Sleep Apnea: Symptoms, Causes, & Diagnosis

Sleep apnea is a common yet often underdiagnosed sleep disorder that can significantly impact one’s quality of life and overall health. 

Understanding the symptoms and causes of sleep apnea and knowing how this condition can diagnosed can give you a headstart when it comes to managing this condition. By knowing what sleep apnea is, you will be better equipped to recognize its signs and seek appropriate medical care, ultimately improving your sleep quality and overall well-being. 

What is Sleep Apnea?

Sleep apnea is a condition where your breathing repeatedly stops during sleep. This disorder occurs either due to an airway blockage or because the brain fails to regulate breathing properly.

When breathing stops while sleeping, the resulting drop in oxygen levels triggers a survival reflex that briefly awakens you to resume breathing. While this reflex is life-saving, it disrupts your sleep cycle, preventing restful and healthy sleep. This disruption can also strain the heart, potentially leading to serious health risks.

Types of Sleep Apnea

Obstructive Sleep Apnea (OSA)

The most common type of sleep apnea, Obstructive Sleep Apnea occurs when the muscles in the back of the throat relax excessively, causing a temporary block in your airway. 

Causes of Obstructive Sleep Apnea

• Obesity: Excess fatty tissue around the neck and throat can obstruct the airway.
• Enlarged Tonsils or Adenoids: Swollen tissues can block the airway, especially in children.
• Thick Neck Circumference: A larger neck may narrow the airway.
• Narrow Airway: Some individuals have a naturally narrower airway due to their genetic makeup.
• Smoking: Smoking causes inflammation and fluid retention in the upper airway, making it narrower.
• Nasal Congestion: Chronic nasal congestion can contribute to OSA by making it harder to breathe through the nose.
• Hypothyroidism: An underactive thyroid can lead to obesity and swollen tissues, which may block the airway.
• Polycystic Ovary Syndrome (PCOS): Hormonal imbalances associated with PCOS can increase the risk of OSA.

Central Sleep Apnea (CSA)

Central Sleep Apnea is a comparatively less common type of sleep apnea. It occurs when the brain fails to deliver proper signals to your muscles that control breathing.

Causes of Central Sleep Apnea 

• Brainstem Dysfunction: Conditions affecting the brainstem, which controls breathing, can lead to CSA.
• Congestive Heart Failure: Heart failure can affect the brain’s control over breathing patterns.
• High Altitude: Sleeping at high altitudes can cause CSA due to reduced oxygen levels and changes in breathing patterns.
• Opioids & Other Central Nervous System Depressants: These medications can interfere with the brain’s ability to control breathing.

Complex Sleep Apnea

Complex sleep apnea syndrome is characterized by a combination of obstructive sleep apnea (OSA) and central sleep apnea (CSA) occurring concurrently or sequentially. 

Causes of Complex Sleep Apnea

The exact causes of complex sleep apnea are not fully understood but may involve a combination of anatomical, physiological, and neurological factors.

What are the Symptoms of Sleep Apnea?

• Morning Fatigue: Feeling tired or exhausted upon waking, even after a full night’s sleep. 
• Daytime Sleepiness: Experiencing drowsiness during the day, which can interfere with activities such as driving, working, or other tasks.
• Snoring: Frequently associated with sleep apnea, though not present in all cases.
• Mood Changes: Experiencing depression and anxiety due to lack of sleep.
• Cognitive Disruptions: Issues such as memory loss, difficulty concentrating, and other brain-related problems.
• Frequent Nighttime Awakenings: Waking up multiple times during the night, often without remembering the reason.
• Observed Breathing Pauses: Pauses in breathing during sleep that are noticed by a spouse, partner, or other loved one.
• Insomnia: Difficulty falling or staying asleep.
• Night Sweats & Restlessness: Excessive sweating and feeling restless during the night.
• Sexual Dysfunction: Experiencing problems while performing sexual activities.
• Waking Up Short of Breath or Choking: Feeling short of breath or as though choking upon waking.
• Morning Headaches: Frequent headaches, especially in the morning.

How Does Sleep Apnea Affect the Body?

Impact on the Cardiovascular System

Frequent drops in blood oxygen levels can lead to surges in blood pressure. This puts extra strain on the cardiovascular system, increasing the risk of hypertension. The stress on the heart can also lead to a higher risk of heart attacks, heart failure, strokes, and other cardiovascular problems. 

Impact on the Metabolic System

Sleep apnea is associated with insulin resistance, which can lead to type 2 diabetes or worsen its control in those already diagnosed. Poor sleep has also directly been related to the disrupted balance of hormones that control appetite, leading to weight gain and making it more difficult to lose weight.  

Impact on the Nervous System

The frequent awakenings prevent deep, restorative sleep, leading to excessive daytime sleepiness and fatigue. Your poor sleep can have an adverse impact on your memory, concentration, and overall cognitive function, making daily tasks more challenging.

Impact on Mental Health

Chronic sleep disruption on a daily basis can contribute to anxiety, depression, and irritability.

The cumulative effects of poor sleep can significantly lower overall quality of life, affecting relationships, work performance, and daily activities.

Tests to Diagnose Sleep Apnea

Overnight Sleep Study (Polysomnogram)

This test is conducted overnight in a specialized medical facility, often referred to as a sleep lab. It monitors your sleep using sensors that track various physiological parameters such as heart rate, breathing patterns, blood oxygen levels, and brain waves. This comprehensive evaluation is considered the standard method for diagnosing sleep apnea.

Home Sleep Apnea Testing

Home Sleep Apnea testing allows individuals to perform a sleep study from the comfort of their own homes. Similar to an overnight sleep study, it typically excludes brain wave monitoring. 

This testing may not be suitable for diagnosing central sleep apnea and is usually not recommended if severe sleep apnea or other sleep disorders are suspected. In cases where a home study does not indicate sleep apnea, experts often advise confirming the diagnosis with an overnight sleep study.

Conclusion

Sleep apnea is a common disorder that disturbs a person’s breathing during sleep, prompting them to awaken briefly to resume breathing. This interruption disrupts sleep patterns, preventing restfulness. 

If left untreated, sleep apnea can lead to severe or potentially life-threatening complications, underscoring the importance of early diagnosis and intervention. With early intervention, including ongoing management and support, individuals can mitigate the risks associated with sleep apnea and achieve better sleep quality and overall well-being.

Contact your dentist or a healthcare provider for the right advice about treating your sleep apnea. 

FAQs

Can sleep apnea cause diabetes? 

Yes, there is evidence suggesting that untreated sleep apnea can increase the risk of developing diabetes. Sleep apnea may lead to insulin resistance and glucose intolerance due to disrupted sleep patterns and reduced oxygen levels during sleep.

What happens if sleep apnea goes untreated? 

If sleep apnea goes untreated, you may face the following risks: 

• Increased risk of heart disease, strokes, and high blood pressure
• Daytime sleepiness and impaired cognitive function.
• Worsening of mood disorders such as depression and anxiety.
• Higher likelihood of accidents, particularly while driving or operating machinery, due to impaired alertness.