Becoming Aware of Obstructive Sleep Apnea
People who feel exhausted during the day may suffer from obstructive sleep apnea, a sleep disorder that has only become widely recognized in the last few years.
In sleep apnea, breathing stops or gets very shallow during sleep. Each pause typically lasts 10 to 20 seconds or more. These pauses can occur 20 to 30 times or more an hour.
The most common type of sleep apnea is obstructive sleep apnea. In this form, the throat briefly collapses, causing pauses in breathing. The pauses in breathing cause the oxygen level in the blood to drop and the carbon dioxide level to rise. Normal breaths then start again with a loud snort or choking sound. The other type of sleep apnea is called central apnea. It is rare and happens when the area of the brain that controls breathing doesn't send the correct signals to the breathing muscles.
The body needs sleep for rest and rejuvenation. "Sleep is an essential part of your life. If your sleep is disrupted or you do not have enough sleep, you'll be less alert during the day and perhaps suffer serious consequences for your health in general," says Vishesh K. Kapur, M.D., M.P.H., a pulmonary and critical care specialist in Seattle.
Other health problems
Untreated sleep apnea can increase the chance of having high blood pressure, a heart attack, or stroke. It can also increase the risk for diabetes, work-related accidents and driving accidents. A 2005 study in the New England Journal of Medicine reported that patients with sleep apnea had twice the rate of stroke and death as people with normal sleep patterns.
If you have sleep apnea, you may not realize it. Your only clue to this sleep disorder may be waking up tired.
A person with sleep apnea may not get enough sleep to begin with, a common problem in today's society, Dr. Kapur says. You may assume your problem is a lack of sleep—and take an afternoon nap or sleep in on the weekends. But the real problem is your quality of sleep.
Your bed partner may notice the chief symptom of sleep apnea: snoring. In obstructive sleep apnea, the soft palate and soft tissues of the pharynx block the airway so much that you simply stop breathing. The buildup of carbon dioxide and interruption of oxygen eventually causes you to arouse enough to gasp for a breath of air. Then the cycle begins again. This disruption prevents you from getting high-quality sleep.
Not everyone who snores has apnea, but many do. There's the regular snore—then a pause. The person has stopped breathing. Then the air rushes back in with a distinctive, loud snort, and then a breath. Many people do this a few times an hour, Dr. Kapur says, and that's OK if they feel alright in the morning. But apnea needs treatment if the person stops breathing dozens of times an hour, and wakes up exhausted.
Obesity ranks high as a cause
One of the chief causes of apnea is obesity. The weight of extra soft tissue in the throat and an obese chin presses down on what is already a narrow airway to begin with, Dr. Kapur says. But thin people can get apnea, too. In part, it's a sign of aging. The muscles lose their resting tension. Other causes are large tonsils and adenoids and a small mouth and throat area.
The first thing to do if you think you have apnea or any other sleep disorder is to discuss it with your health care provider. He or she may refer you to a sleep specialist. The sleep specialist will interview you. If the sleep disorder is affecting your life or threatening your health, you may be invited into a sleep lab. There, you'll be connected to monitors and fall asleep in a comfortable, bedroom-like hospital room. Staff will measure everything from your breathing and brain waves to the tone of your chin muscles. As you doze, they'll diagnose you.
Doctors may suggest many solutions to apnea, including weight loss. One popular treatment is the CPAP, Continuous Positive Airway Pressure machine. The CPAP mask is worn over your nose. As you sleep, the staff adjusts the CPAP so it blows just the right amount of air into your body, propping open your airways. Then, you take the machine home to use at night.
People suffering exhaustion from apnea are often delighted with the CPAP, Dr. Kapur says. Sometimes, people with less severe cases find the machine uncomfortable and not worth the effort. Some of these people may get a dental appliance, which is installed to pull out the jaw enough to open the airway.