Seven Reasons You Probably Have Sleep Apnea
By Susan Hanson, Sleep Clinic Technologist
Obstructive sleep apnea is a common sleep disorder in which breathing rapidly starts and stops. It affects nearly 40 million U.S. adults alone.
If left untreated, obstructive sleep apnea is a serious matter. In many cases it leads to debilitating daytime sleepiness, morning headaches, depression and a general sense of not feeling well.
Over time it can cause high blood pressure, strokes, diabetes and obesity. Other symptoms include:
- Irritability and mood changes
- Trouble concentrating and forgetfulness
- Insomnia
- Decreased sex drive
- Increased urination at night
- Frequent heartburn or gastro-esophageal reflux disease
- Heavy night sweats.
Here are seven ways to know if you might have sleep apnea:
1. You snore loudly
As one falls asleep, the muscle tone of the body relaxes. This can cause the airway at the back of the throat, which is composed of walls of soft tissue, to collapse and become obstructed.
Trying to move air through this obstructed airway vibrates tissue, leading to snoring. Usually, the louder the snoring, the worse the sleep apnea; however, that is not always the case. Even some light snorers can have significant sleep apnea.
There seems to be a stigma associated with loud snoring, so few people want to admit they snore. Since snoring is not a feminine trait, females are especially less likely to be told by their partners that they snore or to admit it to themselves or their doctors.
2. You stop breathing during sleep
The breathing stops because the airway has closed. These pauses in breathing, or apneas, last from 20 to 60 seconds or longer, and can occur up to hundreds of times a night. Generally the person with sleep apnea is totally unaware of these pauses. The sleeping partner is the person who is observing this loss of breathing.
3. You feel excessively tired through the day
At the end of each apnea, when the airway opens to allow a deep breath, the sleeper often gasps, snores, snorts, jerks or kicks, thus causing an arousal from sleep. Usually the sleeper is not awakened completely, but moves into stage one sleep, which is only a transitional stage between awake and asleep.
With repeated apneas, the sleeper is never allowed to drop down into the deeper stages of sleep and get a sold block of restful sleep. This lack of deep sleep and significant level of sleep disturbance causes excessive daytime sleepiness.
During an obstructive apnea, the chest and abdomen often move opposite of each other to build up pressure in the chest to blow open the airway. This paradoxical breathing becomes hard work as the night goes on, causing significant nighttime sweating. Often, the sleeper wakes up in the morning more tired than the night before.
4. You have high blood pressure
The most serious consequence of untreated obstructive sleep apnea is to the heart. Obstructive sleep apnea can lead directly to the development of hypertension or high blood pressure.
People with obstructive sleep apnea have a 30 percent higher risk of heart attack or death.
Our breathing and heart rate work together. When we exert ourselves, we breathe faster and our heart rate speeds up. When we are at rest, our breathing and heart rate are slower.
During an apnea, breathing stops and the heart slows in an attempt to conserve oxygen in the blood. When the airway breaks open, deep breaths are taken, and the heart rate increases to move the newly oxygenated blood to the tissues.
This constant slowing down and speeding up of the heart rate during apneic events causes the heart to enlarge and creates high blood pressure. This puts people on the path to heart disease. High blood pressure is often a precursor for the following:
- Atrial fibrillation
- Coronary artery disease
- Congestive heart failure
- Stroke
5. Your BMI is more than 35
Weight gain is often a problem for people who suffer from sleep apnea. Finding the motivation to exercise can be hard because they are excessively tired. Dieting is difficult because people that are tired all the time actually undergo a change in their digestive hormones.
Leptin is a hunger-suppressing hormone secreted by our adipose tissue. Leptin tells our body that we are full and no longer need to eat any more food. When we are tired all the time, Leptin levels drop.
Ghrelin is a hunger-stimulating hormone made in the gastrointestinal tract. Ghrelin tells our body that we are hungry and we need more food. When we are tired all the time, Ghrelin levels increase
Sleep loss alters the ability of leptin and ghrelin to accurately signal caloric need, producing an internal misperception that energy intake is insufficient. This increases the appetite for high-carbohydrate, calorie-dense foods like cake, bread, chips, and sugars.
6. Your neck circumference is greater than 17" for men or 16" for women
Neck size is an important factor in diagnosing sleep apnea. It is often the extra weight around the neck that actually presses down on the airway causing it to close, literally strangling the person as they sleep. Unfortunately for men, the first place they gain weight is around the neck, and then their waist.
Men can go up a neck size in their shirts and a waist size in their jeans, and not look like they have gained any weight; however, this increase is often enough to cause snoring.
Women usually put on weight in their abdomen and hips first; however, after menopause, the absence of progesterone can add weight around the neck, too.
7. You're over 50
The muscle tone of the body relaxes during sleep. The airway at the throat is composed of walls of soft tissue, which can collapse and obstruct breathing. With age there is often a muscular and neurological loss of muscle tone in the upper airway, thus increasing the risk of airway collapse and obstruction.
Decreased muscle tone can also be caused by sedative medications, chemical depressants and alcoholic drinks.
