Sleep Apnea Symptoms

The statistics related to obstructive sleep apnea, the more common type of apnea is alarming to say the least. Approximately 18 million American adults are affected by it and as if this was not all, of those affected, 10 million are still undiagnosed.

So long as the symptoms remain undetected and the condition undiagnosed, treatment is also delayed. Why should it be like this? Why are the symptoms of sleep apnea so difficult to catch? This is because a majority of the symptoms appear only during sleep. Thus it is usually the person sharing the same bed or room, who notices the distress that the patient is experiencing during sleep.

Before we start to discuss about the elusive symptoms, let us get a better understanding of what obstructive sleep apnea is. 

Recurrent breathing pauses, called apnea episodes are the hallmark of this condition. Such pauses accompanied by shallow breathing happen when the muscles at the back of the throat are unable to keep the airway open for free flow of air to and from the lungs. A single pause may last for 10 seconds or more and based on how serious the condition is, a patient could experience 5 to 30 such pauses in one hour.

How are the breathing pauses linked to brain function? In fact, the pauses happen when the relevant breathing muscles are incapacitated and unable to follow the commands to breathe, as sent out by the brain. Such lapse in coordination between the sender and recipient of the signals happen when there is an obstruction in the respiratory tract.

Of the three types of apnea – namely, obstructive, central and complex sleep apnea, obstructive sleep apnea happens when throat muscles collapse during sleep; central sleep apnea is a result of the brain’s inability to send out breathing signals and complex sleep apnea is a combination of these two types.

Some common sleep apnea symptoms in men and women:

The initial signs of sleep apnea in adults as noticed by the bed or room partner are:

• Loud and persistent snoring
• Restless sleep with frequent tossing and turning in bed.
• Snoring interrupted by frequent pauses when it seems that the sleeper has stopped breathing.
• Gasping and choking   

Fortunately, the patient soon notices several signs, especially when they start to interfere with his or her daily activities. The signs are:

• Pauses in breathing severely impacts quality and quantity of sleep. This causes excessive daytime lethargy and reduced energy to do daily activities.
• Quick and unexplained weight gain. The chronic sleep disturbance eventually impacts the functioning of two important appetite-related hormones – Grehlin and Leptin. This in turn makes the patient indulge in irrational eating which makes him or her put on excess weight.
• Sore throat, headaches and dry mouth in the morning.
• Irritability and depression
• Forgetfulness, problems with concentration – after-effects of severe sleep disturbance.

What are the sleep apnea symptoms in children?

Though sleep apnea can affect anyone no matter what age and gender, as far as children are concerned, approximately 1 to 10% children get affected. Most of these children are between 2 and 8 years old.

The signs that children show are: 

What are the causes in children?

• Adenotonsillar hypertrophy, neuromuscular disease, and craniofacial abnormalities.
• Facial deformities like smaller jaw, smaller opening at the back of the throat
• Enlarged tonsils or adenoids, large tongue or tissues partially blocking the airway
• Deviated septum causing nasal blockage

What are the consequences of sleep apnea in children?

Sleep apnea in children can quickly become life-threatening if not treated on time. when the condition remains undiagnosed it could lead to:

Sleep apnea symptoms in men and women: are they same?

Many symptoms are similar. These include snoring, gasping and choking, pauses in breathing, interrupted sleep, etc. However, a study revealed that close to 50% of women do not report these to the doctor; instead, they report non-specific complaints like sleeplessness, depression, lethargy, tiredness, headaches in the morning, etc. This makes it tough for the treating doctor to diagnose and treat women for sleep apnea. In fact, the cases are either misdiagnosed or not diagnosed at all, though close to 90% women may be suffering from moderate to severe apnea. 

It is also to be noted that symptoms as experienced by women are more subtle and likely to be REM related and differ from the typical clinical symptoms of the condition.

 How prevalent is sleep apnea in women?

Though at one point in time it was thought that sleep apnea affected more men than women, recent research on the subject of prevalence shows that the current ratio of men to women is 2:1. 18 million Americans suffer from this condition; this includes one in four women over the age of 65. 

What are the risk factors for women for developing the symptoms?

What are the risk factors for men?

• Neck size more than 17 inches
• Reduction of space in front of the mouth caused by receding chin
• Anatomical defect including craniofacial deformities.
• Stress-induced rise in cortisol levels.

Enlightening revelations about symptoms in men:

• More than half have excess body weight
• 50% of patients also have high BP.
• Patients are usually smokers, have diabetes, and have had stroke and heart failure.
• One in four men have the disorder
• 4 to 9% of middle-aged men suffer from one of the three types of apnea.
• Men who are between 40 and 70 years of age have a 46% higher risk of death than healthy older men.
• 70% of men over 65 experience sleep apnea with an AHI (Apnea-Hypopnea Index) of at least 10.
• 4% of men between 30 and 60 years are affected by the condition.

Do the signs of sleep apnea in adults differ in terms of the type of sleep apnea?

Symptoms of different types of apnea are based on the cause of onset. While many symptoms of obstructive sleep apnea are similar to those of central sleep apnea, because cause of onset of the latter is different, symptoms are also unique. Since central sleep apnea has more to do with malfunctioning nervous system rather than obstructions in the airway, the symptoms vary according to the cause as well as the part of the nervous system that is affected by apnea. 

One of the prime differences in symptoms between the two is that patients affected with central sleep apnea hardly snore. 

While the obstructive sleep apnea symptoms have been discussed earlier, the central sleep apnea symptoms in adults are as follows:

• Tiredness
• Daytime sleepiness
• Headaches in the morning
• Restless sleep
• Swallowing problems
• Change of voice
• Numbness throughout the body

Conclusion:

It is clear from the above, that loud and persistent snoring is perhaps one of the most easily-identifiable symptoms of sleep apnea.  Therefore prevention of sleep apnea, unless it is fallout of an existing medical condition, should ideally begin with early treatment of snoring, before it worsens into another more serious sleep disorder.