Ever find yourself sleepy during the day? Then you could be one of the millions of people—just in the US alone—suffering from Obstructive Sleep Apnea, or OSA. Since this disorder affects so many people, I want to touch on the basics, in particular, the risk factors and complications.
First: WHAT IS OSA?
Obstructive sleep apnea is a sleep disorder characterized by a sudden stop or a significant decrease in airflow despite breathing. This results in recurrent drops of oxygen delivery to our lungs. OSA is associated with excessive daytime sleepiness.
Apnea is defined by the American Academy of Sleep Medicine (AASM) as the cessation of airflow for at least 10 seconds. Apnea may last for 30 seconds or even longer. The moments of reduction or absence of oxygen supply are known as apneic (app – knee – ic) episodes.
These episodes can occur hundreds of times nightly (even 1-2 times per minute in patients with severe OSA). Furthermore, it is often accompanied by wide swings in heart rate, a significant decrease in oxygen saturation, and loud and labored breathing sounds when the airway reopens.
Who is Affected by Sleep Apnea?
Sleep Disordered Breathing (such as snoring or obstructive sleep apnea) is incredibly common in the United States. The National Commission on Sleep Disorders Research estimates that it affects 7-18 million people, and prevalence increases with age. Perhaps most concerning is the fact that sleep-disordered breathing remains undiagnosed in approximately 92% of affected women and 80% of affected men.
Nocturnal Symptoms of Sleep Apnea may include:
- Snoring, usually loud, habitual, and bothersome to others (witnessed apneas often interrupt the snoring and end with a snort)
- Gasping and choking sensations that arouse the patient from sleep, though in a very low proportion relative to the number of apneas they experience
- Frequent trips to the bathroom during the night
- Insomnia or restless sleep, with patients often experiencing frequent arousals and tossing or turning during the night
Daytime Symptoms may include:
- Nonrestorative sleep (i.e., “waking up as tired as when they went to bed”)
- Morning headache
- Dry or sore throat
- Excessive daytime sleepiness that usually begins during quiet activities (such as reading, watching television); as the severity worsens, patients begin to feel sleepy during activities that generally require alertness (school, work, driving)
- Daytime fatigue/tiredness
- Cognitive deficits; memory and intellectual impairment (short-term memory, concentration)
- Decreased vigilance
- Morning confusion
- Personality and mood changes, including depression and anxiety
- Sexual dysfunction, including impotence and decreased libido
- GERD or heartburn
- Hypertension
RISK FACTORS for OSA:
- Obesity
- Central fat distribution
- Male sex
- Age
- Postmenopausal state
- Alcohol use
- Sedative use
- Smoking/Nicotine use
Other conditions associated with the development of OSA are as follows:
- Hypothyroidism
- Neurologic syndromes
- Stroke
- Family history also plays a role. Relatives of patients with Sleep Disordered Breathing (such as Obstructive Sleep Apnea) have a 2 to 4 fold increased risk of also having it.
As you can see from the risk factors listed above, half of them are controllable through our own choices. These include Obesity, Alcohol use, Sedative use, and Nicotine use. Furthermore, each of these risks will be much easier to reduce if you choose to #LiveYourValue.
IS OBSTRUCTIVE SLEEP APNEA REALLY MORE THAN JUST POOR SLEEP?
Yes! The fact is that Obstructive Sleep Apnea is a multi-system issue. The potential complications include:
- Fatigue/Drowsiness
- Depression
- Memory Loss
- Headache
- Obesity
- Impotency
- Diabetes
- Hypertension
- Peripheral Vascular Disease (hardening of the arteries)
- Cardiac Arrhythmias (irregular heart rhythms)
- Heart Attack
- Stroke
- Pulmonary (Lung) Hypertension
In conclusion, remember that Obstructive Sleep Apnea is very common is often not formally diagnosed or appropriately treated. However, out of the 8 primary risk factors that are not a consequence of our anatomy, 50% of them are under our direct control. This means that even without a formal diagnosis, we can still improve our sleep through our own choices. Finally, Obstructive Sleep Apnea CAN and DOES lead to some very real complications that will not only cause a significant decline in our physical health but consequently, dramatically impact our personal contentment. I hope this helps and remember, today and every day, live your value one choice at a time.
