About 70% of people who regularly snore also have obstructive sleep apnea (OSA) in which the soft tissues in the throat, including the tongue, collapse and are sucked against the back of the throat. This blocks the upper airway and air flow stops, or is greatly reduced. When the blood oxygen level becomes low enough the brain sends a signal known as an arousal and the sleeper partially awakens, the obstruction in the throat clears and the flow of air starts again, usually with a gasp. Most people are not aware this is occurring.
The classic picture of obstructive sleep apnea includes episodes of snoring that begin soon after falling asleep. The snoring proceeds at a regular pace for a period of time, often becoming louder, and for some people is interrupted by a long silent period during which little or no breathing is taking place (apnea). The apnea is then interrupted by a loud snort and gasp and the snoring returns to its regular pace. This behaviour recurs frequently throughout the night.
This cycle of apnea – obstruction and breathing – can occur many times per hour during sleep and stops people getting into the deeper stages of sleep which are important for feeling refreshed and not tired.
These apneas and arousals are associated with spikes in release of adrenaline which have an impact on the cardiovascular system and over time can lead to elevated blood pressure, heart disease, stroke, diabetes and excessive daytime sleepiness as well as having a great impact on quality of life.
The condition known as upper airway resistance syndrome (UARS) lies midway between benign snoring and true obstructive sleep apnea. People with UARS suffer many of the symptoms of obstructive sleep apnea but sleep testing will be negative. The good news is that sleep apnea and upper airway resistance syndrome can be treated easily and effectively with either an oral appliance or a CPAP machine.
Risk Factors of Sleep Apnea
Although obesity can increase the risk, as many as 40% of people with obstructive sleep apnea are not obese. Nasal obstruction, a large tongue, a narrow airway and certain shapes of the palate and jaw also increases the risk of sleep apnea. A large neck or collar size is strongly associated with sleep apnea. Ingestion of alcohol or sedatives before sleep may worsen episodes of apnea. Many people with sleep apnea have a genetic predisposition and it strongly runs in families.
Fortunately the problems relating to sleep apnea can be reversed quickly and effectively with proper treatment. Don’t wait to fall asleep at the wheel before seeking treatment.
Sleep Apnea Symptoms
It is important to emphasise that often the person who has obstructive sleep apnea does not remember the episodes of apnea and wakening during the night. The predominant symptoms are usually associated with excessive daytime sleepiness due to poor quality sleep during the night. Sometimes family members, especially spouses, witness the gasping, pauses or disturbances in breathing
Symptoms that may be observed and experienced can include any of the following:
- Loud snoring
- Disturbances in breathing
- Pauses in breathing (apnea)
- Waking not rested and unrefreshed in the morning
- Excessive daytime sleepiness, including falling asleep at inappropriate times
- Morning headaches
- Recent weight gain
- Limited attention
- Memory loss
- Depression and mood changes
- Poor judgement
- Personality changes
- Sexual dysfunction
If your partner shows any of the above symptoms you should encourage them to have an assessment. Proper treatment will provide a significant improvement in your partner’s health and wellbeing and will no doubt improve your night’s sleep as well.
Complications of Sleep Apnea
- Heart disease
- Abnormal heart rhythm (arrhythmia)