There are approximately 18 million adults in the U.S. who have obstructive sleep apnea, according to the National Sleep Foundation, and among those who suffer from the most common form of sleep-disordered breathing, it often goes undiagnosed.
While sleeping, the throat muscles are usually relaxed and allow the airway to collapse or become plugged by the tongue, which causes the flow of air to stop, sometimes for 10 seconds or more. When the brain senses the distress, people may bolt upright in a panic gasping for air, or they can simply snort and go right back to sleep. This breathing pattern can repeat numerous times during the night without the person realizing it. And it can erode health, according to Michael Twery, director of the National Center of Sleep Disorders Research within the National Heart, Lung, and Blood Institute.
When left untreated, sleep apnea has been linked to high blood pressure, heart disease, stroke, memory loss, obesity, parasomnias (involuntary behaviors like sleepwalking) and insulin resistance, a precursor to type 2 diabetes. Research has also shown a link between severe sleep apnea, the repeated drop in blood oxygen levels, and premature death. The ensuing daytime sleepiness can cause a “public hazard if you happen to be an airline pilot or an 18-wheel truck driver who is sleeping at the wheel,” said Dr. Alex Chediak, a past president of the American Academy of Sleep Medicine.
Do you snore loudly? Or feel exhausted even though you’ve had a good night’s sleep? It might be time to visit your doctor to discuss these symptoms, said Twery, adding: “The initial detection of this condition often stems from things that the patient can tell their physician–there’s no blood test.” Those who are at a high risk of sleep apnea may be referred to a sleep specialist for a sleep study evaluation for obstructive sleep apnea, although a home-based testing option is possible.
Treatment options can include a continuous positive airway pressure (CPAP) machine, which creates a column of air that keeps the airway open, an oral device, or surgery. In the meantime, sleep doctors say that the following behavior and health issues can exacerbate obstructive sleep apnea or put people at risk for this nighttime breathing disorder.
“The main factor that contributes to sleep apnea is obesity,” said Dr. Asha Singh, director of the OHSU Sleep Medicine Program in Portland, Oregon. Excess weight can bulk up tissues in and around the airway, which cause the airway to become vulnerable to collapse as the muscles relax during sleep. Also, heavier people tend to have thicker necks, which can also be a factor, said Dr. David Schulman, a sleep medicine specialist with Emory Healthcare in Atlanta. Although thin people are also susceptible to developing apnea, more than 50 percent of people who have the condition are overweight, according to the NHLBI.
There can be two people who weigh the same and have the same body mass index, and one of them has sleep apnea and the other doesn’t, according to Dr. Amy Guralnick, an assistant professor of medicine at the University of Chicago, and a member of the faculty at the university’s Sleep Disorders Center. “But if somebody has sleep apnea and they gain [weight], almost certainly their sleep apnea will get worse,” she said.
“Alcohol increases muscle relaxation, and that’s true for the muscles of the throat–and actually the tongue muscle,” said Dr. Kathleen Yaremchuk, chair of otolaryngology and a sleep specialist at Henry Ford Health System in Detroit. This makes the airway a lot more vulnerable to obstruction during sleep.