Monday Medical: Signs and symptoms of sleep apnea
May 20, 2017
Editor's note: This article is the first in a two-part series on sleep apnea. Part two will cover diagnosis and treatment.
Sleep apnea is one of the most common sleep disorders, affecting an estimated 22 million Americans.
While it is a treatable condition, it can go unnoticed. Up to 80 percent of the cases of moderate and severe obstructive sleep apnea are undiagnosed.
"Nowadays, sleep apnea is more widely known, though it's still under diagnosed," said William Moore, director of Yampa Valley Medical Center's Respiratory Care Services and Sleep Study Center. "If someone suspects that they do have it, chances are, they're right."
What is sleep apnea?
With sleep apnea, breathing is briefly but repeatedly interrupted during sleep.
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The most common type of sleep apnea is obstructive sleep apnea, or OSA, in which throat muscles relax during sleep, causing surrounding tissue to narrow or obstruct the airway and block breathing.
In central sleep apnea, the brain doesn't properly signal breathing muscles during sleep, causing breathing to repeatedly stop and start. In some cases, a person may suffer from both types of sleep apnea.
Your physician is your first resource when determining whether sleep apnea might be an issue. He or she can review your overall health and symptoms, which are sometimes things only a spouse or sleeping partner might notice, such as snoring and a pause in breathing while sleeping. Other symptoms include waking abruptly with shortness of breath or gasping for air, excessive daytime sleepiness, difficulty staying asleep, attention problems, depression or anxiety and even high blood pressure.
"It's important to have that face-to-face meeting with a physician," Moore said. "They can help you zero in on sleep apnea and recognize whether it might be OSA or a more complex sleep disorder."
A good night's rest is good for you
Sleep apnea has two serious consequences: It can keep people from getting the restorative REM sleep they need and from getting enough oxygen during sleep.
Increased risk for hypertension, heart disease, stroke, depression, anxiety and diabetes, among other ailments, follows.
Each night, people typically cycle through the stages of sleep, which start at stage 1, or very light sleep, and deepen to stage 4, then REM sleep. Sleep apnea can prevent that natural cycle.
"Someone with sleep apnea may fall asleep, reach maybe the second or third stage of sleep, then, all of a sudden, they have an obstruction," Moore said. "They arouse themselves to breathe, maybe to stage 2 or stage 1. They go back into a deeper sleep, start snoring and are back to stage 1 again. That can repeat itself all night long."
The number of times breathing stops per hour determines the severity of sleep apnea. If someone has 15 or more temporary stops, or apneas, per hour, the sleep apnea should be treated.
"Your memory of sleep may be that, 'I slept all night long,' but the reality is, if you have sleep apnea, you may not have reached those later stages of sleep that are restorative," Moore said.
Who's at risk?
Sleep apnea can affect anyone, from toddlers to adults, and it is seen in both men and women.
However, some factors put people at higher risk, including excess weight, a thicker neck circumference, a narrowed airway, family history and use of alcohol, sedatives and tobacco. Men are also more likely to have sleep apnea.
Attention deficit disorder has been linked to sleep apnea in children.
What's most important is getting a proper diagnosis so it can be treated.
"Healthy sleep is very important to be healthy, to be alert and to participate in life," Moore said. "Just about everybody can improve their sleep hygiene. But if somebody has sleep apnea, they need to address that, too."
Susan Cunningham writes for Yampa Valley Medical Center. She can be reached at email@example.com.