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Later this month, I’m getting reevaluated for sleep apnea.  When I mentioned this to some people, they had a variety of reactions.  A few didn’t know what sleep apnea was.  Others thought it wasn’t a bad thing.  This got me thinking about how people don’t really know about this condition.  Well, many do seem to think the following:

1. Sleep apnea is when you’re snoring a lot.
2. Sleep apnea only happens if you’re obese.

In reality, sleep apnea is a dangerous condition that I’m starting to find is not diagnosed as often as it should be.  It’s also much more common in men.  So, let’s learn a bit.

What is Sleep Apnea?

Simply put, this is a condition where a person’s breathing repeatedly stops and restarts while asleep.  It results in broken, unhealthy sleep where you might jolt awake for a bit then pass out again.  Some people can have it so bad that they will wake up in a panic because they pretty much stopped breathing.  This can create a domino effect of health issues that could even mask sleep apnea as the culprit.  For example, a doctor might think high blood pressure is entirely due to diet and weight when severe sleep apnea is a factor as well.

There are two types of sleep apnea:

• Obstructed Sleep Apnea– This is the most common one where muscles in the back of the throat relax block breathing.  This can be caused by obesity, hormonal changes, or even physical issues.  For example, I was told one reason I have sleep apnea is because my tongue is too big for my mouth.
• Central Sleep Apnea– This is when the brain doesn’t send correct signals to the muscles to allow for breathing.  It’s not as common, but you can also get this version as you’re being treated for OSA.

The sleep apnea events happen mostly in Stage 1, Stage 2, or REM sleep.  They are very short, which is why a person won’t usually remember waking up 30 times.  That number is for severe sleep apnea.  Mild has 5-15 nocturnal events and Moderate has 16-29 events.  The only time a person might remember an event is if it’s bad enough to wake them entirely and they are left feeling like they nearly suffocated.

Myth–  Snoring caused by sleep apnea can be fixed by elbowing your significant other.  You might get them into a better sleeping position, but this doesn’t really change anything.  All you’re doing is physically abusing your loved one and possibly making it harder for them to sleep because now they’re afraid of getting jabbed.

What Can Sleep Apnea Do to the Body?

This is probably a better question than symptoms because the effects of sleep apnea are what can confuse people.  The picture at the top of the post shows a lot of what’s going on because you’re getting really low quality sleep.  Not the full amount of time your body needs and what you do get might not come from going through the full REM cycle.  So, here is a list of what this can do to the body:

• Excessive weight gain (This and sleep apnea feed each other.)
• High blood pressure
• Fatigue during the day
• Irritability
• Increase risk of stroke
• Sexual dysfunction
• Enlarged heart
• Type 2 diabetes
• Abnormal cholesterol levels
• Increase risk of heart disease
• Increase risk of long Covid
• Surgery complications if anesthesia is used
• Scarring on the liver
• Memory loss
• Acid reflux
• Depression
• Increase in liver enzymes
• Damaged white matter in the brain
• Dry mouth/coughing especially in morning
• Brain fog/confusion
• Night sweats
• Nocturnal panic attacks due to breathing being stopped
• Snoring

Think you get the general idea.  All of these things can either stem from or be enhanced by sleep apnea.  Consider that sleep is when the body recovers energy and heals.  By not going through the natural cycle, the body is not recovering and carries over the stress/damage from the previous day.  This will inevitably cause a build up, which results in issues from the previous list appearing.  Since all of those are more commonly associated with other health problems or considered a central one in general, sleep apnea might not even be on the doctor or patient’s radar.  For example, I had to bring it up myself after trying two blood pressure medicines.  It was a known problem, but it wasn’t until I requested a sleep doctor referral that it entered the equation.  Honestly, it still hasn’t because I haven’t had the appointment, so the focus is still solely on my heart.

How Is Sleep Apnea Treated?

As stated earlier, it isn’t treated by having your loved one elbow you in the ribs every time you snore.  Let’s say that again.

First, you need to be diagnosed with a sleep test.  This can be done with an overnight study at a facility or at home with a testing kit.  I did the latter years ago and it required putting sensors around my body as well as a mouth/nose device.  Not very comfortable and I freaked every time something shifted.  Didn’t help that my wife was still doing the rib shots, but I got it done.

Anyway, these tests monitor heart rating, oxygen levels in the blood, breathing, and brain wave (only with overnight).  These results will tell a doctor the severity of your sleep apnea and help them figure out if it’s OSA or CSA.  Home tests can’t diagnose CSA, so nothing on a home test typically means you then should try an overnight.

Once you know what’s going on, you can get treated.  Time for another list:

• PAP Machine–  Positive Airway Pressure machine is what most people think about.  This is the device with a mask and tube, which increases the pressure in a person’s airways.  Pushing the air keeps the throat open.  There are different types with the most common being CPAP (Continuous).  Some people shy away from this because it looks uncomfortable and they may fear the humming will keep their significant other awake.  Not that the snoring doesn’t do that already.
• Oral Device–  This is what I use.  These are designed to keep the jaw and tongue in a position that take pressure off your windpipe.  You typically have to start by going through a dentist.  The reason for this is because an oral device is made specifically for your mouth.  A mold is taken of the top and bottom then the piece is made.
• Nerve Stimulator–  I don’t know much about the other ones, but this treatment involves attaching an electrode to the nerve under your tongue.  This pushes the tongue slightly forward to prevent it from blocking the airway.  A device is implanted under the skin of your chest to attach to the electrode.  It isn’t a painful or uncomfortable shock.  Still, we are talking surgery here.
• Surgery–  Now we’re really talking surgery.  This is typically anything done to the nose, throat, and mouth.  The effectiveness varies from person to person.  Surgery can also be very limited in usefulness compared to the others.
• Lifestyle Changes–  This can erase or minimize the issue.  Losing weight, giving up smoking and alcohol, exercising, humidifiers, etc.  There’s a long list of things you can do, but it will take time for them to have an effect.  If you have severe OSA then you might have to try this after getting a PAP machine or oral device.  This way you have the energy and mindset.

So, those are the basics of sleep apnea.  If you learn that you are snoring a lot and feeling very fatigued with no clear reason, I’d recommend talking to your doctor.  It doesn’t hurt to see if you have even a mild case of sleep apnea.  Hope people learned something and will think twice when they are going to be upset at someone who snores.  They don’t do it on purpose and might have a greater health issue than you realize.