Sleep apnea is a serious sleeping disorder that causes individuals to stop breathing while asleep. Sleep interruptions may occur infrequently or hundreds of times per night. This causes the brain to receive insufficient amounts of oxygen. Sleep apnea manifests in one of two ways. The airway becomes blocked during sleep when patients have obstructive sleep apnea (OSA). Central sleep apnea (CSA) results in brain signals failing to control breathing while a person sleeps. The main complication of sleep apnea is a significant lack of oxygen. This often causes other health issues that then create a cycle that further worsens the sleep apnea.
Sleep apnea patients often first complain of snoring -- or more accurately, their partners complain of it. Most often, patients visit a doctor for professional advice after their sleep-deprived partner demands it. Obstructed airways cause the patient to snore loudly, resulting in poor sleep quality for both bedmates. Snoring often accompanies sleep apnea but not always, so it's best to get a sleep study done to confirm the diagnosis.
Not everyone who snores has sleep apnea. However, when someone snores and gasps for air throughout the night, it's a strong possibility. The combination of snoring, gasping, and choking is the body's response to a struggle for oxygen. This may happen once per night or hundreds of times. Gasping or choking can be a sign of other health problems, so it is best to visit a doctor to understand the cause.
Insomnia, the inability to fall asleep, usually exists alongside other issues, including those emotional in nature, such as anxiety or depression, or physical, such as sleep apnea. A leading theory suggests that sleep apnea causes insomnia because the person is aware of the fact that his or her breathing stops during the night, which causes a level of anxiety. It's difficult to fall asleep when the mind is anxious and cannot settle down. When a sleep apnea patient can fall asleep, they often find it difficult to remain asleep. The sound of their own snoring may awaken them or cause gasping. The person may also wake up because the brain is alerting them that something is wrong.
Sleep apnea patients find it nearly impossible to get a good night's sleep. A high-quality night's sleep consists of alternating cycles of REM and non-REM sleep. Sleep apnea prevents the body from adequately cycling back and forth between the two. Patients with sleep apnea may not enter REM sleep at all. Also, because sleep apnea causes a decrease in oxygen levels, it causes many subsequent health problems. As a result, sleep quality degrades drastically, leaving the patient feeling fatigued.
Sleep apnea patients often wake up with a dry or a sore throat because their mouths are open most of the night. Sleeping with one's mouth open causes the throat's mucous membranes to dry out, leading to an uncomfortable or painful feeling in the throat that may last all day. Many people with sleep apnea also snore or choke, which can irritate the throat.
Poor quality sleep can also result in weight gain. When we don't get enough high-quality sleep, our bodies produce an excess of a hormone called ghrelin, which tells our bodies that we need to eat. A lack of sleep also causes the body to produce less of a hormone called leptin, which signals our bodies to stop eating. Sleep may also affect insulin levels. Sleep deprivation makes our bodies insulin-resistant, which causes additional insulin production. The body will crave unhealthy food as a result of these fluctuations.
Many symptoms of sleep apnea contribute to poor sleep quality. When one experiences all of these symptoms, it affects her day-to-day life. She may find herself waking up feeling as though she hasn't slept. Patients may also be unable to complete simple tasks without fatigue and weakness dragging them down. A decrease in overall oxygen levels causes health problems such as cardiovascular disease and inflammation. These health issues also contribute to the excess fatigue associated with poor sleep and sleep apnea.
People with sleep apnea often find themselves becoming increasingly forgetful or scatterbrained. Lack of oxygen has been shown to damage the brain cells associated with memory and concentration. Children with sleep apnea are particularly susceptible to this symptom, which can decrease their ability to learn in school and may lead to hyperactive or angry behavior. As a result, they could be misdiagnosed with -- and medicated for -- ADHD or other behavioral disorders.
Depression, irritability, or anxiety may occur as a result of sleep deprivation. This may be related to sleep apnea, insomnia, or other sleep disorders. Chronic fatigue can develop into full-blown depression. Irritability, anxiety, and impatience are also common symptoms because the mind is unable to focus on everyday tasks. An inability to focus initially leads to feelings of frustration, which can morph into short but powerful bouts of irritability and impatience.
Testosterone, the hormone associated with sex drive in both men and women, increases when we sleep. If testosterone levels do not rise appropriately, then the libido decreases. A lack of testosterone can result in erectile dysfunction in men. Women may experience issues like decreased sexual sensation and desire as a result of inadequate testosterone. Hormone replacement for low testosterone has shown to worsen, and sometimes cause, sleep apnea, so it is not a recommended treatment if this is the cause.
Morning headaches are a common occurrence with sleep apnea and can cause constant, widespread pressure. The pain typically lasts between 30 minutes and four hours and occurs most mornings. The headaches do not appear to be related to the severity of the sleep apnea and may be the first symptom a person experiences. It is unclear what causes these headaches, but they respond well to CPAP (Continuous Positive Airway Pressure) treatment.
Worried you might have sleep apnea? The following factors increase a person's risk of developing this disruptive condition.
Obesity is one of the most common risk factors for sleep apnea. An adult with obesity is almost twice as likely to develop sleep apnea than someone of normal weight. Obese children are at greatly increased risk compared to normal-weight children. Excessive fatty tissue around the upper airways causes a narrowing and intermittent obstruction, particularly when lying flat. Excessive fat around the chest makes the lungs work harder to breathe, which exacerbates problems at night. Weight loss commonly results in reduced symptoms of sleep apnea.
There is a high incidence of sleep apnea in people with an underactive thyroid (hypothyroidism). However, it is unclear whether there is a direct hormonal link between the two conditions, as an underactive thyroid is often related to weight gain, another sleep apnea risk factor. If the thyroid is enlarged, it may cause narrowing of the airway, which can worsen symptoms. Acromegaly is the opposite issue: the condition results from the pituitary gland producing excess growth hormone. This causes, amongst other changes, increased growth of soft tissue around the upper airway, including the tongue and uvula at the back of the throat, which can result in the airway becoming blocked during sleep.
Any blockage to the upper airway will increase the risk of obstruction during sleep. Enlarged tonsils are relatively common in children and is often seen in young people with sleep apnea. Removal of the tonsils will usually resolve the problem. Excessive neck circumference is a sign of obesity and may be noted during a sleep apnea assessment. A circumference of greater than 17 inches for a man and 16 inches for a woman suggests an increased risk.
Sleep apnea is more common in men than in women. It is also more common in the middle-aged than younger age groups. This is thought to be related to the distribution of fat around the upper airway in men making the airway more vulnerable to collapse during sleep. Women in menopause also face increased risk due to hormonal fluctuations and a reduction in estrogen and progesterone. Weight gain is common in these demographics and likely also impacts the frequency of the issue.
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