This condition is caused by narrow, obstructed, or collapsed airways in the throat, which can block your airflow and prevent you from getting enough oxygen.3
If you or a loved one have obstructive sleep apnea, you’re not alone. It is estimated that over 10% of adults and 2% to 4% of children worldwide live with this condition.
This article discusses the causes, symptoms, diagnosis, and treatment of obstructive sleep apnea. We also explore the mental health impact of this condition and some coping strategies that may be helpful.
Symptoms of Obstructive Sleep Apnea
These are some of the symptoms of obstructive sleep apnea:4
- Snoring loudly shortly after you fall asleep
- Not breathing for several seconds at a time, causing a lull in the snoring
- Making gasping or snorting noises, as you try to breathe
- Waking up at night gasping for air
- Not feeling rested when you wake up in the morning
- Feeling tired, lethargic, and drowsy during the day
- Falling asleep during the day while reading, working, watching television, eating, or having a conversation
- Feeling sleepy or falling asleep while driving
- Getting frequent headaches—especially in the morning—that are hard to treat
- Experiencing high blood pressure
A loved one you share a bed with may be the first to notice symptoms like snoring, gasping for air, and breathing interruptions.
Mental Health Impact of Obstructive Sleep Apnea
You’ve probably noticed that you’re not able to function at full capacity or in the best mood when you haven’t slept well. A 2015 study notes that sleep apnea can affect your mental health and cause you to experience symptoms such as:5
- Inability to concentrate
- Difficulty with learning
- Forgetfulness
- Irritability
- Mood changes
- Impatience
- Stress
In addition to these symptoms, sleep apnea is also linked to an increased risk of developing mental health conditions, such as:6
- Depression
- Anxiety
- Psychosis
- Schizophrenia
- Post-traumatic stress disorder
- Suicidal thoughts and behaviors
Causes of Obstructive Sleep Apnea
These are some of the potential causes of obstructive sleep apnea:7
- Genetic variations: Variations in certain genes that control important bodily functions such as breathing, inflammation, nerve conduction, craniofacial tissue development, and the sleep-wake cycle can play a role in the development of sleep apnea.
- Hereditary factors: Sleep apnea can be inherited. A person has a 50% higher risk of developing it if one of their first-degree relatives has it, as compared to the general population.
- Structural factors: Structural factors such as a narrow throat, a lower jaw that is shorter than the upper jaw, or a large tongue, collar, or neck can cause sleep apnea.4
- Obstructions: Enlarged tonsils or adenoids can obstruct your airways and restrict airflow.
- Obesity: It is estimated that 60% to 70% of people with sleep apnea are obese, making obesity a major risk factor for this condition. Excess fatty tissue around the throat can press on the airways and constrict them, while abdominal fat can restrict the lungs and prevent them from fully expanding and contracting.
- Health conditions: Certain conditions, such as hypothyroidism, polycystic ovary syndrome (PCOS), pregnancy, stroke, atrial fibrillation, congestive heart failure (CHF), and chronic obstructive pulmonary disease (COPD), are linked to an increased risk of sleep apnea.8
- Alcohol use: Alcohol use is one of the risk factors associated with sleep apnea since it can relax the muscles that help ensure your throat stays open in order for you to breathe.
Men or people who were assigned male at birth are twice as likely to have sleep apnea than women or people who were assigned female at birth—the highest prevalence of the condition is among middle-aged men.5
Diagnosing Obstructive Sleep Apnea
Diagnosing sleep apnea may involve the following steps:4
- Medical history: Your healthcare provider will inquire about your personal and family medical history.
- Physical exam: Your healthcare provider will perform a physical exam and check your head, mouth, throat, and neck.
- Sleep study: A sleep study that monitors parameters such as your breathing, oxygen levels, heart rate, and brain activity while you’re asleep can confirm the sleep apnea diagnosis. It can be performed at home or in a sleep clinic.
- Arterial blood gas test: This blood test can help check the oxygen levels in your blood.
- Heart function tests: Tests such as an electrocardiogram (ECG) and an echocardiogram can help check your heart function, since sleep apnea can affect the heart.
- Thyroid function studies: As people with sleep apnea often have hypothyroidism, your healthcare provider might recommend testing your thyroid function levels.
If the majority of your apneas (or sleep cessations) are obstructive, you will be diagnosed with OSA versus central sleep apnea (CSA). The main difference is that OSA occurs when you can’t breathe normally due to upper airway obstruction, while CSA occurs because your brain doesn’t send proper signals to the muscles that control your breathing.9
The distinction in diagnosis will allow your healthcare provider to determine the next steps for treatment.
Treating Obstructive Sleep Apnea
Treating obstructive sleep apnea is important, because if left untreated it can cause heart disease, stroke, high blood pressure, metabolic disorders, and increased risk of mortality.10 Daytime sleepiness can also lead to workplace accidents or car crashes, which can be fatal.11
Listed below are some of the treatment options for sleep apnea.4
Lifestyle Changes
Mild sleep apnea can be treated with lifestyle changes, such as:
- Losing excess weight: People who are overweight or obese see a significant improvement in their symptoms of obstructive sleep apnea upon losing 10% of their body weight.12
- Sleeping on your side: Sleeping on your back can cause soft tissue to press against your airways and block them, so it’s recommended that you sleep on your side instead.
- Avoiding alcohol and sedatives: Alcohol and sedatives (such as sleeping pills, muscle relaxants, and opioid painkillers) cause the muscles in the back of your throat to relax, which can make it harder for you to breathe while you’re asleep.
- Quitting smoking: Smoking aggravates sleep apnea by irritating your airways, causing inflammation, inducing snoring, and affecting sleep quality.13
- Using a nasal spray: A nasal spray or adhesive strip can improve airflow in your airways, making it easier for you to breathe and reducing snoring.
Breathing Devices
Devices known as positive airway pressure (PAP) machines help deliver pressurized air into your airways, which helps keep them open while you sleep. You have to wear a mask over your mouth or face while you sleep, and it is connected by a tube to a machine.
These are some of the types of breathing devices your healthcare provider may recommend, depending on your symptoms:8
- Auto-adjusting positive airway pressure (APAP) machine
- Bilevel positive airway pressure (BiPAP) machine
- Continuous positive airway pressure (CPAP) machine (this is the most common)
- Adaptive servo-ventilation (ASV) machine
Oral Appliances
Dental devices that hold your tongue or jaw forward while you sleep, so they don’t press on your airways, can help treat obstructive sleep apnea.
You will have to visit a dentist, who will take your measurements and make the appliance to your size.
Surgery
If you have severe obstructive sleep apnea that is not responding to treatment, your healthcare provider may recommend surgery to:
- Correct structural issues in your mouth or jaw
- Remove your tonsils or adenoids
- Remove any extra tissue at the back of the throat
- Make an opening in your windpipe, if the airway is blocked
- Insert an implant similar to a pacemaker that electrically stimulates your throat muscles, ensuring they remain open while you sleep
Coping With Obstructive Sleep Apnea
Being diagnosed with a serious health condition like obstructive sleep apnea that is associated with major health risks can be distressing. These are some strategies that can help you cope with the condition:
- Remember that it’s natural to feel shocked, confused, angry, or upset in these circumstances.
- Give yourself some time and space to process your emotions.
- Learn about the condition so you know what to expect.
- Accept that your lifestyle will probably have to change.
- Reach out to loved ones for support and assistance.
- Visit a mental healthcare provider if you feel unable to cope.
- Join a support group of people with obstructive sleep apnea or other sleep disorders.