Overview
Obstructive sleep apnea is a sleep-related breathing disorder in which a person repeatedly stops and starts breathing during sleep due to the relaxation of throat muscles, which blocks the airway. This condition is characterized by symptoms such as excessive daytime sleepiness, loud snoring, observed episodes of stopped breathing during sleep, waking during the night and gasping or choking, morning headaches, and a dry mouth or sore throat upon waking. Complications of obstructive sleep apnea can include daytime fatigue and sleepiness, difficulty concentrating, higher risk of work-related accidents, cardiovascular problems, and increased risk of heart disease.
Understanding the disease
Symptoms
The symptoms of obstructive sleep apnea include excessive daytime sleepiness, loud snoring, observed episodes of stopped breathing during sleep, waking during the night and gasping or choking, awakening in the morning with a dry mouth or sore throat, morning headaches, trouble focusing during the day, mood changes such as depression or being easily upset, high blood pressure, and decreased interest in sex. If you or your partner experience these symptoms, it is recommended to consult a healthcare professional.
Risk Factors
Obstructive sleep apnea is a condition where a person's breathing is repeatedly interrupted during sleep, leading to poor sleep quality. The following factors increase the risk of developing obstructive sleep apnea:
- Excess weight: Most, but not all, people with obstructive sleep apnea are overweight. Fat deposits around the upper airway can obstruct breathing. Medical conditions associated with obesity, such as hypothyroidism and polycystic ovary syndrome, can also cause obstructive sleep apnea.
- Older age: The risk of obstructive sleep apnea increases with age but appears to level off after the 60s and 70s.
- Narrowed airway: A naturally narrow airway can be inherited, or the tonsils or adenoids might become enlarged and block the airway.
- High blood pressure, or hypertension: Obstructive sleep apnea is relatively common in people with hypertension.
- Chronic nasal congestion: Obstructive sleep apnea occurs twice as often in those who have consistent nasal congestion at night, regardless of the cause.
- Smoking: People who smoke are more likely to have obstructive sleep apnea.
- Diabetes: Obstructive sleep apnea may be more common in people with diabetes.
- Male sex: In general, men are 2 to 3 times more likely than premenopausal women to have obstructive sleep apnea. However, the risk increases in women after menopause.
- A family history of sleep apnea: Having family members with obstructive sleep apnea might increase the risk.
- Asthma: Research has found an association between asthma and the risk of obstructive sleep apnea. It is essential to note that these risk factors do not guarantee the development of obstructive sleep apnea, and some people without any risk factors can still develop the condition.
Development
Obstructive sleep apnea develops when the throat muscles relax and block the airway during sleep, causing repeated stops and starts in breathing. The airway narrows or closes as you breathe in, which can lower the level of oxygen in the blood and cause a buildup of carbon dioxide. In response, the brain briefly rouses the person from sleep to reopen the airway. This awakening is usually brief and not remembered. The pattern can repeat itself 5 to 30 times or more each hour, all night long, impairing the ability to reach deep, restful phases of sleep and causing excessive daytime sleepiness.
Assessment and Diagnosis
Triage
You should see a doctor if you or your partner observes the following symptoms that may indicate obstructive sleep apnea:
- Snoring loud enough to disturb your sleep or the sleep of others.
- Waking up gasping or choking.
- Pausing in your breathing during sleep.
- Having excessive daytime drowsiness, which may cause you to fall asleep while working, watching television, or even driving a vehicle. These symptoms can cause impaired sleep and affect your quality of life during the day. It's essential to consult a healthcare professional for an accurate diagnosis and appropriate treatment options.
Diagnosis
To diagnose obstructive sleep apnea, a healthcare professional will evaluate your condition based on your symptoms, a physical examination, and tests. The physical exam may involve examining the back of your throat, mouth, and nose, measuring your neck and waist circumference, and checking your blood pressure. The healthcare professional may also refer you to a sleep specialist for further evaluation. Tests to detect obstructive sleep apnea may include polysomnography, which monitors your breathing patterns, heart, lung, and brain activity, and other factors while you sleep. In some cases, an at-home version of polysomnography may be used to diagnose the condition. The sleep study can help identify and evaluate other sleep disorders that may cause excessive daytime sleepiness.
Management and Treatment
Complications
Complications of obstructive sleep apnea can include:
- Daytime fatigue and sleepiness
- Difficulty concentrating
- Increased risk of work-related accidents
- Poor school performance and attention or behavior problems in children
- High blood pressure
- Cardiovascular problems
- Eye problems (e.g., glaucoma)
- Strained relationships due to loud snoring
- Memory problems, morning headaches, mood swings, or depression
- Nocturia (frequent urination at night)
- Increased risk of severe COVID-19
- Coronary artery disease, heart attack, heart failure, and stroke
- Heart rhythm problems (arrhythmias)
- Complications with medicines and surgery
- Worsened breathing problems during and after major surgery It is always recommended to consult a healthcare professional for personalized advice and information.
Prevention
Obstructive sleep apnea can be prevented or managed to some extent by addressing its risk factors. Some ways to prevent or reduce the likelihood of developing obstructive sleep apnea include:
- Maintaining a healthy weight: Losing weight if you are overweight or obese can help reduce the risk of obstructive sleep apnea.
- Avoiding smoking: Smokers are more likely to develop obstructive sleep apnea. Quitting smoking can lower the risk.
- Managing allergies and nasal congestion: Treating chronic nasal congestion can help reduce the risk of obstructive sleep apnea.
- Avoiding alcohol before sleep: Alcohol intake can relax the throat muscles and worsen obstructive sleep apnea symptoms. Limit alcohol consumption, especially before bedtime.
- Regular exercise: Engaging in regular physical activity can help reduce the risk of obstructive sleep apnea.
- Sleeping on your side: Sleeping on your back can worsen obstructive sleep apnea symptoms. Using pillows to keep yourself on your side during sleep may help.
- Managing other medical conditions: Controlling high blood pressure, managing diabetes, and treating asthma can help reduce the risk of obstructive sleep apnea. While these measures can help prevent or manage obstructive sleep apnea, it's essential to consult a healthcare professional for proper diagnosis and appropriate treatment recommendations.
Home Remedies
Some general lifestyle changes and natural remedies can help alleviate the symptoms. These include:
- Maintaining a healthy weight: Losing excess weight can help reduce the risk of sleep apnea and alleviate its symptoms.
- Avoiding alcohol and sedatives: Alcohol and sedatives can worsen sleep apnea symptoms. Limiting or avoiding these substances can help improve sleep quality.
- Sleeping on your side: Sleeping on your back can worsen sleep apnea symptoms. Using pillows to prop yourself on your side can help keep your airways open during sleep.
- Nasal decongestants: If nasal congestion is causing or contributing to your sleep apnea, using over-the-counter decongestants or saline nasal sprays can help alleviate the symptoms.
- Exercise: Regular physical activity can help reduce sleep apnea symptoms and improve overall health. Consult your doctor before starting an exercise program.
- Good sleep hygiene: Maintain a consistent sleep schedule, create a comfortable sleep environment, and avoid electronics before bedtime to promote better sleep quality.
- Humidifiers: Using a humidifier in your bedroom can help alleviate dry air-related nasal congestion, which may contribute to sleep apnea symptoms. It is essential to consult a healthcare professional if you suspect you have sleep apnea, as they can provide appropriate guidance and recommendations based on your specific condition.
Treatment
Treatments for obstructive sleep apnea include:
- Positive airway pressure devices: These devices deliver pressurized air through a mask to keep the airway open during sleep.
- Mouthpieces: Mouthpieces can be used to thrust the lower jaw forward during sleep, helping to keep the airway open.
- Surgery: In some cases, surgery might be an option to remove tissue or improve the airway. These treatments can help improve sleep quality, reduce daytime sleepiness, and alleviate other symptoms associated with obstructive sleep apnea. It's important to consult with a healthcare professional for proper diagnosis and guidance on the most suitable treatment options.
Preparing for medical consultation
To prepare for an appointment for obstructive sleep apnea, you should:
- Keep a sleep diary: Record your sleep patterns, daily routine, naps, and how you feel during the day.
- Note your symptoms: Write down your sleep-related symptoms, their onset, and any unrelated symptoms you've experienced.
- Gather personal information: Prepare to share any new or ongoing health problems, major stresses, or recent life changes.
- List your medications: Bring a list of all medicines, vitamins, or supplements you take, including doses and sleep aids.
- Consider bringing your bed partner: If possible, bring someone who can provide information about your sleep habits, such as whether you snore or sleep well.
- Prepare a list of questions: Write down any questions you have for your healthcare provider, such as the cause of your symptoms, necessary tests, recommended treatments, and how to manage other health conditions. Remember to be honest and thorough when sharing your information with your healthcare provider, as this will help them provide the best possible care and treatment.