Could sleep apnea be taking years off your life?

Obstructive sleep apnea (OSA) is a condition characterized by heavy snoring and waking up repeatedly during the night. During each episode, breathing stops momentarily.

Sleep apnea typically results in poor sleep at night and daytime drowsiness. When it’s left untreated, it increases the risk for a host of chronic illnesses, including high blood pressure, stroke, irregular heartbeat, and heart failure. These may, in turn, contribute to a shorter life expectancy. In fact, research has shown that moderate and severe sleep apnea are associated with an increased risk of premature death.

What is sleep apnea exactly?

When you sleep, the throat muscles typically used for speaking, breathing, and swallowing relax and the throat becomes narrower. If you already have a narrow throat, these relaxed muscles may partially or completely block the airway. Enlarged tonsils, a small mouth, large tongue, and obesity might compound the problem.

If the blockage is severe enough to stop breathing or reduce the ability to breathe, you’ll move from a deep sleep into a light sleep. You’ll often start breathing again with a loud snore and you may wake up choking. In the most severe cases of sleep apnea, this may happen up to 30 times per hour.

Why sleep apnea is dangerous

In addition to interfering with quality sleep, sleep apnea places stress on the body and reduces the amount of oxygen the body receives. As a result, it raises your risk of many other conditions, including:

• Cardiovascular disease, such as high blood pressure, heart attack, stroke, heart failure, and irregular heart rhythm
• Type 2 diabetes
• Asthma
• Eye problems, including glaucoma and dry eye
• Chronic kidney disease
• Cancers, including pancreatic, kidney, and skin cancer

You’re most at risk for sleep apnea if you’re male, overweight or obese, ages 40 or older, or if you smoke or drink alcohol. People who have a family history of sleep apnea also have a higher risk of developing the condition, as do people who have heart failure or kidney failure.

Physical traits may also play a role, as people with large tonsils, large tongues, and large necks are at increased risk. These factors lead to narrowing of the upper airways.

Warning signs of sleep apnea

About 30 million adults in the United States are thought to have sleep apnea, but many don’t know they have it. In fact, as many as 9 in 10 people with the condition are undiagnosed, according to some research.

Often, a spouse or partner will signal a problem if a person is snoring loudly and/or gasping for breath in the middle of the night. A person may be able to look for clues on their own, however. Snoring and daytime fatigue are two of the main signs. Others include:

• Headache upon waking
• Depression and irritability
• Frequent urination at night
• Dry mouth or sore throat upon waking
• Decreased libido or sexual dysfunction

How sleep apnea is diagnosed

The first step is to see a healthcare provider (HCP). They will take a medical history and may do a physical examination, looking for a large uvula (the fleshy structure that hangs down at the back of the mouth just before the throat), soft palate, or tonsils that may be obstructing the flow of air.

A sleep study is typically the best way to diagnose sleep apnea. Sensors at a sleep study center record the amount of oxygen in the blood, air movement while you breathe, brain waves, chest movements, and heart rate. Home sleep studies using monitors are available, as well, and may be appropriate for some people.

When the study is finished, an HCP reviews the results to determine how many times breathing stopped or was blocked. Having 5 to 15 of these breathing events per hour indicates mild sleep apnea, between 15 and 30 signals moderate sleep apnea, and having more than 30 breathing stoppages per hour is severe.

How sleep apnea is treated

People with sleep apnea have several options for treatment. For mild cases, lifestyle changes—such as weight loss, smoking cessation, and avoidance of drugs and alcohol—may help reduce symptoms. Sleeping on your side and keeping nasal passages clear might help, too.

Another option for mild sleep apnea is a mouthpiece that pulls the jaw forward and keeps the tongue from blocking airflow down the throat. A dentist or orthodontist can provide this device.

A continuous positive airway pressure (CPAP) machine is the most common treatment for moderate to severe sleep apnea. A CPAP machine forces air through your nostrils and mouth to keep airways open while you sleep. The machine has interchangeable masks, from full-face to low-profile nose pillows that sit over the nostrils. It may take some experimenting to find the one that’s right for you. Tell your HCP if you find the CPAP machine uncomfortable, or if there are side effects like dry mouth or headaches.

Surgery is often a last resort, if a person can’t or doesn’t want to wear a CPAP machine. It may involve resetting the lower jaw, shaving off parts of the uvula or soft palette, removing tonsils or adenoids, or some combination of these measures.

One newer remedy that has shown promise in research is hypoglossal nerve stimulation therapy. Rather than surgically adjusting the airway, a small device is implanted under the skin beneath the collarbone, with a wire leading to the hypoglossal nerve of the tongue. With each breath, it sends an electrical signal to stiffen the tongue and prevent it from falling backward and blocking the airway.