Sleep Apnoea 101 – Types, Risk Factors, Symptoms, And Treatment Options

Sleep apnoea (usually spelled “sleep apnea” in the USA) affects approximately 42 million American adults, and yet 75% of severe cases remain undiagnosed.

Sleep apnoea is a disease that not only affects your sleep – it can also have a long-term impact on your overall health.

And at worst, if it is left undiagnosed, sleep apnoea can even be a slow killer.

This article is about identifying what sleep apnoea is and the problems it can cause. I’ll also talk about risk factors and the signs and symptoms, as well as treatment options for sleep apnoea.

What Is Sleep Apnoea?

Sleep apnoea is a condition where your breathing literally stops. In fact the word “apnoea” is Greek for “without breath”.

It happens when you’re sleeping – you can stop breathing for a minute or longer, and it can happen up to hundreds of times each night.

The danger is that, when you stop breathing, your brain and body don’t get the oxygen that they need.

Not only that, but most people don’t wake up when this happens, which means they’re completely unaware that they’ve stopped breathing.

It does, however, lead to very restless sleep – if you have sleep apnoea you may wake up feeling just as tired as you were when you went to bed. Your body simply hasn’t had the time, rest, or nutrients it needs to recharge.

There are three different types of sleep apnoea. Let’s take a look at each type in a bit of detail.

1. Obstructive Sleep Apnoea

   Obstructive sleep apnoea (OSA) occurs when the airway collapses or becomes obstructed. As you try to breathe, you can’t because the airflow is blocked, so your blood oxygen level drops and the oxygen reaching your brain decreases.

   Your brain, which is designed to keep you alive, sends an SOS signal to your body and you wake up and take a gasping breath. If you share a bed, this gasping breath may also wake your partner. However, in most cases, people don’t fully wake up when this happens.

   When the apnoea occurs, the brain tends to only shift from deep sleep to shallow sleep, which is when the muscles can contract and a breath can be taken. Most people remain asleep but their deep and restful sleep is disrupted.

   OSA is the most common type of sleep apnoea.

2. Central Sleep Apnoea

   Central sleep apnoea occurs when your brain stops sending the right signals to your body. In other words, it forgets to tell your body to breathe. When your muscles don’t receive a signal from your brain, nothing happens – no breath.

   Of course, your brain then realizes there’s not enough oxygen and sends out an emergency signal to your lungs and diaphragm and you resume breathing.

   This type of sleep apnoea is not as common as obstructive sleep apnoea.

3. Mixed Sleep Apnoea

   Mixed sleep apnoea is also called complex sleep apnoea, and it’s a condition where the obstructive sleep apnoea patient’s brain doesn’t send that SOS signal to breathe after their airway has been obstructed and their breathing stops.

   They make no effort to breathe after their breathing has stopped.

   This type of sleep apnoea actually occurs fairly often in patients with diagnosed obstructive sleep apnoea but usually only in those with severe cases.

As you can see, sleep apnoea can be a significant condition that can have a profound impact on your health, not to mention your day-to-day energy levels.

So what causes sleep apnoea? Let’s take a look at risk factors next.

Risk Factors – What Causes Sleep Apnoea?

First, it’s important to note that anybody can have sleep apnoea – children can suffer from it, as can senior citizens.

That being said, there are some risk factors that can increase the likelihood of your having this condition:

• A soft palate or a long uvula may fall backwards into the throat of a person sleeping on their back and block airflow. The back of the tongue can fall backwards and a narrow throat may also cause obstructive sleep apnoea.
• Being a smoker – smokers tend to be more susceptible to sleep apnoea than non-smokers.
• Being male – men tend to have sleep apnoea more often than women. According to the U.S. Department of Health and Human Services, 9% of middle-aged women and 25% of middle-aged men suffer from obstructive sleep apnoea. Hispanic and African-American men seem to have a higher incidence of sleep apnoea than other ethnicities.
• Being over age 40 – while infants and children can have sleep apnoea, if you’re over 40 you’re at a greater risk.
• Being overweight – people with a body mass index (BMI) of 30 or greater have a higher incidence of OSA.
• Excessive use of alcohol or sedatives.
• Having a large neck size (17 inches or greater in men and 16 inches or greater in women).
• Having a nasal obstruction due to a deviated septum, allergies, or sinus problems can cause reduced airflow, especially when sleeping. Swollen turbinate in the nasal passage can obstruct as well.
• Having a large tongue, large tonsils, or a small jaw bone.
• Having a family history of sleep apnoea.
• Suffering from gastroesophageal reflux (GERD).

It’s also possible to be born with sleep apnoea and many babies, particularly premature infants, suffer from central sleep apnoea. They usually outgrow it and an apnoea monitor is used to make sure the child remains breathing throughout the night.

As well as that, medications and health conditions can cause central sleep apnoea. For example, it can be caused by heart failure and stroke. High altitude sleeping has also been shown to cause central sleep apnoea.

In many cases a person just doesn’t know they have sleep apnoea. You might wake feeling terrible or wonder why you’re always tired.

You may have some of these risk factors or none at all, which is why a sleep study is really the only way to know for sure.

Before I talk about what sleep apnoea can do to the body or how to treat it, let’s talk about some signs and symptoms.

Signs And Symptoms – How Do I Know I Have It?

Some of the signs and symptoms of sleep apnoea are apparent – if you wake up feeling exhausted or like you didn’t really get any sleep, even though you slept through the night, then something is wrong.

However, there are some other more subtle signs that you may have sleep apnoea.

• Depression

  A lack of oxygen to the brain affects your brain chemistry. Depression is a common side effect that many people are unaware of.

• Morning Headaches

  Do you wake up in the morning with a headache? A chronic lack of oxygen to the brain and a lack of restful sleep can give you a dull headache that you wake up with, so if you find that you’re taking pain killers each morning to fight your pounding head, you may have sleep apnoea.

• Snoring And Noisy Night-Time Breathing

  Do you ever wake yourself up with your snoring? Does your partner complain about your breathing at night? You may have sleep apnoea, because people who snore loudly often have this problem.

Other signs and symptoms of sleep apnoea include:

• anxiety
• confusion
• daytime attention problems
• having to get up to use the bathroom a lot during the night
• irritability
• reflux
• sexual dysfunction

If you feel constantly tired, need frequent naps, and depend on caffeine to get you through the day, then these are other signs you may have a sleep disorder.

Sleep apnoea is the most common sleep disorder and it can have long-lasting effects.

Next, I’ll take a look at the health problems that sleep apnoea can cause, and why it’s so important to get it diagnosed and treated.

Why Is Sleep Apnoea A Problem? What Does It Do To The Body?

Sleep apnoea causes a number of health complications.

First, and perhaps most apparent in everyday life, is that it weakens your immune system – your body isn’t able to get to restful sleep and go through the restorative processes.

This means your body doesn’t react well to stress, nor does it manage bacteria, viruses, or foreign invaders as well. The result is that you get sick more often and more easily.

Other significant problems include:

• High Blood Pressure

  There are more long-term complications, including the fact that sleep apnoea is a risk factor for hypertension (aka high blood pressure).

  Up to 83 percent of patients with hypertension have sleep apnoea, and it’s estimated that up to 80 percent of people who have diagnosed high blood pressure have it because of sleep apnoea.

  And for those who have obstructive sleep apnoea but presently do not have high blood pressure, within four years, 45 percent will develop it.

• Stroke And Heart Disease

  Sleep apnoea has also been shown to cause stroke and cardiovascular disease.

  In fact, the risk of congestive heart failure, aka a heart attack, increases by 2.3 times if you have obstructive sleep apnoea.

  And the risk of stroke increases by 1.5 times with OSA.

I’ve also discussed that some of the symptoms of sleep apnoea include anxiety, depression, irritability, and sexual dysfunction, but there are other complications of sleep apnoea.

For example, when you don’t get enough sleep it can have an impact on your mood and brain function, as well as your hormones – including sex hormones.

People with sleep apnoea have twice the risk of being involved in a car accident.

They’re often overweight and have a higher incidence of diabetes. Again, obesity and diabetes may be connected to hormone levels like leptin, ghrelin, and insulin.

These hormones control hunger and blood sugar levels, and when they’re not kept in balance and regulated and released during sleep, you may feel hungry – even when you’re not.

Your body may not get the energy it needs from your food and disease can develop.

The solution to preventing these long-term and often deadly diseases is to have your sleep apnoea diagnosed, and to do this you have to go to the doctor.

You’ll likely undergo a sleep study and then create a treatment plan with your physician.

The good news is that sleep apnoea is treatable, and diseases caused by sleep apnoea can be prevented.

So, let’s talk about getting treatment for sleep apnoea so you know what to expect from the diagnosis and treatment process.

How To Get Treatment For Sleep Apnoea

If a sleep study determines that you have sleep apnoea, your doctor will meet with you to discuss and recommend treatment options.

A sleep study is nothing to fear – you sleep with some monitors attached to you for just one night. They then compile the results and give you their findings. It’s a relatively simple experience – and all you have to do is sleep.

Treatment options for obstructive sleep apnoea often include airway devices.

These devices keep your breathing passage open so that it isn’t restricted or blocked. The devices include machines such as continuous positive airway pressure (CPAP) machines that regulate the air pressure in your breathing passages.

Oral appliances are another option for many. Resembling mouth guards, they’re worn at night and they alter the position of your mouth. Most function by positioning your lower jaw slightly forward and can then keep the airway open.

There are also stimulation devices that can be used when these devices do not work.

Your doctor may also talk with you about other behavioural therapies.

For example, if you’re overweight, your doctor may create a weight loss plan for you, because added weight can cause sleep apnoea.

If you smoke or have a medical condition that causes sleep apnoea, your doctor will recommend treatment programs to help you quit smoking, or different medications to manage your health condition.

Sleep positioning can make a difference in some cases. For example, if you only have sleep apnoea when you sleep on your back and your airway closes, simply changing how you sleep can cure the condition.

In some cases surgery can be useful. If you have a large uvula or other physical conditions that block your airway and can be altered surgically, then that can remedy the situation.

Keep in mind that there are different severities for sleep apnoea – some people may only deal with sleep apnoea occasionally or only a few times each night, while others may struggle with sleep apnoea hundreds of times each night and on a nightly basis.

Your severity and the causes of your sleep apnoea will determine the best treatments.

In the meantime, if you suspect you have sleep apnoea, start taking positive action today.

For example, stop drinking alcohol in the evenings and if you smoke, quit or get help to quit. If you’re overweight, start a program right now to lose weight. Even a few pounds can make a difference.

There are sleep-monitoring devices that you can use to monitor your sleep. For example, there are low-cost applications for your smartphone. These devices collect data on breathing, movement, heart rate and more depending on the device. They can provide a lot of information and help you decide if the next step to improving your sleep and your health is to visit a doctor and have a sleep study.

Conclusion

Sleep apnoea affects millions of people each year, it can lead to deadly conditions and it can bear a heavy impact on your quality of life – but, it can also be treated and managed.

And while you can find some of the above-mentioned devices online, I am not going to suggest any specific types or models – because this is something you need to discuss with your doctor, to ensure you use the most appropriate device for your specific situation.

Additional Resources

These are suggestions for those who wish to delve deeper into any of the above:

1. Relief From Snoring And Sleep Apnea