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Sleep Apnea

Sleep apnea is one of the most common and potentially serious sleep disorders. It is caused by obstruction of the upper airway which includes the nose and throat. This can lead to snoring and choking noises as you try to breathe at night. Sleep apnea can reduce the oxygen flow to your brain and body causing significant long-term health consequences and increase the risk of stroke, heart attack, and sudden death. Distinguishing snoring from obstructive sleep apnea is important.

What is Obstructive Sleep Apnea? (OSA)

OSA is characterized by multiple episodes of breathing pauses greater than 10 seconds at a time, due to upper airway narrowing or collapse. This results in lower amounts of oxygen in the blood, which causes the heart to work harder. The noise typically results from vibration of normal tissues in the throat as air passes through it. During the daytime, our muscles are awake and this keeps the throat open so this vibration does not occur. When we go to bed at night, especially during the deep stages of sleep, the body’s muscles will relax, including those around your throat. Gravity allows the loose tissues in the throat to fall backward, i.e., the palate and the back portion of the tongue. As the air passes through the throat, the collapsed tissues will vibrate and make the snoring sound. In some people, the throat collapses for a long period and breathing stops. This is called apnea.

Even though you may not be aware, sleep apnea causes you to wake up many times during the night. Because the snorer does not get a good rest, he or she may be sleepy during the day, which impairs job performance and makes him or her a hazardous driver or equipment operator. Untreated obstructive sleep apnea increases the risk of developing heart attacks, strokes, diabetes, and many other medical problems.

What are the long-term effects of sleep apnea?

Sleep apnea is a severe problem. If you periodically stop breathing whenever you go into the deep stages of sleep, your body and brain send signals to wake you up and get oxygen. This limits the time you stay in the deep stages of sleep. It is the deep stages of sleep which are the most needed for our body to get properly rested. Sleep for a patient with sleep apnea becomes less restful, and a person with sleep apnea feels tired during the day even though they were in bed for many hours. Such a person tends to nod off when things are slow because the body is craving sleep whenever it can get it. Despite spending additional time "sleeping," the person is not getting rested because of the lack of deep stage sleep.

Why should I seek treatment for sleep apnea?

Untreated, sleep apnea can also lead to more serious long-term health problems. Because the person is chronically tired, they exercise less and gain weight. This can be associated with other medical issues. As the body goes without breathing at night during sleep, it also drops body oxygen levels, which over time cause the heart and lungs to work harder, and can lead to heart and lung disease. The additional weight gain further worsens sleep apnea, introducing a vicious cycle. Many people function well enough despite their sleep apnea and are unaware of the process going on at nighttime.

Frequently a spouse or significant other is the one to identify the problem, noticing the loud snoring with prolonged pauses of breathing while sleeping.

Sleep Apnea Symptoms

The following are symptoms common to sleep apnea:

  • You have been told by others you snore, but you are unaware of it.
  • You have been told you have pauses in breathing while you sleep.
  • You have high blood pressure.
  • You often get easily irritated.
  • You are unusually grumpy and impatient.
  • You always lack energy and wish you had more.
  • You sweat excessively at night.
  • You are having irregular heartbeats at night.
  • You have an unexplainable headache when you wake up in the morning.
  • You suddenly wake up at night gasping for air.
  • You are overweight.
  • You are losing your sex drive.
  • You feel extremely sleepy during the day.
  • You struggle to keep focus and remain alert.
  • You wake up most of the time with a dry mouth.
  • You have mood swings and feel easily depressed.
  • You cannot concentrate on your daily tasks either at work or at school.
  • You fall asleep when driving.
  • You wake up in the middle of the night feeling like you’re choking.
  • Even if you’ve slept an adequate amount of time, you still feel exhausted and sleepy during the day. 

© Benjamin Liess, MD, FACS