Sleep Apnea: How Serious is It? Here's How It Affects Your Health

Despite an estimated 30 million Americans living with sleep apnea, only one-fifth of these cases are clinically diagnosed, according to the American Medical Association. Living with undiagnosed sleep apnea doesn't just hurt your sleep, it can affect your health, too. Sleep apnea is associated with a higher risk of type 2 diabetes, heart attacks and memory issues.

Sleep apnea is a big topic, with different types and treatment options. Keep reading to identify the warning signs of sleep apnea and determine your risk factors.

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What is sleep apnea?

Sleep apnea is a medical condition that causes your breathing to stop and start continuously while sleeping. There are several risk factors for sleep apnea, including obesity, having a large tongue or tonsils, or having certain medical issues, like heart or lung diseases.

If untreated, sleep apnea can pose serious health problems, potentially increasing your risk of heart disease, and GI-related issues like heartburn, high blood pressure and depression.

What are the symptoms of sleep apnea?

Since sleep apnea occurs while you're sleeping, you might not even know you have it, but your partner may be able to point out some of the signs. Common sleep apnea symptoms include:

• Loud snoring: When your airway is blocked or narrowed from sleep apnea, it's harder for oxygen to get through. The reduced airflow can cause your throat tissue to vibrate, which results in snoring.
• Breathing that stops and starts while you're asleep: Sleep apnea can cause your throat muscles to relax, which can then constrict your airway and stop your breathing momentarily.
• Gasping, choking or snorting: You may experience these symptoms as your body tries to correct your breathing during sleep.
• Feeling tired during the day: Because sleep apnea interrupts your sleep, you may wake up feeling tired or not well rested.
• Waking up with a dry mouth: Since it's harder to breathe with sleep apnea, you may overcompensate by breathing with your mouth open, which can dry it out (known as xerostomia).
• Getting up frequently to use the bathroom at night: Some people with sleep apnea experience nocturia, which is a condition that causes you to wake up repeatedly during the night to urinate.
• Impaired focus: A lack of restorative sleep can affect your ability to concentrate in your day-to-day life.
• Irritability: Similarly, when you don't get enough restful sleep, you may feel more irritable or frustrated during the day.
• Anxiety and depression: Sleep apnea can also trigger anxiety and/or depression.
  

Types of sleep apnea

There are two different kinds of sleep apnea: obstructive sleep apnea and central sleep apnea. While the symptoms are similar, the causes are different. Here's how they compare.

Obstructive sleep apnea

Obstructive sleep apnea restricts air from getting through your throat while you're sleeping. It occurs when the soft tissue in your airway gets blocked during sleep and results in less airflow into your lungs and, in some cases, snoring, choking or gasping. Like central sleep apnea, this disorder is more likely to occur in men and seniors.

Causes of obstructive sleep apnea

There are a few causes of obstructive sleep apnea, with obesity being one of the most common. Other possible contributing factors include having a large or thick neck, heart failure, endocrine and metabolic disorders, smoking and a family history of sleep apnea.

Central sleep apnea

With central sleep apnea, your breathing stops, starts and becomes more shallow as you sleep. It's triggered by a miscommunication between your brain and the muscles you use to breathe. It's less common than obstructive sleep apnea. The disorder is more prevalent in men and people over 65.

Causes of central sleep apnea 

Central sleep apnea is usually caused by other medical conditions, which include heart failure, stroke and kidney failure. Ongoing prescription drug use and sleeping at a high altitude are other potential causes of this type of sleep apnea.

How sleep apnea affects your health

From your heart to your liver, sleep apnea can have wide-ranging impacts that affect many parts of your body. These are some of the most common health issues associated with the disorder.

Cardiovascular issues

When your breathing stops during the night, your body releases stress hormones, which can eventually lead to coronary heart disease, high blood pressure, stroke, heart failure and cardiac arrhythmia. On top of that, sleep apnea negatively impacts your quality of sleep, which can have detrimental effects on your heart health as well.

Excessive fatigue

If you have sleep apnea, the constant stopping and starting of your breathing can make it difficult to get a restful night's sleep. As a result, you may feel fatigued during the day. Being tired all of the time can trigger a host of other issues, like mood changes, depression, and concentration problems. It can also weaken your immune system and make it dangerous to drive.

Type 2 diabetes

Research has found that people with OSA are more likely to develop type 2 diabetes, and more than half of people with type 2 diabetes have sleep apnea. Plus, sleep apnea deprives the body of oxygen, which increases insulin resistance and raises glucose levels – so dealing with this disorder can worsen your type 2 diabetes.

Liver issues

Obstructive sleep apnea raises liver enzymes and is linked to the development and progression of nonalcoholic fatty liver disease, a medical condition where excess fat builds up in the liver. If you have NAFLD, you may be at a higher risk for other health issues, including cirrhosis and liver failure.

Risk factors

There are a number of risk factors that influence your chances of developing sleep apnea. Here are some of the most prevalent ones.

Age

While people of any age can have obstructive sleep apnea, it's more widespread among older people, and the chance of developing it increases as you age. Central sleep apnea is most common in people 60 and over.

Gender

Men and those assigned male at birth have a higher risk of developing sleep apnea, but the chances start to even out as people get older. For women, menopause and pregnancy can increase the chances of getting sleep apnea.

Medical conditions

People with certain health conditions -- including some thyroid and heart problems -- may have a greater likelihood of contracting either type of sleep apnea. On top of that, medical conditions like hypertension, nasal congestion, diabetes, and asthma can also create a bigger risk for obstructive sleep apnea.

Weight

Studies indicate that being overweight or obese is a risk factor for obstructive sleep apnea. That's because heavier individuals tend to have more fat deposits in their necks, which can block their airways.

Family history

Having a family history of sleep apnea ups the chance of developing the disorder. The reason is that genetics help determine the size and shape of someone's neck area -- a larger area makes it easier to get obstructive sleep apnea. Genes also play a role in how the brain controls breathing, which could raise a person's chance of developing central sleep apnea.

Lifestyle

Drinking and smoking have been shown to raise the risk of obstructive sleep apnea because alcohol relaxes your throat muscles and tobacco increases inflammation in your airway, both of which restrict breathing.

Regardless of risk factors, you should get tested if you suspect you have sleep apnea. Slim, young women are often overlooked, so speak with your doctor to get tested. For more information about sleep apnea and possible treatments, check out why you may feel tired after a full night of sleep.

Treatments for sleep apnea

If you're feeling chronically tired after a whole night of sleep, it's probably time to speak with your doctor. 

In addition to a physical exam and health history, your doctor may require that you undergo a polysomnography or sleep study to diagnose and create a treatment plan for sleep apnea. During a sleep study, your breathing patterns and blood oxygen levels will be monitored, as well as heart, lung, and brain activity. The sleep study results will determine what type of sleep apnea you have.

Alternatively, you may be prescribed an at-home sleep device if you're at risk for moderate or severe obstructive sleep apnea. While you skip the long lines for sleep studies with these devices, there can be room for error since you have to set it up yourself. They won't give you nearly as much data as a sleep study would. It's only recommended if sleep apnea is likely your only sleep disorder. 

Once you have a sleep apnea diagnosis, your doctor will likely recommend a continuous positive airway pressure machine. Bilevel-positive airway pressure and adaptive servo-ventilation machines are also used in central or complex sleep apnea cases. These machines help keep the airways open so you can breathe while sleeping. 

In less severe cases, oral appliances can treat sleep apnea by allowing the jaw to open. These dental devices either block the tongue from restricting the throat and airway or push the lower jaw forward. Your phsyicain and a dentist can determine if this is right for you. Be aware that this can cause dry mouth or pain in your teeth or jaw. 

If you aren’t drawn to any of the treatments above, surgery is also a viable option for sleep apnea.

Read more: What is Inspire for Sleep Apnea? What to Know About the New Treatment