Sleep Apnea Symptoms

Symptoms of Obstructive Sleep Apnea

Sleep apnea (SA) is a common sleep disorder where people experience multiple interruptions in breathing when they sleep. It can last up to 20 seconds or longer and can occur up to 30 times or more in an hour. According to National Sleep Foundation, apnea is when breathing pauses last for up to 10 seconds or more. Symptoms include loud snoring, excessive daytime sleepiness, waking up with a choking or gasping sensation, and restless sleep.

Untreated sleep apnea can result in poor quality of sleep, low blood oxygen levels, high blood pressure, diabetes, stroke, heart failure, heart attacks, cardiomyopathy (a heart disease that makes it more difficult for your heart to pump blood to your body), and other heart problems. It goes on to lead to low productivity at home, school, work, and society at large.

Sleep Apnea Signs &Amp; Symptoms

Types of Sleep Apnea

Obstructive Sleep Apnea (OSA)

This is the  most common type of sleep apnea. Obstructive sleep apnea occurs when the upper airway at the back of the throat become partially or completely blocked repeatedly during sleep. Usually, it is because the muscles and soft tissues in the throat, the tonsils, adenoids, and tongue relax during sleep. It is frequently seen in people who are overweight or obese, have large necks, have structural abnormalities, or are older. Examples of structural abnormalities include nasal obstruction, a low soft palate, tonsillar hypertrophy (enlarged tonsils), and jaw problems like micrognathia (small jaw) with an overbite or jaw malalignment.

When you stop breathing, the diaphragm and chest muscles work  to build pressure within the airway and push it open.  The brain notes that your oxygen levels are low and then signals for the body to wake. The person resumes breathing with a gasp, snort, cough, or a body jerk. These repeated interruptions can prevent restful sleep, lower blood oxygen levels and supply to vital body organs, and cause arrhythmias.

Central Sleep Apnea (CSA)

Central sleep apnea is a less common type of sleep apnea. This type of sleep disordered breathing is not as a result of airway obstruction. Instead, it occurs when the  respiratory control center in the brain does not send appropriate signals to the muscles responsible for breathing. 

This results in slow and shallow breathing and disrupts sleep. It occurs commonly in people with stroke, brain infection, heart failure, or those who use certain types of drugs including opioids or benzodiazepines.

Complex Sleep Apnea Syndrome

Complex sleep apnea syndrome is a type of sleep apnea where the individual has both obstructive sleep apnea (OSA) and central sleep apnea (CSA). It is also known as mixed sleep apnea or treatment-emergent central sleep apnea.

 

Obstructive Sleep Apnea Airway

Sleep Apnea Signs and Symptoms

Sleep apnea must be diagnosed by a sleep physician. We recommend that you talk to our dentist, as well as your physician, if you suffer from the symptoms of sleep apnea. Common signs of sleep apnea include:

      • Frequent loud snoring
      • Repeated stopping and starting of breathing during sleep
      • Excessive daytime sleepiness (hypersomnia), even after a full night’s sleep
      • Personality changes and irritability
      • Mood swings
      • Waking up with a very dry or sore throat
      • Frequent morning migraine  headaches
      • Restlessness during sleep
      • Frequent nighttime awakenings
      • Frequent nighttime urination
      • Waking up with a gasp or body jerk from deep sleep
      • Trouble falling asleep and/or staying asleep (insomnia)
      • Night sweats
      • Difficulty paying attention and poor memory
      • Reduced sex drive and/or sexual dysfunction
      • Bruxism or teeth grinding

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What Causes Sleep Apnea

The main factor that causes Sleep Apnea in adults is excess weight and obesity, as this associates with the soft tissue of the throat and mouth.  

 

Sleep Apnea Causes
Several factors can put someone at an increased risk of sleep apnea. They include congenital, structural and medical factors such as the following:
Obesity

Obesity is a common cause of SA and is responsible for up to 40-60% of sleep apnea cases in adults. Being overweight or weight means you have higher amounts of fat in and around your neck that can reduce or completely block the upper airway, especially when you sleep or lie down. Hence, it is an major risk factor for OS. Studies show that a 10% increase in weight increases one’s risk for obstructive sleep apnea by six.

Gender and Age

While sleep apnea affects all ages of both sexes, it is prevalent is men and in older people. Being male and aging increases one’s risk of developing sleep apnea.

According to experts, fat deposits increase in our neck region as we age, thus increasing the risk for obstructive sleep apnea. Also, men are two to three times more likely to develop sleep apnea than women.

Family History
If there is a record of obstructive sleep apnea in your family, there is a high risk that you may develop the condition. Genetics play a role in your facial features and structure of your airway. Hence, a family history of sleep apnea may mean you have inherited characteristics that may predispose you to sleep apnea as well.
Enlarged Adenoids and Tonsils
Enlarged adenoids and tonsils are the most common cause of obstructive sleep apnea (OSA) in children. When the tonsils and adenoids grow bigger, they make the airway smaller and tighter, resulting in breathing problems when you sleep.
Jaw Issues
Jaw issues can make the tongue push back or relax and close up the upper airway when they sleep, leading to sleep apnea. These jaw issues could be malalignment or size problems caused by congenital or acquired conditions. These conditions could affect the structure of the jaw, face or skull.

Examples of congenital conditions include cleft lip, cleft palate, congenital hypoventilation syndrome, Down syndrome, and so on. These conditions are marked by a relatively smaller lower jaw compared to the upper jaw and collapsible palate which can cause obstructive sleep apnea.

High Blood Pressure (Hypertension)
While hypertension is a complication of untreated sleep apnea, hypertension can also cause obstructive sleep apnea. When you stop breathing or breathing is slow and shallow, your oxygen levels drop. At this junction, your brains signals for the release of adrenaline.

The released adrenaline constricts or narrows your blood vessels to increase the pressure and hence, the supply of blood and oxygen to the heart and the brain. Overtime, this levels of adrenaline can remain constantly high in the blood even when you are breathing fine, leading to hypertension.

Diabetes
Research reports that persons with type 2 diabetes have up to 48% per cent higher risk of having obstructive sleep apnea than those who do not have diabetes. According to an expert, about three-quarter of people with sleep apnea suffer from diabetes. This has been linked to being overweight or obese as well as insulin resistance, a feature of diabetes. Both characteristics can cause sleep apnea.

On the other hand, inflammation from sleep apnea can cause diabetes. Undiagnosed and untreated sleep apnea can worsen diabetes and make it harder to manage.

Endocrine Disorders
Examples include:

Hypothyroidism

This is an endocrine disorder. When you have hypothyroidism, your thyroid produces low amounts of thyroid hormones. Underactive thyroid can result into many other problems. First, it affects the respiratory control center of the brain, including the nerves and the muscles needed for effective breathing. Secondly, it causes obesity, which is a primary risk factor of obstructive sleep apnea.

Acromegaly

This is another endocrine disorder where levels of growth hormone in a person are abnormally high. This condition brings about the following:

  • enlarged facial features
  • enlarged  throat muscles
  • large or big tongues

These features can potentially block the upper airway, making acromegaly a risk factor for obstructive sleep apnea.

Polycystic ovary syndrome (PCOS)

An endocrine condition that affects the ovaries and disrupts normal ovulation in women. PCOS has been found to cause weight gain and obesity, which are risk factors to develop obstructive sleep apnea.

Heart and Kidney Failure
Studies show that people with heart failure can develop obstructive and central sleep apnea. Heart failure causes edema due to water and sodium retention. when the edema progresses, fluid may enter the lungs and cause obstructive sleep apnea.  Heart failure may also cause central sleep apnea as it interferes with respiratory control functions.

As in heart failure, obstructive sleep apnea occurs when someone has kidney failure. Kidney failure can result in fluid accumulation within spaces in the lungs and in the neck or airway. This makes kidney failure a potential cause and risk factor of obstructive sleep apnea.

History of Stroke
Stroke is a risk factor for sleep apnea. Interesting enough, sleep apnea can cause stroke as well. This is because sleep apnea reduces blood oxygen levels and increases blood pressure, both of which are risk factors for stroke. According to sources, up to three-quarters of patients with stroke suffer from sleep apnea.
Asthma
Research has fond out that people with asthma have sleep apnea. Their effects are also bi-directional. as they both can worsen the symptoms of each other, if not properly managed.
Neurologic and Neuromuscular Conditions
Neurologic conditions including brain tumors, brain infection, spinal conditions. multiple sclerosis (MS), spinal muscular atrophy, and other problems can cause sleep apnea. Neuromuscular diseases and disorders like Chiari malformations, myasthenia gravis, Lambert-Eaton myasthenic syndrome, myotonic dystrophy, amyotrophic lateral sclerosis (ALS/ Lou Gehrig’s disease), post-polio syndrome, and dermatomyositis, are also risk factors of sleep apnea.

This is because they can affect the respiratory center of the brain, and increase the risk for central sleep apnea.

Medication
Medications such as opioids and benzodiazepines can disrupt normal breathing activity. Their mode of action can suppress the brainstem where the center for respiration is, make the muscles to relax and cause sleep apnea.
Smoking
If you smoke, you are at a higher risk of having obstructive sleep apnea. Smoking makes the upper airway inflamed, sore, and open to infections. Nicotine also affects the chest muscles and diaphragm used in breathing. Smoking can also cause fluid retention in the airway and result in obstructive sleep apnea.

These all can affect breathing and the how well the brain sends proper signals to the muscles that control breathing. Studies state smokers are three times more likely to suffer from obstructive sleep apnea than those who do not smoke.

Alcohol
Alcohol intake can make the muscles of your mouth and throat relax. This puts you at a risk for sleep apnea and if you already have, it makes sleep apnea worse.
Nasal Congestion
Chronic or prolonged periods of nasal congestion where you find it hard to breath through the nose and your airway is narrower can increase your risk for obstructive sleep apnea.
Premature Birth
Babies born as pre-term or before 37 weeks of gestation are at higher risk of sleep apnea when they sleep. This is often known as apnea of prematurity, a form of central sleep apnea  because their brain are yet to mature fully. However, they outgrow this as they and their brains mature.
Sleeping Position
Sleeping positions, particularly sleeping on your back can allow your mouth and throat tissues to relax, hence blocking your upper airway and resulting in obstructive sleep apnea.

 

When to See a Doctor

Sleep apnea has been linked to several health issues including depression, diabetes, stroke, heart failure, heart attacks, cardiomyopathy (a heart disease that makes it more difficult for your heart to pump blood to your body), and other heart problems.

 Sleep apnea may also be indicative of an underlying health problem. Hence, you should see a doctor when you, bed partner, family members, and/or colleagues at work notice any worrisome symptoms.

Your doctor will help provide medical advice and recommend the best treatment. You may be asked to undergo an overnight sleep study at home or in a sleep laboratory.

Complications of Untreated Sleep Apnea

Undiagnosed sleep apnea has potentially life-altering complications. When left untreated or poorly managed, severe sleep apnea could result in sleep deprivation. Untreated obstructive sleep apnea affects a person’s mental, physical, and emotional wellbeing, hence, bringing out serious health complications. These include:

  • Daytime fatigue
  • Hypertension (high blood pressure)
  • Stroke
  • Diabetes including type 2 diabetes and gestational diabetes
  • High cholesterol levels
  • Chronic kidney disease
  • Heart disease and disorders like cardiomyopathy, heart attack, heart failure, and atherosclerosis
  • Cancers, including skin, pancreatic, and renal cancers
  • Liver problems
  • Cognitive and behavioral disorders such as problems in paying attention, concentration, memory, motor skills, etc.
  • Learning disabilities in children
  • Glucose intolerance
  • Eye conditions like dry eye, glaucoma, and/or keratoconus
  • Risk of having a baby weighing  less than 2.5kg (5 lbs. 8 oz.)
  • Postoperative complications
  • Atrial fibrillation
Medical Complications Of Sleep Apnea
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