Maybe your partner is always poking you during the night to stop your loud snoring. Perhaps you doze off in work meetings even though you were asleep by 9 p.m. Either way, it’s clear that you, and possibly your partner, are not getting the best night sleep.
An occasional restless night is one thing. But if you always snore or are consistently tired or anxious, it may be a sign that you have sleep apnea – a common condition that can have serious health complications. Unfortunately, up to 80% of people with sleep apnea may be undiagnosed.
Read on to learn more about the signs and symptoms of sleep apnea and how to get treatment.
What is sleep apnea?
Sleep apnea is a serious sleep disorder that causes you to stop breathing repeatedly while you sleep. If left untreated, you could stop breathing hundreds of times in a single night. And that means the brain – and the rest of your body – may not be getting enough oxygen.
If your brain doesn’t get enough oxygen, it will wake you up so you can reopen your airway – allowing your body to get more air. Because you’re only awake for a second or two, you probably won’t even remember waking up.
The more times you stop breathing during the night, the greater the risk to your health. So, the severity of your sleep apnea is based on how often you stop breathing.
- Mild sleep apnea – You stop breathing 5-14 times per hour.
- Moderate sleep apnea – You stop breathing 15-29 times per hour.
- Severe sleep apnea – You stop breathing 30+ times per hour.
How do I know if I have sleep apnea? Common signs and symptoms
If you share a bed with someone, they may know you have sleep apnea before you do since loud snoring is one of the most common symptoms. But you can still have sleep apnea if you don’t snore. That’s why it’s important to look out for other symptoms.
Keep in mind that you may not remember experiencing nighttime symptoms. So, pay attention to how you’re feeling during the day and watch for sleep apnea daytime symptoms. If you’re clocking 7-9 hours of sleep a night but still feel exhausted, it could be a sign that you have sleep apnea and should talk to your doctor.
Nighttime sleep apnea symptoms include:
- Loud snoring
- Gasping for breath during sleep
- Stopping breathing
- Frequently waking up
- Frequent nighttime urination
- Restless sleeping
Daytime sleep apnea symptoms include:
- Morning headaches
- Irritability and moodiness
- Depression and anxiety
- Frequent napping
- Daytime tiredness
- Falling asleep, even when you don’t mean to. For example, dozing off when working, watching television or behind the wheel. If you have sleep apnea, you’re more likely to get in a car crash or have an accident at work.
Mild sleep apnea symptoms vs. severe sleep apnea symptoms
Your sleep apnea symptoms are usually the same whether you have mild sleep apnea or severe sleep apnea. However, if you have severe sleep apnea, you’re more likely to have significant health complications.
Mild sleep apnea can turn into severe apnea without treatment. So, it’s important to get treatment as early as possible.
Complications of sleep apnea
Sleep apnea is linked to an increase in:
- Type 2 diabetes. If your breathing stops while you’re sleeping, there is an increase in carbon dioxide in your blood. This can lead to insulin resistance, meaning your body won’t be as effective when using insulin.
- Heart problems. Low levels of oxygen in your blood can put extra stress on your heart and cardiovascular system, increasing your chance of high blood pressure and heart disease.
- Stroke. Increases in blood pressure and low oxygen levels can also increase your chances of having a stroke.
- Weight gain. Being overweight increases your chance of developing sleep apnea. But, having sleep apnea can also lead to weight gain. Without a good night’s sleep, you’re unlikely to have the energy to be active. Also, sleep apnea can cause hormone imbalances that affect healthy eating patterns.
- Memory issues. While you sleep, your brain commits your day’s activities to short or long-term memory. But if you have sleep apnea, the oxygen to the brain is cut off multiple times during the night, interrupting this process. This can lead to memory problems.
- Liver problems. Sleep apnea can make liver problems worse. If you have sleep apnea, you’re more likely to have abnormal liver function results, and liver scarring.
Can you die from sleep apnea?
The answer is complicated. You’re not going to suffocate in your sleep because of sleep apnea – if your body doesn’t get enough air, your brain will force you awake so you can breathe. However, sleep apnea places significant stress on your heart and circulatory system, which means that sleep apnea can lead to a heart attack, stroke or other health emergencies while you’re sleeping.
Types of sleep apnea and what causes them
There are two main types of sleep apnea – obstructive and central. While they result in the same symptoms, they have different causes.
Obstructive sleep apnea
Obstructive sleep apnea is, by far, the more common type of sleep apnea –affecting an estimated 1 in 15 Americans. This type of sleep apnea happens when the muscles at the back of your throat relax so much that it blocks your airway, making it hard to breathe.
Central sleep apnea
Central sleep apnea is due to problems with how the brain signals the breathing muscles. Because the signals aren’t working correctly, your body won’t try to breathe for a short amount of time. This type of sleep apnea affects about 1 in 100 Americans, so it’s less common.
Complex sleep apnea syndrome
It’s also possible to have a combination of obstructive sleep apnea and central sleep apnea, a condition called complex sleep apnea syndrome. Usually this condition isn’t diagnosed until after people start treatment for obstructive sleep apnea.
Who gets sleep apnea?
Your chance of developing sleep apnea increases as you pass middle age. Still, younger adults and even children can also be diagnosed with sleep apnea – the American Academy of Family Physicians estimates that 1-5% of children have obstructive sleep apnea, starting when they’re between 2 and 8 years old.
Men are two to three times more likely to get sleep apnea than women. However, women can get sleep apnea as well, especially if they have other risk factors.
Differences in sleep apnea symptoms between men and women
For men with sleep apnea, the most common symptom is usually extremely loud snoring that causes them to wake up from choking or gasping for air. Men also tend to notice general fatigue that can cause them to fall asleep anytime during the day.
In women, snoring isn’t always a main symptom of sleep apnea. In general, women snore less loudly and less frequently than men – and some women with sleep apnea may not snore at all. Instead, the most noticeable signs of sleep apnea in women tend to be anxiety, depression, headache, insomnia and daytime fatigue.
Family history and your chance of sleep apnea
You may wonder, is sleep apnea genetic? Your genes play a role in your chance of getting sleep apnea. If others in your family have sleep apnea, you are more likely to get it. There are a couple of reasons for this.
First, it’s possible that your family is more likely to have anatomical differences – such as narrower airways – that make breathing more difficult while sleeping.
Secondly, genetics play a role in some of the conditions that increase your chance for getting sleep apnea. For example, family history is linked to heart disease and high blood pressure.
Risk factors for sleep apnea
The types of sleep apnea (obstructive and central) have different risk factors:
Risk factors for obstructive sleep apnea
Certain factors increase your chance of getting obstructive sleep apnea, including:
- Being overweight. When you’re overweight, fat deposits build up throughout your body. If there are fat deposits around your upper airway, breathing can become more difficult.
- A thicker neck. People with thicker necks may have more narrow airways.
- Swollen tonsils or adenoids. If your tonsils or adenoids are enlarged, they can block air from getting into your airway.
- Chronic nasal congestion. You may be more likely to get sleep apnea if you are usually stuffed up because of allergies, chronic sinus infections or an anatomical problem such as a deviated septum.
- Smoking. Smoking can increase inflammation and fluid retention in your airway, causing it to narrow.
- Using alcohol, sedatives or tranquilizers. These substances relax your throat muscles, which can make it harder for you to breathe.
- A range of medical conditions. Numerous medical conditions are linked to an increased risk of obstructive sleep apnea, including:
- High blood pressure
- Congestive heart failure
- Type 2 diabetes
- Parkinson's disease
- Polycystic ovary syndrome
- Hormonal disorders
- Chronic lung conditions
Risk factors of central sleep apnea
The list of risk factors for central sleep apnea includes:
- Irregular breathing patterns. About half of people with central sleep apnea experience Cheyne-Stokes breathing, which is when your breathing speeds up, slows down, stops and then begins again. This type of breathing is common in people who have congestive heart failure or had a stroke.
- Use of opioid medications. Medications like morphine, oxycodone and codeine can interfere with breathing and make it harder for your body to rouse itself.
- High altitudes. Some people experience central sleep apnea when they are at high elevations – usually above 8,000 feet.
- Certain medical conditions. Conditions associated to central sleep apnea include:
- Congestive heart failure
- Parkinson’s disease
- Kidney failure
How to get diagnosed with sleep apnea
Help for sleep apnea starts with making an appointment with your primary care doctor and keeping track of your symptoms.
In preparation for your appointment, start tracking your sleep symptoms. If possible, document how much you snore and wake each night – if you share a bed, make note of all the details your bedmate tells you. Also write down when you:
- Go to bed and wake up
- Get tired throughout the day
- Drink caffeine and alcohol
- Take sleeping medications
- Feel depressed or anxious
When you meet with your doctor, they’ll talk with you about your symptoms and sleep habits. If they think you could benefit from a sleep study, they’ll refer you to a sleep center for additional testing.
During a sleep study, sensors will measure your heartbeat, breathing, sleep cycles, eye movement, body movements and blood oxygen levels while you sleep.
Some sleep studies can be done at home. Others take place at specialty center where you’ll be in a comfortable hotel-like room, and someone will monitor your sleep from another room.
By learning what happens to your body during sleep, the doctor will be able to determine if you have sleep apnea and if sleep apnea treatments could help.
If you think you have sleep apnea, talk to your primary care doctor
Untreated sleep apnea can be serious and lead to severe complications. But if you think you have sleep apnea, don’t hesitate to make an appointment with your primary care doctor. They can help make a diagnosis and refer you to a sleep medicine expert if needed.
Based on what’s causing your sleepless nights, there are effective treatments available that can reduce your health risks and improve your quality of life. Patients report that when they use their treatment plan each night, they feel more alert during the day, have improved mood and better memory. Sleep apnea treatment may even help prevent or reverse the serious health problems linked to the condition.