When it comes to snoring, it’s something we treat as a joke and take lightly…until it affects us directly. While partners struggle to sleep through the loud noises, those affected can experience daytime fatigue. If you recognize these signs, it might be worth checking in with a doctor since sleep apnea may be present, and this is a serious problem.
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What’s Sleep Apnea?
Essentially, this disorder will lead to pauses in breathing while sleeping. Despite occurring dozens or even hundreds of times each night, you might not be aware of these pauses but instead experience the disturbance to your sleep pattern. If you wake up feeling drained, a lack of concentration, and then struggle to be productive, this could be a sign of sleep apnea.
Currently, obstructive sleep apnea is the most common type of this disorder and it comes from a blockage in the airway. Due to the nature of the problem (we’re asleep, so struggle to spot an issue), it’s normally partners and roommates who notice loud snoring and bring it to our attention. In the moment, we feel defensive and brush it off with a joke. This is normal, but you should also take sleep apnea seriously.
Sadly, thousands of people see an impact in emotional and physical health as a result of sleep apnea. As the days go on, our bodies and minds are deprived of the precious sleep we need. Over time, this increases the risk of accidents, slows our reflexes, and reduces concentration levels. In more serious cases, it can also cause;
- Drastic swings in mood
- Constant irritability
On the physical side, we’ve seen liver conditions, diabetes, heart disease, and fluctuations in weight. It’s important to note that with the right treatment and some self-care techniques, you can deal with the problem and get the sleep you need.
Signs of Sleep Apnea
Before we delve into potential solutions, we first want to look in more detail at the symptoms of sleep apnea. Since central and obstructive sleep apneas have similar symptoms, identification can sometimes be difficult. However, the most common signs include;
- Loss of concentration (even with simple tasks)
- Loud snoring
- Sudden loss of breath or gasps for air while sleeping
- Dry mouth
- Hypersomnia (sleepiness during the day)
In some cases, a partner may also notice that you stop breathing during sleep.
Identifying Sleep Apnea - The Types and Their Causes
There are three main types of sleep apnea;
As mentioned previously, this is the most common disorder. At the back of the throat, we have soft tissue; if this relaxes too much during sleep, it can block the airway, and this causes snoring.
Normally, these muscles will provide much-needed support for the tonsils, soft palate, uvula (small section of tissue shaped like a triangle), the tongue, and the throat’s side walls. When we sleep, these muscles aren’t needed, and they can relax. Unfortunately, as the airway narrows, air intake isn’t sufficient which can lower the oxygen level in your blood.
When this happens, our brain cleverly switches to survival mode and briefly wakes you up in order to reopen the airway. Why don’t we remember in the morning? Because we aren’t awake for long enough. Depending on the seriousness of the issue, this can occur every 15 minutes or even every two minutes. All the while, we aren’t reaching the deeper sleep cycle and our body and mind aren’t allowed to relax.
As the name suggests, this disorder relates to the central nervous system and it’s much less common. The muscles in charge of breathing don’t get the right signals during sleep as the brain fails to send them, so we stop breathing. People with this problem rarely snore, can struggle to fall asleep and experience shortness of breath.
Complex Sleep Apnea
Finally, the third type of sleep apnea is a combination of the two. As a result, each case can be somewhat unique.
Potential Risk Factors
What factors increase your risk of sleep apnea? Let’s take a look.
Obstructive Sleep Apnea
- Neck Size - Due to the narrower airway, sleep apnea is a higher risk in those with thicker necks.
- Gender - Although sleep apnea can occur in both males and females, sleep apnea is two to three times more common in the former. For women, sleep apnea is a potential issue after menopause and when weight increases.
- Excess weight - Breathing can be disrupted by fat deposits around the airway, so obesity is a risk factor.
- Narrow Airway - Even without excess weight or a thick neck, you might still have a narrow throat. For children especially, enlarged adenoids and tonsils can cause problems.
- Nasal Congestion - As a result of allergies or just the anatomy of your nose, obstructive sleep apnea occurs in those who naturally struggle to breathe through their nose.
- Age and Family History - Somewhat unfairly, those with sleep apnea in their family tree are more likely to experience the issue themselves. It also becomes more likely as we age.
- Smoking - The habit that keeps on giving (nasty side effects, that is!), smoking increases the risk of sleep apnea THREE TIMES over. Why? The upper airway retains more fluid while inflammation is also common.
- Alcohol - Also true of tranquillizers and sedatives, alcohol will relax the muscles in your throat and we’ve already seen the problem with this.
Central Sleep Apnea
With central sleep apnea, two of the risk factors are the same; age and gender. Not only are we more susceptible to sleep apnea as we get older, it’s a problem more common in men than women. In addition to this, there are three others;
- Narcotic Pain Medication – As well as methadone and other long-acting medication, opioids increase the risk significantly.
- Stroke - After a stroke, our risk of central sleep apnea and treatment-emergent central sleep apnea increases.
- Heart Problems - Finally, congestive heart failure can lead to central sleep apnea.
Should I Visit the Doctor?
Now we understand more about sleep apnea itself, it begs the question of when medical attention is required. First things first, it doesn’t mean you have sleep apnea just because you snore, so don’t panic just yet. However, we recommend making an appointment if you and/or your partner recognize the signs and symptoms mentioned earlier. In particular, if the loud snoring is coupled with daytime fatigue, a loss of concentration, insomnia, etc.
Sleep Apnea Complications
Unfortunately, sleep apnea is more than just a sleeping problem. It also has the potential to cause;
Heart Issues and High Blood Pressure
As we saw earlier that oxygen levels in the blood will decrease through sleep apnea. This causes the strain on the cardiovascular system and blood pressure. As well as causing hypertension (high blood pressure), sleep apnea can increase the risk of;
- Abnormal heartbeats (atrial fibrillation)
- Heart attacks
For those with a heart disease, the problem is even more serious. Known as hypoxia (or sometimes hypoxemia), low blood oxygen can cause an irregular heartbeat and, sadly, death.
Life is tough, and we all feel tired from time to time. This being said, you shouldn’t feel drowsy, irritable, and fatigued every single day. For some, they even feel depressed and short-tempered with loved ones, friends, and colleagues. For children, these side effects can lead to problems with behavior and performance. For adults, there’s a risk of accidents while driving or at work.
Metabolic syndrome includes high blood sugar, distorted cholesterol, difference in waist circumference, and high blood pressure. Not only this, it has been linked with heart disease risks.
Did you know that non-alcoholic fatty liver disease is essentially scarring on the liver? It’s true, and it’s more common in those with sleep apnea. Liver function tests are also more likely to end in abnormal results.
Type 2 Diabetes
As insulin resistance occurs, type 2 diabetes is a real risk in those with sleep apnea.
With sleep apnea, it’s normal to focus on the sufferer. However, loud snoring can lead to frustrated partners and sleeping in separate rooms. Unfortunately, this has led to many broken relationships and it continues to do so today.
Surgery and Medication Difficulties
As the final complication, the breathing problems that come with sleep apnea can make recovery after major surgery more difficult. Even during surgery, we’re sedated and on our backs which can lead to breathing problems; this is why surgeons and doctors need to be aware of sleep apnea before making a decision. Additionally, general anesthesia and some medications don’t blend well with sleep apnea.
Self-Help and Lifestyle Changes for Sleep Apnea
In this section, we want to talk about lifestyle changes and positive adjustments that you can make alone. Although they should never replace medical advice, and they may not be effective for more severe cases, these steps certainly won’t cause any harm and can go a long way in reducing sleep apnea symptoms.
According to experts, both resistance and aerobic training can reduce the symptoms that come with sleep apnea. What’s more, you can improve breathing and strengthen the muscles around the throat with yoga.
Of course, exercise will help you to lose weight, and this is our next tip. Whenever there’s excess weight, the extra tissue can fall down over the airway and prevent air to and from the lungs. By reducing the amount of tissue present around the airway, the symptoms of sleep apnea will improve.
For some, sleep apnea only occurs when lying on their back. Although it sounds simple, you might alleviate the problem by sleeping on your side and preventing the soft tissues and tongue from blocking your airway.
Over the years, we’ve learned that smoking is good for nobody. By increasing fluid retention and inflammation in the upper airway and throat, this is also true for those with sleep apnea.
Add a Pillow
Often, gravity is the problem, so why not add another pillow to prop your head up a little? Alternatively, you can use a special cervical pillow or foam wedge from your waist upwards.
Work the Jaw Muscles
Just before bed, tire your jaw by holding a pen between the teeth or chewing gum; this will tighten the muscles designed to keep the mouth shut.
Steer Clear of Sedatives, Heavy Meals, Sleeping Pills, Caffeine, and Alcohol
All these things are bad, and they get even worse just before bedtime. While heavy meals and caffeine keep you awake, the others will relax the throat muscles and cause breathing issues while trying to sleep.
Buy Some Tennis Balls
By placing some tennis balls in a pillow and wedging it behind your back, you won’t roll onto your back while you sleep. Stitching a tennis ball or two to the back of your pajamas also works.
Just as we’ve mentioned previously, introducing a regular sleeping pattern should help. Meanwhile, you can open the nasal passages with;
- Neti Pot (nasal irrigation system)
- Nasal dilator
- Breathing strips
- Saline spray
In this next section, we want to strengthen those airway muscles and reduce the risk of them collapsing during sleep. Though results can take weeks, we think it’s worth the effort. Here are some effective exercises;
- Hold your tongue to the roof of your mouth for three minutes.
- Twice a day, gargle water for five minutes.
- With your lips on a balloon, breath in through the nose and out through the mouth. The goal is to inflate the balloon as far as you can. Do this exercise five times.
- With the tongue held firmly against the floor of your mouth, grab a toothbrush and brush the top and sides. Do this exercise five times in a single session, with three sessions per day.
- Purse the lips tightly and bring them up and left, then up and right. We recommend ten repetitions with three sessions per day.
- Three times a day, pull outwards with your finger on the inside of your cheek. Simultaneously, pull the cheek muscle inwards (against your finger). Repeat ten times on each side.
- Finally, five times a day, hold your tongue between the teeth and swallow a few times.
Medical Treatment Options
We’ve explored home remedies and self-help, but what about more serious cases? You may have tried some of the home remedies above only to be left disappointed. We’ve got good news, treatment for sleep apnea is now much better than it once was.
For complex and central sleep apnea, the goal will be to resolve the underlying medical problem while offering a breathing device for sleep. Common underlying health issues include neuromuscular disorders and heart problems.
For obstructive sleep apnea, there are five main treatments and we’ve explored them below.
Short for Continuous Positive Airflow Pressure, most moderate to severe cases will lead to this mask-like device being offered to the patient. Worn during sleep, a CPAP keeps the breathing passages open and provides supplemental oxygen.
We know what you’re thinking, especially if you tried CPAP machines long ago; ‘they’re uncomfortable’. This was true, but the technology surrounding these machines has advanced significantly. Not only are they more comfortable today, they’re quieter and lighter too. Countless people nowadays enjoy immediate relief, and a boost to their physical and mental energy.
The topic of CPAP machines often leads to questions and confusion, so we’ve compiled some tips below.
- You’re likely to miss sleeping with freedom, but the improvement in sleep quality and duration is worth persisting.
- Above all else, check the fit with your doctor so you aren’t experiencing unnecessary discomfort.
- Replace the CPAP and humidifier filters as instructed, keep everything clean, and this will keep results positive.
- The noise can be a sticking point for many, so why not hide the machine under your bed or find another way to mask the noise (some play white noise or relaxing music on their phones).
- Like anything in life, there’s nothing wrong with easing your way into it. Start slow and gradually increase the air pressure as you grow comfortable with the whole process.
- If you’re experiencing dryness or skin irritation, buy a moisturizer and ensure your device has a built-in humidifier.
- Using a CPAP is a personal and unique experience, so have it customized to your needs. Need a chinstrap to reduce irritation in the throat? Want pads to reduce irritation? Interested in reducing nose discomfort with nasal pillows? Just ask your doctor.
- If you’re experiencing nasal congestion, try a nasal decongestant or saline spray.
As they improve, we’re also seeing more and more custom-made oral appliances. Compared to breathing devices, they’re generally more comfortable, quieter, and can be carried around much easier. In terms of those approved for the treatment of sleep apnea, some will fit inside your like a mouth guard while others fix the jaw position by fitting around the chin and head.
In our experience, the two most popular devices are;
- Tongue Retaining Device
- Mandibular Advancement Device
By lowering the jaw or bringing the tongue forward, this opens the airway. If you try an oral appliance, we urge you not to give up if the first device doesn’t work as expected. There are so many devices that it’s worth experimenting and finding the one that works for you. It’s also very important to see a dentist accustomed to sleep apnea cases, so all problems are corrected, and the mouthpiece can be adjusted whenever required.
Some side effects are possible when the device isn’t fitted correctly, and these include saliva build-up, soreness, and permanent position changes in the teeth, mouth, and/or jaw.
Alongside the CPAP, other breathing devices exist;
- Bilevel Positive Airway Pressure (BPAP/BiPAP) - If you struggle to get used to the CPAP, or show signs of a weak breathing pattern, this may be offered. This machine works by adjusting pressure while you sleep, your inhales and exhales are handled as needed. With more advanced units, they even deliver breaths when one hasn’t been detected for a set time.
- Expiratory Positive Airway Pressure (EPAP) - Secondly, these single-use devices fit over the nostrils and keep the airway open in a less intrusive way. If your obstructive sleep apnea is only mild to moderate, this may be recommended.
- Adaptive Servo-Ventilation (ASV) - Suitable for obstructive and central sleep apnea, this device is extremely clever because it first stores the information about your normal breathing pattern. To prevent pauses in breathing, airflow pressure is applied automatically.
Although still a new treatment option, it’s worth mentioning the pacemaker system designed to keep the airway open via a stimulation of muscles. For those with moderate to severe obstructive sleep apnea, the FDA has now approved such treatments; some studies have suggested its effectiveness with central sleep apnea. For now, this is still a new field and therefore an expensive one to try.
As a last resort, airway size can be increased with surgery. Depending on the case, specialists may remove excess tissue or even the tonsils or adenoids. Elsewhere, we’ve seen plastic rods implanted into the soft palate and jaw reconstruction surgery. Of course, the risk of complications is much higher with surgery and some unfortunately experience infection. Though rare, a small number have their symptoms get worse.
As you’ve probably noticed, we didn’t include medication in this list, and this is because they can only really help with the associated sleepiness…not the sleep apnea itself.