Sleep apnea: what you need to know

Today we're diving into the world of sleep apnea. It's a topic that's keeping many people up at night (literally), so let's unpack this sleep disorder.

What is sleep apnea? 

Imagine your breathing playing hide and seek while you sleep - that's essentially what sleep apnea does. It's a condition where your breathing repeatedly stops and starts during the night. These pauses, or apneas, can last from a few seconds to minutes and can occur all throughout the night ^[1].

Here's the kicker: you might not even remember these episodes. Your brain briefly wakes you up to restart breathing, but these micro-awakenings are often so short that you don't recall them in the morning ^[4]. It's like your body is running a midnight marathon without your knowledge!

There are two main types of sleep apnea:

1. Obstructive sleep apnea (OSA)

This is the most common type of sleep apnea. It's like your throat is playing limbo with your airway - things get a little too relaxed and block the air from flowing freely ^[2].

2. Central sleep apnea

Less common, affecting 0.9% of adults over 40. This one's all in your head - literally. Your brain forgets to send the "breathe" memo to your muscles ^[2].

Who's at risk?

Sleep apnea doesn't play favorites, but it does have some preferences:

Gender

Gentlemen, you've won the not-so-lucky lottery here. You're 2-3 times more likely to experience sleep apnea than ladies. But ladies, don't celebrate too soon - your invitation arrives around menopause ^[5].

Age

As we add candles to our birthday cakes, our risk of sleep apnea increases. It's like an unwanted loyalty program, with peak membership around 60-70 years old. However, it's important to note that sleep apnea can occur at any age, including in children ^[5].

Weight

Carrying extra pounds? Your airways might be too. Excess weight, especially around the neck, can be your fast-track ticket to sleep apnea land ^[9].

Family history

There appears to be a genetic component to sleep apnea. If you have close family members with the condition, your risk may be higher. Thanks, genetics! ^[9]

Other risk factors 

• Smoking: Can increase inflammation and fluid retention in the upper airway.
• Nasal congestion: Difficulty breathing through the nose can contribute to sleep apnea.
• Medical conditions: Conditions such as hypertension, diabetes, and asthma are associated with higher sleep apnea risk.
• Alcohol use: Relaxes throat muscles, potentially worsening obstruction.

Having these risk factors doesn't guarantee you'll develop sleep apnea. However, if you're checking these boxes and your nights are more restless than restful, it might be time for a chat with your healthcare provider. 

Sleep apnea symptoms: more than just snoring

Let's face it, snoring is the poster child for sleep apnea. But it's not the only sign.

Other symptoms to watch out for:

• Loud snoring (affects 37% of adults and 27% of women) ^[10]

• Gasping or choking during sleep (not the most romantic nighttime sound)

• Excessive daytime sleepiness (hello, 3 PM coffee run)

• Morning headaches (experienced by 18-29% of sleep apnea patients) ^[11]

• Difficulty concentrating (where did I put my keys... again?)

• Mood changes (turns out, not breathing well can make you grumpy - who knew?) ^[3]

(If you're suspecting sleep apnea, have a look at our self check guide!)

Why brief awakenings matter

Remember those micro-awakenings we mentioned? Even though you might not remember them, they're doing a number on your sleep quality. Here's why:

1. Disrupted sleep cycles

These awakenings prevent you from spending enough time in deep sleep and REM sleep, the stages crucial for physical and mental restoration ^[12].

2. Increased stress on your body

Each time you stop breathing, your body goes into fight-or-flight mode. This raises your heart rate and blood pressure, even if you're not consciously aware of it ^[13].

3. Oxygen deprivation

Those pauses in breathing mean less oxygen is getting to your brain and body. Over time, this can lead to a host of health issues ^[14].

4. Fragmented sleep

Even if you're in bed for 8 hours, these interruptions mean you're not getting 8 hours of quality sleep. It's like trying to watch a movie that keeps buffering - frustrating and unsatisfying ^[15].

Diagnosing sleep apnea: time for a sleep study?

If you're suspecting sleep apnea, it's time to become a sleep study star. Here's what you can expect:

Home sleep apnea test

This is often the preferred choice for a lot of people. You can do it in the comfort of your own bed, using a small, easy-to-use device like the Sunrise home sleep test. Today’s home sleep test technology makes them super convenient and can accurately detect up to 87% of obstructive sleep apnea (OSA) cases ^[17]. You get to sleep naturally in your own environment while the device collects all the necessary data.

(Learn more about sleep apnea testing here)

In-lab sleep study

This option is usually recommended for more complicated cases — patients who have secondary heart or lung conditions and who may have other sleep conditions that need sleep center monitoring. You’ll spend a night at a sleep center, connected to monitors that track various aspects of your sleep. While it provides a detailed analysis, it can sometimes be less accurate since you're not in your natural sleeping environment.

Remember, only a healthcare professional can diagnose sleep apnea, so make sure to follow up with your doctor to discuss the best testing option for you and to interpret the results. Don’t rely on Dr. Google for this one!

(Learn more about the pros and cons of home sleep testing vs polysomnogpraphy here)

Treating sleep apnea: solutions

Good news: Sleep apnea is treatable! But before we dive into the solutions, let's talk about a key term you'll hear a lot: AHI, or Apnea-Hypopnea Index ^[25]. This is the number of times per hour that you either stop breathing (apnea) or have significant shallow breathing (hypopnea) during sleep. It's like your sleep apnea score card - the lower, the better!

Treatment options for sleep apnea:

1. CPAP (Continuous Positive Airway Pressure)

The gold standard treatment for moderate to severe OSA. It's like a gentle breeze keeping your airway open all night. It should be able to fully treat sleep apnea. 

(Learn more about CPAP therapy here) 

2. Lifestyle changes

Losing weight can lead to significant improvements. A 10% reduction in body weight can decrease the AHI by 26% ^[19]. That's a pretty good return on investment for your health!

3. Oral appliances

These devices can help keep your airway open, by moving your bottom jaw forward and down. Think of them as night guards with a mission. They're effective for mild to moderate OSA, reducing AHI by 42% on average ^[20].

(Learn more about oral appliances here) 

4. Surgery

In some cases, surgical options or implantable devices might be recommended to treat sleep apnea. Success rates vary depending on the procedure, ranging from 30-80% ^[21].

5. Weight loss medications

New weight loss medications such as Zepbound can help patients with obesity and obstructive sleep apnea reduce AHI by 50-60% ^[22]. 

The impact of sleep apnea: more than just bad sleep

Untreated sleep apnea isn't just about feeling tired. It can lead to some serious health issues:

• Cardiovascular disease: Severe sleep apnea can increase the risk of heart failure, stroke, atrial fibrillation, and hypertension.Your ticker needs its beauty sleep too!

• Metabolic health: OSA is associated with a 30% increased risk of developing type 2 diabetes ^[23]. Turns out, good sleep and stable blood sugar are besties.

• Cognitive function: Untreated sleep apnea can lead to a 20-50% reduction in cognitive performance [24]. So if you're forgetting where you put your keys more often, sleep apnea could be the culprit.

Remember, addressing sleep apnea isn't just about quieting the snores - it's about improving your overall health and quality of life. If you're suspecting sleep apnea, don't sleep on it (pun intended). Reach out to a healthcare provider and take the first step towards better sleep and brighter days!