Coping with Sleep Apnea: Causes and Diagnosis Explained

Sleep apnea is a sleep disorder that causes interruptions in breathing during sleep, leading to decreased sleep quality and potential daytime fatigue.

The condition can disrupt sleep patterns and cause long-term discomfort in many areas of life. Understanding sleep apnea, its types, potential underlying causes, and available treatment options can help alleviate the symptoms and manage the disorder effectively.

In the following article, we will learn all about sleep apnea. If you are ready to claim back your sleep, keep reading.

What is sleep apnea?

Sleep apnea – or sleep apnoea – is a sleep disorder that causes breathing to stop for short periods during the night.

These episodes cause oxygen deficiency, which fires a survival reflex that wakes you up and restarts your breathing. Sleep apnea can interrupt healthy sleeping patterns, decrease sleep quality significantly, and cause other problems.

Types of sleep apnea

There are two main types of sleep apnea, each with a different underlying cause.

Obstructive sleep apnea (OSA)

Obstructive sleep apnea – or OSA – happens when your airways are blocked, causing you to lose breath. The reason is usually a dysfunction in the throat or neck muscles.

Central sleep apnea (CSA)

With central sleep apnea – or CSA – your brain fails to send signals related to breathing, causing episodes of breathlessness associated with sleep apnea. CSA is less common than OSA.

Treatment-emergent CSA

A third type of sleep apnea can appear when OSA treatments lead to the development of CSA. This condition is also known as complex sleep apnea.

Sleep apnea symptoms

The main symptom of sleep apnea is a sudden stop in breathing while asleep, causing a feeling of breathlessness, followed by a brief moment of waking up and breathing returning to normal.

Not everyone experiences sleep apnea in the same way. Some remember these episodes, while others do not.

However, there are some other signs of sleep apnea that might help identify the condition.

• Waking up tired in the morning
• Excessive daytime sleepiness
• Snoring or unusual breathing patterns during the night
• Shortness of breath or choking during sleep
• Depression, anxiety, and mood changes
• Insomnia
• Sexual dysfunction
• Headaches
• Slower thinking or memory problems
• Night sweats
• Children with sleep apnea might also wet their bed or display symptoms similar to ADHD

Not everyone experiences all of these symptoms. If you experience some of the above, you might want to consult your healthcare provider, who could order a comprehensive sleep test to determine if you have sleep apnea or some other sleep disorder.

The dangers of sleep apnea

A common question when it comes to sleep apnea is: “Can sleep apnea kill you?”

While it is very unlikely that one would die because of breathing cessation, the dangers of sleep apnea are still something to be aware of.

Chronic sleep apnea can increase your risk of sudden death during sleep, especially at an older age. It can also increase the risk of developing other medical conditions, such as high blood pressure, diabetes, and heart disease.

Doctors define severe sleep apnea as having more than 30 episodes of breath cessation per hour.

Sleep apnea causes

The underlying causes of sleep apnea can vary depending on which type of the condition you have.

What causes OSA?

Obstructive sleep apnea is a result of a blockage in the airways. This usually happens due to the muscles in your throat getting relaxed. While this happens with everyone during sleep, some people have narrower airways, or their muscles become looser, causing an abnormal obstruction in the airflow.

As a result, your oxygen levels get lower, and you might wake up choking or gasping for air. Your breathing usually corrects almost instantly with one or two breaths, so you might not even remember these episodes at all.

With OSA, these sleep obstructions can happen 5-30+ times per hour, leading to restless sleep.

What causes CSA?

Central sleep apnea can have various underlying causes.

Cheyne-Stokes breathing is an abnormal pattern of quick, deep breaths followed by a long pause in breathing, potentially leading to apnea. It’s often associated with various heart conditions.

CSA can also result from something affecting your brain’s ability to control breathing. This might be due to some form of brain damage, a disease, or a side effect of medications.

The oxygen concentration of the air is lower at higher altitudes, which can also lead to CSA.

While rare, CSA can also develop as a side effect of OSA treatments using positive airway pressure therapy.

Diagnosing sleep apnea

The most reliable way to diagnose sleep apnea is an overnight polysomnography, a sleep study conducted in a specialized sleep center. Doctors monitor various parameters during the test, such as eye movements, muscle tone, blood pressure, breathing patterns, airflow, blood oxygen levels, heart rate, and brain activity. From these data points, doctors can diagnose sleep apnea and any other underlying sleep disorders you might have.

At-home sleep apnea testing kits are also available, but they don’t measure brain activity and are less reliable in diagnosing central sleep apnea.

Doctors might also use a questionnaire called STOP-Bang to diagnose obstructive sleep apnea.

Sleep apnea treatments

There is currently no known cure for sleep apnea, but various treatment methods can ease the symptoms significantly.

Positive Airway Pressure therapy

Positive airway pressure (PAP) therapy is the most effective treatment method for sleep apnea. Using a PAP machine, pressurized air is pumped into the lungs through a mask. This helps with the episodes of breathlessness associated with sleep apnea and keeps oxygen levels constant during sleep.

There are various forms of positive airway pressure therapy, like CPAP, APAP, and BiPAP, which we explain further in our PAP therapies article.

Lifestyle changes for sleep apnea

In mild cases of obstructive sleep apnea, minor lifestyle changes could help alleviate the symptoms to some extent.

• Keeping a healthy weight can lower your risk of severe OSA.
• Maintaining a strict sleep schedule and a quiet environment can promote better sleep quality.
• Sleeping on your side might provide relief for OSA. You can use special sleep apnea pillows to help with this.
• Taking sleeping pills, alcohol, and smoking can worsen your sleep apnea symptoms, so it’s best to avoid them.
• Some medications might cause sleep apnea symptoms. If you suspect that this might be the case, consult your healthcare provider about alternative medications.

Surgery for sleep apnea

Surgical approaches can help in severe cases of obstructive sleep apnea. There are several options, like tissue removal, tissue shrinkage, implants, or jaw repositioning, but doctors usually only recommend these when other treatment methods have failed.

Other treatment methods

There are some other methods that doctors might recommend on a case-to-case basis.

• Oral appliance for sleep apnea – Special mouth guards and repositioning mouthpieces can help keep your mouth in a position during sleep that doesn’t obstruct airflow.
• Orofacial therapy – Orofacial therapy strengthens the muscles in your mouth and face through various exercises. It helps by repositioning the tongue, giving a better way for airflow.

Nerve stimulators – These machines send a mild electrical current through certain nerve endings to keep some muscles in a position that helps you breathe better.