroom
  • Drowsiness in the daytime
  • Trouble paying attention
  • Headaches
  • Dry mouth
  • Lower sex drive

Children may exhibit a different set of symptoms:

  • Problems with schoolwork
  • Bedwetting
  • Hyperactivesness 

If you’re experiencing these types of symptoms, it may be time to seek medical help. While you eventually may need to see a sleep specialist, it’s usually best to start with an appointment with your primary care physician. Not only does this help to rule out other diagnoses, but it also establishes a referral in case your health insurance company requires one for specialized care. Even if you don’t have every symptom related to sleep apnea, you should consult your doctor anytime you’re suffering because of poor sleep.

What Causes Sleep Apnea?

Sleep apnea can happen for a number of reasons, and there are certain risk factors that make you more likely to start experiencing symptoms. 

Obesity and neck circumference: Being overweight may lead to excessive fat deposits that constrict your upper airway. Alternatively, you may have a thicker neck or a naturally narrow airway regardless of your weight. Any of these issues can trigger breathing issues while you sleep.

Gender: Men more commonly get sleep apnea than women. In fact, men are anywhere two to three times more likely to have sleep apnea than their female counterparts.  

Menopause: Women are at increased risk of sleep apnea, however, once they reach menopause due to the decrease in estrogen and progesterone. Women are also more likely to gain weight during menopause, which can disrupt the airway if more fat is gained around the throat.

Age: Your age factors into your likelihood of sleep apnea. The risk increases at age 40, then jump even higher for those who are 60 and older.

Family history: Genetics can be involved with sleep apnea. If someone in your family has this disorder, you may be more likely to have it as well.

Use of alcohol/sedatives/tranquilizers: Lifestyle choices like using alcohol and other sedatives may contribute to sleep apnea because they can relax the airway.

Smoking: Smokers are much more likely to suffer from sleep apnea than non-smokers. This habit can cause the upper airway to become inflamed and have fluid build-up. 

Nasal congestion: This is another contributing factor to developing sleep apnea because the upper airway narrows. Taking steps to reduce nasal congestion could help improve sleep apnea symptoms

Medical conditions: Individuals with certain medical conditions may also be at a higher risk for sleep apnea. Common correlating disorders include Parkinson’s disease, heart failure, high blood pressure, and Type 2 diabetes. Asthma, lung disease, and some hormonal issues may also contribute to the presence of sleep apnea.

Some of these risk factors are controllable, while others are not. But, if you have sleep apnea and do have some risk factors that you can change, it’s worth the effort to reduce the risk of negative outcomes. Crafting a plan to lose weight, stop smoking, or lower your alcohol intake could help lessen symptoms and improve your health in the long run.  

Complications and Outcomes of Sleep Apnea 

Complications may arise as a result of sleep apnea, especially if it’s uncontrolled. Here are some issues that you may experience because of this condition.

High blood pressure: Sleep apnea can cause drops in oxygen levels in your blood, consequently increasing your blood pressure.

Stroke: Medical research shows that sleep apnea is a common condition among stroke patients. Recurrent strokes could even occur if sleep apnea goes untreated

Heart attack: Lower blood oxygen levels caused by sleep apnea can also eventually lead to a heart attack

Diabetes: The loss of oxygen in the bloodstream (and corresponding increase in carbon dioxide) can also worsen type 2 diabetes symptoms. Your body can’t use insulin as effectively due to this imbalance.

Gastroesophageal reflux disease: Also known as acid reflux (or heartburn), this chronic condition frequently coexists with sleep apnea. An apnea episode can change your digestive processes, potentially leading to acid reflux.

Nocturnal angina: Sleep apnea can also trigger nocturnal angina, which is chest pain that occurs at night. It’s typically caused by reduced blood flow to the heart

Heart failure: Another type of heart disease that can result from sleep apnea is heart failure. This occurs when your heart can’t keep up with your body’s demand for either blood or oxygen.

Hypothyroidism: Hypothyroidism occurs when your body’s glands don’t produce enough thyroid hormone to function properly. You’ll likely feel fatigued and may experience other symptoms like extreme coldness, high cholesterol, and a slow heart rate. This disorder can also lead to sleep apnea, so if you manage your hypothyroid with your doctor, you may alleviate your apnea symptoms as well.

What Makes Sleep Apnea More Severe? 

There are several risk factors that can make sleep apnea worse. If you can control some of these issues, you may be able to relieve your symptoms. While not every trigger is within your ability to change, identifying multiple options and addressing them can be a great way to start finding relief from your sleep apnea

Weight gain: If you’re overweight or obese, your sleep apnea symptoms could worsen. The reason is because your body stores excess fat around your airway and even by your tongue. Losing between 10% and 15% of your body weight can greatly reduce the risks surrounding sleep apnea. Someone who weighs 250 pounds, for example, would need to lose between 25 and 37 pounds to experience these benefits.

Aging: Unfortunately, no one can turn back time. As you get older, you become at higher risk for sleep apnea simply because your airway muscles lose tone just as any other muscle would. Although you can’t control how many years pass by, lowering your risk through other categories within your control can help combat age-related apnea. 

Menopause: On average, women go through menopause around age 50. As your body stops having periods, it produces fewer estrogen hormones. While menopause can bring a variety of symptoms with it, sleep-related disorders (including sleep apnea) are common. Poor sleep quality, insomnia, and fatigue may also be present. 

Sleep position: Sleeping in a poor position can also contribute. Luckily, finding the right mattress and sleeping in a supportive way can improve your snoring and sleep apnea symptoms. Consider elevating your head and sleeping on your head to feel better.

Alcohol and sedative medicines: Alcohol can negatively impact the severity of your sleep apnea symptoms. Not only does it affect your natural sleep patterns, but it also relaxes your airway muscles in a way that can trigger apnea. In addition, you may experience more shallow breathing, further decreasing your blood oxygen levels. 

Individuals who are on muscle relaxers and other prescription sedatives may have trouble with sleep apnea. Many categories of prescription drugs can impact breathing and the tautness of your airway muscles. But for many people, these medications are a must-have. That’s why it’s so important to talk to your doctor about sleep issues in addition to any other health problem you’re experiencing.

Sleep Apnea Diagnosis 

If you’re exhibiting signs of sleep apnea, you should visit your doctor for a diagnosis and formulate a treatment plan. In addition to asking you questions about your sleep habits, the doctor will perform a physical exam. There are several types of tests to test you for sleep apnea. 

EEG

An EEG monitors your brain waves through electrodes attached to your head while you sleep. The test is painless and comes with virtually no risk; in fact, you shouldn’t feel anything at all. You’ll simply have some small discs attached to your scalp with an adhesive, although sometimes you may be fitted with a cap. You’ll likely receive test results within a few days. 

EKG/ECG

An EKG or ECG is a heart test and can be used to determine if you’re experiencing any cardiac issues during an apnea episode. It can also measure your blood oxygen levels. Rather than having electrodes placed on your head, they’re placed on your chest over your heart and potentially on your limbs. Again, the process is safe and there’s no shock or other type of sensation.

Pulse Oximetry Test

This is another test to gauge the oxygen levels in your blood. It generally involves a small clip to your finger or earlobe which then measures how much oxygen is pumped away from your heart. The test can also determine if you stop breathing during sleep, which can indicate sleep apnea.

Sleep Apnea Treatment 

Once you’ve been diagnosed with sleep apnea, you can start treating your symptoms. A continuous positive airway pressure (CPAP) machine is commonly used to improve nighttime breathing.  

What is a CPAP Machine?

A CPAP is a medical device that can improve your breathing when experiencing sleep apnea. The machine attaches to a mask that you put on your face. It pushes air through the tube, keeping your airway open and allowing more oxygen to pass through. The mask comes in different shapes and sizes for a more customized fit. 

This treatment differs from an oxygen machine that is used for respiratory conditions like emphysema and COPD. An oxygen concentrator draws and purifies oxygen from the air, giving the patient a purer level to breathe. A CPAP machine, on the other hand, gives a constant flow of air to lessen restrictions in your airway.

What does using a CPAP feel like?

It can take some time to get used to sleeping with a CPAP. Set some benchmarks for yourself such as keeping it on for a few hours a night, then lengthening the amount of time. You can even practice keeping it on while you read or watch television as you adjust to the feeling of air coming through the mask. Ultimately, you’ll feel much better as you get better sleep without constricted airways impacting your blood oxygen levels.

Does insurance cover a CPAP machine?

Most health insurance policies do cover a CPAP machine, but you may need to pay a deductible or copay for medical equipment. Talk to your insurer to find out the details of your policy. Without insurance, expect to pay anywhere between $500 and $3,000. 

However, some insurance companies may simply rent a machine on your behalf rather than letting you purchase it outright. If you’re found to not be using it consistently, you may have to return the machine. In some cases, it may be more cost-effective to purchase a CPAP machine out of pocket.

Sleeping Comfortably With Sleep Apnea 

There are a few strategies you can employ to sleep better and improve your health with sleep apnea. 

Get Comfortable with Your CPAP

Make sure your CPAP mask fits comfortably, otherwise leaking air will disrupt your slumber. Get the right size mask for your face, and wait to adjust your straps until you’re laying down and about to go to sleep. Consistently using your CPAP every night also creates a habit and makes it feel more natural. Also, don’t be afraid to make adjustments if you’re not comfortable. Red marks on your face in the morning, for example, indicate that your straps should be loosened.

Many CPAP machines come with a ramp-up feature, which starts off with low air pressure and then increases in intensity after you fall asleep. You can also turn on the humidifier function to avoid excessive dryness in your nose or mouth.

Choose the Right Mattress

The way you sleep can also impact your breathing and support the benefits from a CPAP machine — or may even provide relief without one. When looking at the setup of your bed, evaluate the angle of your frame. Many bed frames are adjustable so you can elevate your head to help combat snoring. 

If you suffer from asthma, allergies, or nasal congestion (or a combination of all three), consider a hypoallergenic mattress that comes with an antibacterial coating. These attributes can lessen inflammation and congestion, allowing you more quality sleep and better health. You can also pick a firmness level to support your sleep position. Sleeping on your side is typically recommended to help with sleep apnea and snoring, and a softer mattress usually offers the most comfort and pressure-relieving support.

More tips for better sleep

When you’re suffering from sleep apnea, you may want to try multiple strategies to sleep better. A positioning pillow is another tool you can use to elevate your head, especially if an adjustable bed frame is unrealistic. You can also have a humidifier on in your room each night; just remember to clean it out regularly to avoid mold growth. Finally, another low-effort potential remedy is to go to your dentist and get fitted for a mouth device. Similar to a mouth guard, they keep your tongue in a better position to allow air to pass through your mouth. 

The Bottom Line 

Sleep apnea is certainly a serious condition, but it’s not one without hope. Consult your doctor and create a multi-pronged strategy to lessen the severity of your sleep apnea. Both lifestyle changes and a CPAP machine can be used together to improve your sleep. Once you do, you may even notice positive changes in your overall health as well.