Does Everybody Have Sleep Apnea? It’s Complicated


Does Everyone have Sleep Apnea

It is more than likely that you can name at least one or two people who claim to have sleep apnea. It seems like everyone has it, right? What causes it? What are the symptoms? Is it really as common as it seems?

Does everybody have sleep apnea? No, not everyone has sleep apnea; however, it is more common than people think. It turns out you might not know you have it; that’s where it gets complicated. 

Maybe you suspect you, your partner, or a member of your family has sleep apnea. Read on to learn essential facts you need to know, from risk factors to symptoms and even treatments and lifestyle changes that may help.

What is Sleep Apnea?

Sleep apnea is a sleeping disorder that affects the airways and breathing. The term comes from the Greek word “apnea,” which means “without breath.”  

When suffering from sleep apnea, the airways become relaxed and narrowed during sleep, this causes episodes where breathing stops. Each time your breathing restarts, you may choke, snort, gasp, or snore loudly. This will more than likely wake you or your partner. When a person with sleep apnea stops breathing, they can stop breathing for 30 seconds at a time. This can happen up to 400 times in one night.

Often people who suffer from sleep apnea wake up and need to use the bathroom. They think this is the reason they woke up when they actually probably realized their bladder was full when waking from a sleep apnea episode.

Partners of people with sleep apnea often describe it as insufferable, they struggle to sleep as their partner is noisy, waking often, and sometimes their breathing worries them and keeps them up. Couples who usually sleep next to each other have been known to sleep in another bedroom or even different floors in the house to get some rest.

Many factors can cause sleep apnea, but it is mostly linked to obesity and getting older. Results can vary from daytime sleepiness to severe medical issues if untreated. Sleep apnea tends to appear in men more than women and usually starts around 50-60 years old. The sleep disorder seems to affect African-American and Hispanic men more often, as well.

Symptoms of Sleep Apnea

The signs and symptoms of both types of sleep apnea overlap. It takes a diagnosis from a doctor to determine which type of sleep apnea you suffer from. If you are suffering from symptoms of sleep apnea, it is essential to visit the doctor and get an appointment with a sleep specialist.

Here are just some of the symptoms that may point to sleep apnea: 

  • Loud snoring 
  • Gasping for air during sleeping
  • Making choking sounds in your sleep
  • Stopping breathing for short periods
  • Waking up with a dry mouth and sometimes a dry, sore throat
  • Waking up often in the night
  • Excessive daytime fatigue (hypersomnia)
  • Irritability, short temper, and moodiness
  • Forgetfulness
  • A decrease in sex drive
  • Difficulty paying attention, focusing can become difficult. In children, this can affect their school work and performance in school
  • Headache in the morning

Types of Sleep Apnea and Who Is At Risk?

Although some risk factors overlap on the different types of sleep apnea, some differ. The more of these risk factors you have, the more likely it is that you have or will develop sleep apnea.

Here are the risk factors for the two types of sleep apnea: obstructive sleep apnea and central sleep apnea.

Obstructive Sleep Apnea

Obstructive sleep apnea is when the airways narrow, obstructing breathing. This is caused by the muscles in the throat relaxing. Obstructive sleep apnea is the most common type of sleep apnea. Factors that contribute to the risk of you having obstructive sleep apnea are:

  • Genetic – Believe it or not, sleep apnea is often hereditary. Sometimes people are born with wider necks or smaller jaws. This contributes to having narrower airways, another cause of genetics.
  • Overweight/obesity – If you struggle with obesity, your chances are much higher. Fat causes the airways to narrow, thus making it harder to breathe
  • Male – Gender plays a role in the likelihood of you having sleep apnea. Men are more likely to get it than females.
  • Older age Puts you more at risk, especially if you’re over 40.
  • Large tonsils 
  • Allergies
  • Use of alcohol sedatives or tranquilizers – Relaxes muscles in the throat
  • Smoking – If you smoke, you are three times more likely to have sleep apnea. Smoking increases inflammation and fluid retention in the upper airway
  • Prior diagnosis of GERD (gastroesophageal reflux)
  • Prior diagnosis of a deviated septum or nasal issues – A deviated septum is a common reason as to why someone may have sleep apnea. A deviated septum is when the cartilage in between the nostrils is crooked or off-balance, this causes breathing problems. If this is the cause of your sleep apnea, surgery can fix it.

Central Sleep Apnea

Central sleep apnea develops when there is a problem with the signals the brain sends to the muscles that control breathing. They sometimes may stop all signals or send the wrong signals for short periods. Here are some risk factors that can contribute to the development of central sleep apnea:

  • Over 40
  • Being male – Men tend to have a larger but more collapsible airway than women; this is believed to be the cause.
  • Narcotics/pain medication – Opioids and methadone are just some. Other medications that may cause sleep apnea are antihistamines, antidepressants, sleeping medications, and medicines with muscle relaxants.
  • Heart disorders If you have congestive heart failure, you have an increased risk of sleep apnea.
  • Stroke – If you have ever had a stroke, your chances of sleep apnea are higher.

Complex Sleep Apnea Syndrome

This specific type of sleep apnea is when a person has both obstructive sleep apnea and central sleep apnea.  This can be caused by any of the risks mentioned above. It can also be caused by constant treatment for obstructive sleep apnea. 

For instance, when somebody uses the CPAP machine (treatment for obstructive sleep apnea) for a prolonged time, it can cause them to develop central sleep apnea, too.

How Common is Sleep Apnea? 

Over 100 million people are diagnosed with sleep apnea worldwide. In America alone, 22 million have a moderate to severe case of sleep apnea, often resulting in some form of surgery. However, according to studies, 80-90% of people have sleep apnea and never know; therefore, they are not diagnosed (Source: American Sleep Apnea Association). 

50-70 million American adults have a sleep disorder; sleep apnea is the most prevalent. Gender also plays a role in how likely you are to have sleep apnea. When it comes to severity, 4% of people have obstructive sleep apnea severe enough to have surgery. 

Can You Have Sleep Apnea if You’re Slim?

Sleep disorders don’t discriminate. You can have sleep apnea if you’re slim. Although your chances of having sleep apnea are higher if you’re overweight, you can also have a sleep disorder and be slim. However, more than half of people with sleep apnea are obese. 

However, anyone of any age, including children, can get sleep apnea, regardless of weight.

Could You Have Sleep Apnea and Not Know?

According to the National Institute of Health (NIH), up to 90% of the people with sleep apnea don’t know they have it. Unless you have a partner that sleeps beside you, it’s almost impossible to know your symptoms if they’re mild. 

Usually, people get a diagnosis because their partners witness their symptoms. Otherwise, the only symptom they could usually go off would be tiredness. Sleep apnea seems to be extremely common; however, the symptoms can be so broad, it can often be overlooked.

Complications

If you suspect you have sleep apnea, it is vital to be seen by a doctor. Usually, sleep apnea is so mild you don’t know you have it; however, sometimes sleep apnea can cause problems later down the line or cause complications. Never take sleep disorders lightly.

Some complications of sleep apnea are listed below.

  • Extreme daytime fatigue – This tends to happen because of repeatedly waking up in the night. Fatigue in the daytime can affect your mental health. You can become depressed, moody, and quick-tempered. It can become difficult to pay attention and cause poor performance at work or school.
  • Type 2 diabetes – With sleep apnea, you have an increased risk of type 2 diabetes and insulin resistance. 
  • High blood pressure (hypertension) – Sleep apnea causes sudden drops in blood oxygen; this increases blood pressure. 
  • Heart complications – Increased blood pressure causes stress on the cardiovascular system. This results in an increased risk of stroke, atrial fibrillation, and heart attack. If you already have some form of heart disease, episodes of low blood oxygen can lead to an irregular heartbeat that results in sudden death. 
  • Complications with surgeries and medications – With sleep apnea, there is a concern with anesthesia. Before surgery, make sure you speak to your doctor about your sleep apnea.
  • Metabolic Syndrome – This is linked to heart disease; it causes high blood pressure, high blood sugar, and increased weight circumference.
  • Liver problems – Likely to show scarring (non-alcoholic fatty liver disease)
  • Sleep-deprived partners – If you have a partner and you are struggling with sleep apnea, your partner may become sleep deprived, whether it’s from your constant waking or snoring.  Some partners of sleep apnea patients sleep in separate rooms.

Can it Be Fatal?

In short, yes, sleep apnea can kill you if it is severe and untreated. As mentioned earlier, the disorder can lead to high blood pressure (hypertension), stroke, heart attack, heart arrhythmias, which can all be fatal.

Sleep apnea can also contribute to death in other ways. When someone is overly sleepy in the day, it can lead to accidents. Studies show that people who have sleep apnea are 2.5 times more likely to be behind the wheel in a car accident (Source: American Academy of Sleep Medicine).

Sleep apnea and other sleep disorders have been known to cause mood changes, depression, and a decline in mental health. The National Institute of Health did a study that finds significant links between suicide and insomnia (Source: National Institute of Health). They found lack of sleep can cause depression and other mental health issues, which can result in suicidal thoughts and, ultimately, death by suicide.

Diagnosis

To be diagnosed with any sleep disorder, a specialist will need to do a sleep study. If you suspect you have sleep apnea, a doctor will probably refer you to a sleep specialist who will carry out a polysomnogram (also known as PSG.) A polysomnogram is used in a sleep study and as a diagnostic tool in sleep medicine.

The sleep study is performed overnight, and the patient is watched continuously by a technologist. The test measures the following:

  • blood oxygen levels
  • breathing
  • REM sleep
  • eye movement
  • brain activity
  • heart rhythm

For a diagnosis of sleep apnea, patients must have at least five episodes per hour under sleep study.

Sleeping Positions

Different sleeping positions can affect your sleep apnea. Some make it better and some worse.

  • Back – Sleeping on your back is the worst sleeping position for sleep apnea as the jaw, tongue, and soft palette are drawn back towards the throat by gravity, and this obstructs breathing and narrows airways.
  • Stomach – Sleeping on your stomach is not suitable for sleep apnea sufferers, either. Although your tongue and soft palette are drawn forward, your breathing is now obstructed by your pillow. Your nose and mouth will be blocked or impaired by the pillow, or your neck is twisted to breathe better but obstructs your throat.
  • Side – The best position to sleep in if you suffer from sleep apnea is to sleep on your side. In this position, your airways are less likely to restrict air, so your breathing becomes more stable. To successfully get a good night’s sleep in this position, it may be beneficial to purchase a memory foam pillow to support your neck. 

There are many memory foam pillows on the market for side sleeping that are very effective. Some of the best-rated pillows are The Leesa Hybrid Pillow, Xtreme Comforts Bamboo Memory Foam Pillow, and Nest Bedding Easy Breather Pillow. All of these pillows come highly rated and highly recommended. 

Sleep Apnea in Children

Pediatric obstructive sleep apnea is the term for sleep apnea in children. When this sleep disorder is found in children, it is usually caused by enlarged adenoids or tonsils.

Symptoms in children are usually similar to sleep apnea in adults. However, there are a few more signs a child may be suffering from sleep apnea, such as:

  • Bedwetting
  • Mouth breathing
  • Sleep terrors
  • Hyperactivity
  • Poor performance at school
  • Behavioral problems
  • Learning problems
  • Poor weight gain

There are also other risk factors in children that are not common risks in adults. These risks are:

  • History of low birth weight
  • Sickle cell disease
  • Cerebral palsy
  • Down syndrome
  • Abnormalities in the skull or face

Pediatric obstructive sleep apnea can have severe complications, including:

  • Heart problems
  • Failure to grow
  • Death

Is There A Cure?

Depending on your type of sleep apnea and reason, there may be a cure. This usually comes in the form of surgery to correct whatever is causing the obstruction. However, most cases are managed with lifestyle changes or treatments.

At-home treatments and lifestyle changes may consist of:

  • Avoiding alcohol
  • Losing weight/maintaining a healthy weight
  • Avoiding smoking
  • Yoga – Breathing techniques that are practiced in yoga are known to assist in managing the illness. There are specific yoga poses that, if practiced, can help. The breathing exercises tone and strengthens airways, benefiting the person with sleep apnea. Some of those poses are the cat-cow, the seated twist, and the seated forward bend. Yoga also helps to calm the mind and therefore aids better sleep.
  • Altering your sleeping position may be extremely beneficial
  • Using a humidifier – A humidifier could be beneficial to help give you better breathing and clear any congestion problems you may have. There are a few humidifiers we would recommend.  They are Homech Cool Mist Humidifier, TaoTronics Cool Mist Humidifier, and GENIANI Cool Mist Humidifier.

There are some treatments your doctor or a sleep specialist may give you, depending on the severity of your case; they are:

  • CPAP Machine – This is the most common treatment given. This machine pumps air into a mask that you wear in bed. This improves your breathing while you are asleep and stops your airways from becoming too narrow. With this machine, people say their sleep quality is significantly improved, and they feel less tired. This machine is excellent for reducing the risk of high blood pressure (hypertension). This will put the person wearing it at a lesser risk of heart complications caused by sleep apnea.
  • Surgery – This is to remove obstructions or problems that cause your sleep apnea and to help to breathe. People may have their tonsils removed during surgery. This is a less common treatment but is still valid.
  • Gum shield device – This device holds the patient’s airways open while they sleep, stopping obstruction. This is also a less frequent treatment.

Final Thoughts

Overall, it’s evident that sleep apnea is a widespread sleep disorder. However, although it may seem like everyone has it, they don’t. It is always important to always seek advice from a doctor if you think you may have sleep apnea. 

Sources:

https://www.nhs.uk/conditions/sleep-apnoea/

https://www.webmd.com/sleep-disorders/sleep-apnea/sleep-apnea

https://www.mayoclinic.org/diseases-conditions/obstructive-sleep-apnea/symptoms-causes/syc-20352090

https://www.menshealth.com/health/a19532060/sleep-apnea-could-be-killing-you/

https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/obstructive-sleep-apnoea

 

Dan

Dan was diagnosed with sleep apnea in 2017 when he was only 32 years old. He has been using a BIPAP machine for his treatment. He hopes to provide a patient's perspective on the sleep apnea experience. Dan lives in Tampa with his girlfriend and 2 dogs.

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