Are you kept awake each night by a partner’s snoring? It’s not just an annoying habit — it could actually be sleep apnea.When we fall asleep, the muscles in our body, including our throat and airway, relax. As these muscles loosen, the airway can become narrowed or completely blocked, leading to pauses in breathing, often longer than 10 seconds at a time. Almost everyone has a brief pause in breathing during sleep, but those with obstructive sleep apnea (OSA) — the most common form of sleep apnea, which affects over 25 million Americans — have more reasons for concern. Constant pauses in breathing then leads to decreases in oxygen throughout the night.
Sleep apnea is diagnosed when there are several complete or partial cessations in breathing (aka apneas) per hour, with mild being between 5 to 15 apneas per hour, moderate at 15 to 30 apneas and severe being 30 or more. Yes, that’s right, I said per hour. Many people who have sleep apnea have no clue that they have it since they don’t hear themselves snoring at night. I like to call OSA a “silent(ish)” disease. The snoring is more often a bigger annoyance for the bed partner, with the actual snorer not knowing it’s even happening.
Although being overweight increases your risk of developing OSA, you needn’t necessarily be overweight. The most common risk factors include being a male, over 40 years old, having a large neck, gastroesophageal reflux, allergies, sinus problems or a deviated septum. The snoring in people with OSA is caused by air trying to squeeze through a narrowed airway. The most common symptoms of obstructive sleep apnea include loud snoring, excessive daytime sleepiness, stops/pauses in breathing, waking up in the morning with a headache or dry mouth, heartburn, using the bathroom a lot at night and trouble staying asleep.
Think about it: if your sleep is being disrupted even five times an hour on average throughout the night due to pauses or cessations in breathing, your body isn’t getting the necessary oxygen it needs on a consistent nightly basis. On top of that, you aren’t having continuous, restorative sleep, which can have multiple consequences including, but not limited to: problems with memory, motor control, energy, mood, attention and concentration.
The current gold standard treatment for obstructive sleep apnea is continuous positive airway pressure, or CPAP—a small machine that sits on the bedside table. Attached to the CPAP base machine is a hose and mask, which the patient wears while sleeping. CPAP gently blows air through the hose, keeping the airway open when the patient falls asleep and the muscles relax. Essentially, it works as a splint for the airway, keeping it open through the use of blowing air; in many patients, it dramatically reduces the number of apneas throughout the night.
A 2014 study in the journal Sleep investigated changes in the brain’s structures before and after CPAP treatment, hypothesizing that effective treatment for obstructive sleep apnea improved cognitive functioning and brain structures over time. The researchers investigated 17 never-before-treated obstructive sleep apnea patients and compared them to healthy matched control participants.
They looked at the integrity of the brain’s white matter using diffusion tensor imaging and measured cognitive performance using neuropsychological testing. Obstructive sleep apnea patients in the treatment group were immediately started on CPAP and were evaluated before treatment, three months into treatment and 12 months into treatment. The results were quite striking: with 12 months of regular CPAP use, an “almost complete reversal” of white matter abnormalities was observed in patients, with significant improvements in memory, executive-functioning and attention.
This study is just one of many over the past two decades to demonstrate the significant impact that obstructive sleep apnea has on both the mind and body. Effective treatment of obstructive sleep apnea is crucial for health and can lead to many vast improvements when the proper treatment is applied over time.
If you think you—or someone you sleep with!—has sleep apnea, consider scheduling an evaluation with a sleep medicine specialist. Early recognition and treatment can help improve your overall quality of life.