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If you find yourself frequently waking up tired, suffering from headaches, or noticing your breathing repeatedly stops during sleep, you may be experiencing symptoms of sleep apnea. This serious sleep disorder can have significant impacts on your health and daily life if left undiagnosed and untreated. [1]
In this article, we’ll dive into sleep apnea symptoms, diagnosis, and treatment options.
Sleep Apnea Symptoms
Sleep apnea is a common sleep disorder in which breathing is interrupted during sleep. Nearly 30% of Americans have sleep apnea, though many remain undiagnosed. By learning the key symptoms of this condition, you and your partner can identify potential signs and decide if it's time to talk to a doctor. [1]
- Loud snoring: This is one of the most common symptoms, though not everyone who snores has sleep apnea. Doctors will look at your complete medical history and sleep patterns to determine if disruptive snoring is caused by sleep apnea.
- Choking or gasping for air: If you or your partner notice that you are gasping or choking after pauses in breathing during sleep, it is crucial to seek a referral for a sleep study. You may not remember these episodes in the morning, so your partner's observations can be invaluable.
- Sleepiness during the day: You may find yourself feeling tired and struggling to stay awake during activities such as reading, being a passenger in a car, or attending meetings.
- Headaches in the morning: This can also indicate sleep apnea, affecting around 30% of individuals with the disorder. These headaches typically present as pain on both sides of the front part of the head, often feeling like a squeezing sensation.
- Waking throughout the night: Difficulty staying asleep and waking throughout the night is a common issue for one-third of people with sleep apnea. [1]
Diagnosing Sleep Apnea
Medical History and Physical Examination
To diagnose sleep apnea, your doctor will start by reviewing your medical history and conducting a physical exam. The doctor may use the mnemonics STOP and BANG to guide the evaluation. [2]
STOP refers to your sleep behaviours. If you answer “yes” to two or more questions, there is a 66% chance you have sleep apnea. In these questions, your doctor will ask about your daily symptoms, such as: [2]
- S: Do you snore loudly enough to be heard through closed doors?
- T: Do you feel tired during the day?
- O: Has anyone observed you stop breathing while sleeping?
- P: Do you have high blood pressure? [2]
To confirm your answers, your doctor may talk with your partner. Patients often minimize or forget symptoms, so a partner's input is valuable.
BANG refers to physical traits that increase sleep apnea risk. These include:
- B: BMI over 35
- A: Older than 50 years of age
- N: Neck circumference greater than 17 inches in males and 15 inches in females
- G: Male gender [2]
If you meet the BANG criteria and have two or more STOP factors, your risk of sleep apnea jumps to 93%. [2]
The STOP-BANG questionnaire has proven to be reliable in identifying obstructive sleep apnea, though ongoing research aims to enhance its accuracy across diverse patient populations. [2]
In conjunction with this assessment, your doctor may inquire about specific conditions that can contribute to an increased risk of sleep apnea:
- Congestive heart failure
- Pulmonary hypertension
- Stroke
- Metabolic syndrome
- Type 2 diabetes [2]
Home Sleep Apnea Test
If your doctor suspects you have sleep apnea based on your symptoms, they may recommend an at-home sleep study to diagnose your condition. A home sleep apnea test is a simple, non-invasive test you can do in the comfort of your own home. A doctor may recommend an at-home sleep study if you:
- Present with symptoms indicating moderate to severe sleep apnea.
- Do not have a medical condition that could be causing sleep apnea symptoms. [3]
However, not everyone is eligible for a sleep apnea test. Your doctor may avoid prescribing a home sleep study if you:
- Are not at high risk for sleep apnea.
- Have a medical condition that could be causing sleep apnea, such as congestive heart failure, pulmonary disease, or a neuromuscular disorder. [3]
If sleep apnea is suspected and you’re eligible for a test, you may be given a home sleep apnea test and a sleep diary to diagnose your condition.
- Home sleep apnea test: You’ll wear a small device while you sleep. It monitors your breathing, oxygen levels, and heart rate. It can detect if you have breathing interruptions or drops in oxygen that point to sleep apnea.
- Sleep Diary: In addition to the monitor, you may be asked to keep a sleep diary for two weeks. Jot down details like when you go to bed, how often you wake up, and when you get up for the day. This diary gives your doctor more insight into your sleep habits. [3]
In-Lab Sleep Studies
An overnight in-lab sleep study, known as a polysomnogram, allows for a comprehensive analysis of your sleep and any conditions impacting your rest. [3]
During a polysomnogram, board-certified sleep specialists gently attach sensors to your face, scalp, chest, and legs. As you sleep, these sensors will monitor and record your brain waves, oxygen levels, heart rate, breathing patterns, and eye and limb movements.
By evaluating these readings, your sleep specialists can determine if you have sleep apnea. [3]
Treating Sleep Apnea
There are numerous effective ways to treat sleep apnea. Whether you opt for continuous positive airway pressure (CPAP), oral devices, lifestyle changes, or even surgery, your healthcare provider will likely recommend a follow-up sleep study to ensure that your sleep apnea is effectively managed by the treatment.
Breathing Devices
Getting a good night's rest can be challenging when you have sleep apnea. Thankfully, there are effective breathing devices that can help keep your airway open while you sleep.
- Continuous Positive Airway Pressure (CPAP): This provides a constant flow of air pressure through a mask that covers your nose, or nose and mouth. The steady pressure prevents your airway from collapsing. CPAP is often the first recommended treatment because it's effective at preventing apnea events through the night.
- Auto-Adjusting Positive Airway Pressure (APAP): APAP machines are like CPAPs but automatically adjust the air pressure to meet your needs. The pressure changes are based on the airflow limitations detected. APAPs can be more comfortable for some people as the pressure varies to keep your airways open.
- Bilevel Positive Airway Pressure (BiPAP): This option also delivers positive airway pressure through a sleeping mask. The difference is BiPAP provides more pressure when you inhale and less when you exhale. This makes breathing feel more natural. [4]
Oral Appliances
Oral appliances may be a good option if you have mild to moderate sleep apnea. These dental devices help keep your airway open while you sleep. By preventing obstruction, they allow you to breathe easier throughout the night.
- Mandibular repositioning devices gently adjust the position of your lower jaw forward. This helps open space behind the tongue so air can flow freely.
- Tongue-retaining devices pull your tongue forward during sleep. [4]
Regardless of the device you choose, follow up with a sleep study while using your oral appliance. This allows your doctor to monitor its effectiveness and make any adjustments needed. [4]
Surgery
If PAP machines or oral devices haven't improved your symptoms, surgery may be the next step. Surgery for sleep apnea aims to open your airway so you can breathe easier during sleep. There are several surgical approaches:
- Reducing the tissue at the back of your throat
- Pulling your tongue forward
- Inserting a nerve stimulator to stimulate the nerves that open up the airway
- Removing tonsils if they’re blocking your airway [4]
Lifestyle Changes
Making a few changes to your daily habits can have a big impact on managing your sleep apnea. Small steps to improve your health will help you sleep better at night. Focus on these areas to start seeing results:
- Lose weight: Losing as little as 10% of your body weight can significantly improve sleep apnea symptoms. In fact, weight loss alone can cure sleep apnea in some cases.
- Avoid alcohol and sedatives: Try stopping all alcohol and sedative consumption at least 4 hours before you plan to sleep.
- Quit smoking: The chemicals in cigarette smoke cause inflammation and swelling in your airways, making it harder for you to breathe.
- Don’t sleep on your back: Sleeping on your side rather than your back can also minimize apnea episodes. Try using a body pillow or wedge to stay comfortably on your side throughout the night. [4]
Benefits of Treatment
Diagnosing and treating obstructive sleep apnea can lead to several health and wellness benefits. Treating sleep apnea allows your body to get the rest it needs, improving your overall health and reducing risks associated with this condition.
- Improved heart health: Studies suggest that sleep apnea therapies can lower blood pressure, decrease irregular heartbeats during sleep, and reduce the risk of heart failure.
- Lower stroke risk: Because CPAP machines lower high blood pressure, using it as prescribed can help prevent strokes.
- Lowered daytime sleepiness: About 75% of people who use sleep apnea treatments report decreased daytime sleepiness and improved alertness. Treatment gives you more energy and motivation to participate in activities.
- Improved mental health: People with untreated sleep apnea have a higher chance of depression, mood changes, and irritability. Studies show that treatment can ease depression in those with sleep apnea.
- Less snoring: Because treatment prevents your airway from closing while you sleep, the tissues in the airway are less likely to vibrate and cause snoring sounds. [5]
Conclusion
If you've recognized some of the signs and symptoms of sleep apnea in yourself or a loved one, don't ignore them. Untreated sleep apnea can lead to potentially serious health complications like high blood pressure, heart disease, diabetes, and stroke. But the good news is that the condition can be well-managed with timely medical diagnosis and proper treatment.
If you have more questions on sleep apnea, visit our dedicated sleep apnea blog for details.
The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.