For the vast majority of our lives, we breathe without any conscious input. It happens automatically, whether we’re awake, asleep, or even in a coma.
Sometimes, though, that system, which is usually so robust, can go awry, especially during the night. The muscles and nerve impulses that control our breathing patterns stop operating in the usual way, causing breathing to cease – at least temporarily.
ENT doctors call this condition sleep apnea, and it is way more common than you might think. Here, the usual autonomic system that regulates breathing stops functioning correctly, leading to interruptions in the flow of oxygen through the lungs. In most cases, the affected person will partially wake up panting, and then fall asleep again soon afterwards, but not always. In some cases, breathing can stop dozens of times in one night, preventing oxygen from reaching vital parts of the body, like the brain, leading to serious side effects.
The Two Types Of Sleep Apnea
Researchers split sleep apnea into two categories. The first and most common is the obstructive variety. Here the muscles that hold the airways open relax to the point where they close up, preventing oxygen from traveling in and out of the lungs. Usually, the collapse happens in the throat, but it can occur in the nasal passages too.
Medics call the other form of the condition “central sleep apnea.” Here, there’s no physical blockage of the airways. Instead, the brain simply doesn’t issue signals to the diaphragm, telling it to breathe. Usually, this occurs because of some kind of dysregulation of the respiratory control center.
What Are The Consequences Of Sleep Apnea?
The consequences of sleep apnea are more severe than most people would like to admit. It is a condition that can lead to a variety of health problems – some of which are very severe indeed.
High Blood Pressure
High blood pressure is currently the number one cause of disability and death worldwide, responsible for more health problems than smoking. Sleep apnea causes high blood pressure by forcing the body into panic mode when it feels that it is running out of oxygen. When it detects a shortage of energy, it churns out signaling molecules telling the walls of blood vessels to tighten. Blood pressure then rises and, in some instances, can remain dangerously elevated for many hours at a time.
People with diabetes appear to be at a higher risk of developing sleep apnea. Researchers think that the disease interferes with the nerves that send signals from the brain to the diaphragm, telling it to contract. Those with the condition are more likely to go on to develop breathing difficulties at night.
The reason why diabetes results from sleep apnea are less clear cut, but the leading theory is that it has to do with poor sleep quality. When you have sleep apnea, you’re continually waking up in the night as your body jolts you awake so that you can breathe. This regular waking decreases the quality of your sleep, which leads to more insulin resistance throughout the day. The more insulin your body needs, the more blood sugar levels will rise in response to any food you eat, regardless of how healthy it is.
The high blood pressure that the condition causes significantly increases your chance of having a stroke. Delicate blood vessels in the brain can burst under strain, leading to a stroke.
Perhaps the number one issue with sleep apnea is that it can eventually lead to heart failure. When the heart doesn’t get a regular supply of oxygen, it struggles to continue beating and sending the blood around the body. When this happens, the affected person’s respiratory system shuts down completely, and they can die.
The brain requires a continual supply of oxygen to be at its best. It cannot live without it. Brains that go without oxygen for five minutes or more often experience irreparable damage.
What Puts You At Risk For Sleep Apnea?
Sleep apnea is a condition that can develop at any point in your life. It’s not just something that affects the elderly. Knowing what puts you at risk, therefore, could help you avoid developing the condition – or get rid of it if you have it already.
The main risk factor for sleep apnea is overweight. People who are obese appear to struggle with the condition much more than those who aren’t.
Researchers think that it might have to do with increased packing of fat and muscle tissue around the airways. As you gain weight, the body shuttles fat into the spaces around your neck and lungs. When you go to sleep, relaxed muscles can’t hold back all the new adipose tissue, causing the collapse that blocks your airways.
Interestingly, you don’t need to put on a vast amount of weight to be at risk. It is not the amount of weight that you put on that matters in this case, but the distribution. If all the additional fat surrounds your windpipe, then it is much more likely to lead to sleep apnea.
Having a Large Neck Size
Some people have a large neck. In women, medics define this as a neck that is more than 16 inches around. In men, the figure is 17 inches.
The reasoning here is the same as before. People with large necks have more material surrounding their windpipe. Thus, when their bodies relax during sleep, there’s a higher chance of a cave-in that blocks the airways.
Large Tonsils Or A Large Tongue
Every person is unique, both inside and out. Some people have big hands, while others have small waists and long legs. It’s just natural variation. The same distribution of sizes and shapes also applies to structures inside the body, too, including the tonsils and tongue.
Doctors believe that people with large tonsils are more at risk from sleep apnea because the tonsils reduce the size of the airway. Large tongues may be a problem too since they are heavier and more likely to fall back and block the windpipe than their smaller counterparts.
Sleep apnea can also occur because of problems much higher up the respiratory tract. Nasal obstructions, including inflamed sinuses and allergies, can cause the nose to close up, interrupting breathing during sleep.
The Problem Of Diagnosing Sleep Apnea
Sleep apnea is one of the trickiest conditions to diagnose. Most people who have the disease don’t usually know that they’ve got it. They might feel tired and have a headache in the morning, but the reasons for that aren’t clear. Most sufferers don’t remember experiencing any episodes of sleep apnea during the night. And that’s a problem.
For this reason, sleep apnea is insidious. It can rumble on for months without the affected person knowing that they have it. The only clue usually is a feeling of being unable to breathe, and sudden jolting awake as the body releases adrenaline compounds. The problem, though, is that most people are only semi-conscious – just conscious enough for breathing to resume, but not enough to evaluate what’s going on.
People who sleep in the same room as a partner are actually in a better position. The partner may wake up during the night to the sounds of snoring or difficulty breathing and be able to raise the alarm. Those who sleep alone, though, may not discover that they have sleep apnea until something goes wrong.
How To Treat Sleep Apnea
The best way to treat sleep apnea is to improve your lifestyle and lose weight. Simple changes like avoiding snack food and regular walking can make a massive difference to the amount of fat putting pressure on your windpipe.
Doctors also offer a range of tools that help to keep your airways open, even while you’re unconscious. The most common is the CPAP, which stands for “continuous positive airway pressure” device. You place this appliance over your face around your nose and mouth, and it ensures that your airways always remain open. It is, however, uncomfortable to wear, so it can make sleeping difficult.
When it comes to sleep apnea, there are a lot of myths. It’s not just another form of snoring. It’s far more severe – even life-threatening. What’s more, it can affect people of any age, not only those past the age of retirement.
You might think that a nightcap will help you sleep, but there’s evidence that drinking alcohol before bed can make sleep apnea even worse. Sleeping pills may have a similar effect.
The best way to deal with sleep apnea in the short term is to sleep on your side. This position will make it less likely that your tongue will fall back and block your airway during sleep. You can buy special pillows to make lying on your side more comfortable.
Simple lifestyle changes and treatments can reduce or even eliminate sleep apnea. You don’t have to opt for full-blown surgery. That’s unlikely to make a lasting difference.