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What is sleep apnea?

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Do you wake up exhausted? Does your partner complain about your snoring? You may be one of up to 6% of people who suffer from sleep apnea 1,2 – in obese people that number is 77% 3 – and you may not know you have it.

What is sleep apnea?

Sleep apnea (also known as sleep apnoea) is a condition where the pharyngeal muscles in the back and sides of your throat relax so much when you sleep that your breathing is blocked for a few moments. When this happens, your brain notices a lack of oxygen in your blood, wakes you up just enough for your conscious mind to tense the muscles and take a breath. Then you fall into a deeper sleep again and the cycle continues – usually without you even noticing.

Early detection of your sleep apnea means that it can be treated before it damages your health, relationship or work performance.

The end result of sleep apnea is that you may suffer from a lack of sleep and oxygen, and wake up exhausted. Your partner may also complain about your snoring. Some sleep apnea sufferers find themselves falling asleep at work or while driving.

There are three types of sleep apnea

  • Obstructive sleep apnea (OSA) – the most common – where the tissue of the throat closes over the airway, causing you to stop breathing
  • Central sleep apnea – which is not as common as OSA – where the brain or nerves fail to signal the muscles that control breathing to tell them that you need to take a breath
  • Combination or complex sleep apnea where obstructive and central sleep apnea occur together
Patient trying on mask

Is it normal to stop breathing like this?

It is normal to stop breathing, wake a little, breathe and fall into a deeper sleep again.

Everyone does it occasionally, however when it happens more than five times per hour, you have sleep apnea. In severe cases it can happen more than 30 times per hour.

Who gets sleep apnea?

Sleep apnea occurs in all age groups – including newborn babies – but is most common in people over 50 years old and people who are overweight4. It is also more common in men than women5. Other physical characteristics that may predispose you to sleep apnea are large tonsils, a small nose, some thyroid conditions and nasal congestion. Also, drinking alcohol or taking sedatives or sleeping pills before sleep can relax your throat and make your sleep apnea worse.

What are the symptoms?

Sleep apnea has a range of symptoms. You may have sleep apnea if you have more than two or three of them:

  • Snoring – many sleep apnea patients are referred to the doctor because their snoring keeps their partner awake
  • Feeling sleepy during the day – some people seek treatment after they have fallen asleep while driving or at work
  • Poor concentration
  • Feeling depressed, irritable or moody6,7
  • Suffering from a reduced sex drive or erectile dysfunction
  • Going to the toilet frequently at night
  • Nightmares

Why is sleep apnea bad for me?

People who suffer from sleep apnea often suffer from other conditions associated with, and possibly caused by, sleep apnea.

By treating your sleep apnea, you may also be able to reduce the severity of, or risk of suffering from8,9,10,11 :

  • Poor cardiovascular health
  • Hypertension
  • Stroke
  • Type 2 diabetes12, 13, 14

Am I at risk of having sleep apnea?

Try this quiz to assess your likelihood of having sleep apnea and whether you should see your doctor.

References:

  1. Chronic respiratory diseases, The World Health Organizaton,   www.who.int/gard/publications/chronic_respiratory_diseases.pdf  viewed 21 May 2015
  2. Reawakening Australia: the economic cost of sleep disorders in Australia, 2010, A report for the Sleep Health Foundation by Deloitte Access Economics© 2011 Deloitte Access Economics Pty Ltd  http://www.sleephealthfoundation.org.au/pdfs/news/Reawakening%20Australia.pdf
  3. O’Keefe, et.al., Evidence supporting routine Polysomnography before bariatric surgery, inObesity Surgery, January 2014
  4. Hargenset TA, Kaleth AS, Edwards ES, and Butner KL (2013). Association between sleep disorders, obesity, and exercise: a review. Nat Sci Sleep. 5: 27-35.
  5. Young, T., Palta, M., Dempsey, J., Skatrud, J., Weber, S., & Safwan, B. (1993). The occurrence of sleep-disordered breathing amount middle-aged adults. The New England Journal of Medicine. 328, 1230-1235.
  6. Paul E. Peppard; Mariana Szklo-Coxe; K. Mae Hla; Terry Young (2006). Longitudinal Association of Sleep-Related Breathing Disorder and Depression. Arch Intern Med. 2006;166(16):1709-1715.
  7. Anne G. Wheaton; Geraldine S. Perry; Daniel P. Chapman; Janet B. Croft. Sleep Disordered Breathing and Depression among U.S. Adults: National Health and Nutrition Examination Survey, 2005-2008
  8. Young, T., Peppard, P.E., & Gottlieb, D.J. (2002). Epidemiology of obstructive sleep apnea: a population health perspective. Am. J. Respir. Crit. Care Med, 165, 1217-1239
  9. Young T. et al (2008): Sleep Disordered Breathing and Mortality: Eighteen-Year Follow-up of the Wisconsin Sleep Cohort
  10. Peppard PE, Young T, Palta M, Skatrud J (2000): Prospective study of the association between sleep-disordered breathing and hypertension. NEJM 342(19): 1378-1384
  11. Dincer HE, O’Neill W (2006): Deleterious effects of sleep-disordered breathing on the heart and vascular system. Respiration 73(1): 124-130
  12. Meslier N, Gagnadoux F, Giraud P, Person C, Ouksel H, Urban T, Racineux JL (2003): Impaired glucose-insulin metabolism in males with obstructive sleep apnoea syndrome. Eur Respir J 22(1): 156-160
  13. Bottini P, Dottorini ML, Cristina Cordoni M, Casucci G, Tantucci C (2003): Sleep-disordered breathing in nonobese diabetic subjects with autonomic neuropathy. Eur Respir J 22: 654- 660
  14. Elmasry A, Lindberg E, Berne C, Janson C, Gislason T, Awad Tageldin M, Boman G (2001): Sleep-disordered breathing and glucose metabolism in hypertensive men: a population-based study. J Intern Med 249(2): 153-161

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