Sleep Apnea: What It Is, Its Types, Symptoms, and Treatment
If you wake up at night wondering, "Do I have sleep apnea?" - you are not alone. According to the National Sleep Foundation, 18 Million American Adults have sleep apnea. More people are diagnosed each year, and the public awareness is expanding.
What Is Sleep Apnea?
Sleep apnea is a serious sleep disorder characterized by frequent pauses in breathing during the night. Pauses often occur multiple times per hour and can last 10 seconds or longer.
During these pauses, the brain and the rest of the body are deprived of vital oxygen. Sensing your lack of oxygen, the brain rouses you awake (usually only partially so you're often unaware of it) to start breathing again.
Most people don't know they have sleep apnea and are only made aware of it after visiting their doctor for symptoms of excessive daytime sleepiness and complaints by their partner of their intolerably loud snoring.
The snoring sounds are a result of the air trying to squeeze its way around the blockage. While sleep apnea is a broad term for frequent pauses in nighttime breathing, there are actually two types of sleep apnea: Obstructive Sleep Apnea and Central Sleep Apnea.
Central vs. Obstructive Sleep Apnea
Obstructive Sleep Apnea
Known as OSA for short, obstructive sleep apnea is the most common type of sleep apnea, affecting approximately 2% to 9% of people in the U.S. It's caused by a physical blockage of the airway, typically the muscles at the back of the throat that relax and collapse during sleep, obstructing the airway.
Symptoms of OSA
The telltale symptoms of OSA are loud snoring, waking up short of breath with a snort and periods of breathing cessation that's observed by a partner. Other symptoms include:
- Excessive sleepiness during the day
- Difficulty focusing and concentrating on daily tasks
- Dry mouth and sore throat in the morning
- Morning chest pain
- Morning headaches
- Mood changes: bouts of depression, anxiety or excessive irritability
- Insomnia or restless sleep
- Hypertension (high blood pressure): when oxygen level in the blood significantly decrease, blood pressure typically rises
Central Sleep Apnea
Unlike OSA, central sleep apnea is not caused by a blockage; rather, it's caused by a dysfunction of the respiratory control centers in the brain during sleep, failing to send the right signals to the muscles that control your breathing.
CSA may occur because of other medical conditions, including heart failure, stroke, neurological diseases, such as Parkinson's disease, Alzheimer's disease and ALS, and damage caused to the brain stem by a stroke, encephalitis and other factors.
It may also be caused by taking certain medications such as opioids which may cause breathing to become irregular as well as being in very high altitudes.
Symptoms of CSA
In CSA, snoring is not as prominent as it is in OSA. In addition to feeling extreme fatigue during the day and experiencing abrupt awakenings during the night, other symptoms include:
- Shortness of breath that's alleviated upon sitting up
- Chest pain at night
- Trouble concentrating at work or at school
- Irritability and mood changes
- Morning headaches
Signs and Symptoms of Sleep Apnea in Children
While obstructive sleep apnea can be common in children, it's not always easy to recognize. In addition to continuous loud snoring, children with sleep apnea may adopt strange sleeping positions and suffer from bed-wetting, excessive perspiration at night, or night terrors.
If you suspect your child may have sleep apnea, consult a pediatrician who specializes in sleep disorders. Once obstructive sleep apnea is diagnosed, surgery to remove the child's tonsils or adenoids usually corrects the problem.
“Do I Have Sleep Apnea?”
Sleep apnea can only be diagnosed by a trained professional, such as a doctor or dentist. However, there are a few things you can do and look for to give yourself a sort of pre-diagnosis.
Again, we must stress that these will NOT confirm that you have sleep apnea. Only a sleep study can truly confirm that you have sleep apnea. For this same reason, by law, you are required to get one before purchasing a CPAP machine within the United States.
However, the following can give you an idea if you should seek out a sleep study in the first place.
Look at your FitBit Readings
Smart devices that monitor your health, such as a FitBit, are a great way to alert you when you are not getting the sleep you need. They can monitor how much true sleep you are getting and record the time during the night actually spent in restful sleep.
The National Sleep Foundation recommends 7 to 9 hours of sleep in adults age 18-65 and 7 to 8 hours for adults over 65. Anything under 6 hours is unhealthy.
If you notice that your smart device is sensing that you are consistently not getting the right amount of sleep, you should begin the next step of consulting a professional.
Install a Sleep Monitoring App
They really do have an App for that; Several, in fact! These apps use your phone's microphone to record you while you sleep. The program will then monitor for any snoring, restlessness, or disruptions in your sleep.
When you wake up, your data will show you how long you slept and explain any disruptions you had overnight. These apps aren't infallible, but if you notice several nights of unrest, it may be time to talk to your doctor.
Learn to Read Your Body
Not everything has to be super high tech! Simply slowing down and reading your own signs and symptoms can give you enough information to determine if you should see your doctor.
- Have you been irritable?
- Fatigued through the day?
- Can anything account for this like too much coffee or Netflix before bedtime?
A simple journal of when you wake up, when you go to bed and how restful your sleep was can tell you a lot about your quality of rest. If you are consistently getting the recommended amount of sleep but are still exhausted, it may be time for an in-depth sleep study.
Talk to Your Spouse/Partner
Your loved one can be indispensable in alerting you if there is a problem. Are you constantly told you snore too loud? Have they noticed you not breathing at night? These are both signs that you might have sleep apnea.
Even if your significant other isn't all that observative, you can ask them to pay attention to how you sleep. If they tell you that something is not right, it is time to see your doctor.
High Blood Pressure and Heart Related Issues
High blood pressure, arrhythmia, stroke, and heart failure are well documented to have links to sleep apnea. They often can feed into each other and make each problem worse.
Having a BMI Over 35
Of the multitude of health problems aggravated by being overweight, sleep apnea is one of them. Having a BMI over 35 is a risk factor related to sleep apnea.
You Are Over 50
The risk of sleep apnea increases after the age of 50. Your skin is not as elastic as in your youth, and muscles aren't as strong. Because of this, blockages can occur in your airway.
Your Neck Circumference Is More than 16 Inches
Extra inches can add up and factor into a blockage in the airway which may cause snoring and less air to enter your lungs.
Sleep Apnea Quiz
If you are still unsure, we have created a quiz below to help you determine if you have sleep apnea. If you answer Yes to three or more of the questions below, it is well worth speaking to your doctor or sleep specialist to set up either an In-Home or In-Lab sleep study. (To see the pros and cons of both types of studies click here.)
- Am I commonly tired throughout the day, despite following the recommended hours of sleep?
- Do I have trouble falling/ staying asleep?
- Do I often wake up with nightmares?
- Am I told by my spouse / partner frequently that I snore?
- Do I stop breathing at night?
- Do I breathe through my mouth at night?
- Do I wake up with my mouth feeling dry?
- Do I wake up with my throat feeling dry?
- Do I breathe loudly?
- Have I had signs of depression?
- Am I feeling frequently fatigued?
- Do I frequently have headaches?
- Am I frequently irritable?
- Does my mood change frequently?
- Have I gained weight?
I Think I May Have Sleep Apnea - Now What?
It may be time to talk to your doctor. Keep a list of all the symptoms you are experiencing and discuss options with your doctor. Being open and honest will benefit you in the end.
Getting a Diagnosis: A Sleep Study
If your doctor agrees that your symptoms are in line with a diagnosis of sleep apnea, they will likely prescribe a sleep study for you. From there they can monitor your symptoms and give you a definite yes or no.
A sleep study is a test administered while you sleep to evaluate the quality of your sleep and to determine whether you have sleep apnea. Please read this article to learn more about Sleep Studies.
Treatment for Sleep Apnea
While sleep apnea is a serious condition and sounds scary, treatment options are available, and many find great success.
If you have mild sleep apnea, your physician will likely start with lifestyle changes, such as:
- Avoiding alcohol and medications that make you sleepy
- Losing weight
- Keeping your nasal passages open at night with nasal sprays or allergy medicines
- Having you sleep on your side rather than your back, which helps keep your airway open.
For those who suffer from moderate to severe OSA and central sleep apnea, sleep devices, such as CPAP (continuous positive airway pressure) machines have been found to be extremely beneficial.
There are several types to choose from, including manual, automatic, BiPAP/VPAP and BiPAP/VPAP/BiLevel ST machines, as well as different masks. You can learn more about different CPAP machines by reading this article.
For central sleep apnea, certain medications may also be prescribed to stimulate the brain during sleep. Other options include specialized mouth guards and tongue restraining devices. Your physician will work with you to find the right type of device and fit to make sure you adhere to your treatment plan.
Don't Ignore Sleep Apnea
Left untreated, sleep apnea can have serious and life-threatening consequences: heart disease, stroke, diabetes, depression and other ailments. Moreover, untreated sleep apnea often leads to poor performance at work and at school and can lead to automobile accidents caused by falling asleep at the wheel.