Snoring is indeed annoying in most cases and often the trigger for insomnia in the bed neighbor. But as a rule, the nocturnal sounds are harmless. Sometimes, however, a loud snore is followed by sudden silence that leaves the previously annoyed partner listening anxiously to see if the snorer is still breathing at all. Then a gasping, loud inhalation – and the whole thing starts all over again. If it comes to such nocturnal breath interruptions, one speaks of a sleep apnea. Sleep apnea increases the risk of numerous diseases. In the following, you will learn about the dangers of sleep apnea, the symptoms and diagnosis, and the treatment options available.
What is sleep apnea?
The name sleep apnea or sleep apnea syndrome describes brief pauses in breathing that occur during sleep. There can be several causes for this. Depending on the underlying cause, there are two types of sleep apnea:
- The most common type is obstructive sleep apnea (OSA): here, sleep apnea syndrome occurs due to blocked airways.
- In the rare central sleep apnea (ZSA), the cause of the breathing disorder is in the central nervous system. Despite open airways, breathing is not sufficiently controlled here – for example, genetically caused by neurological damage due to a disease or stroke.
If more than five such breathing pauses occur per hour, which also last more than ten seconds, it is called sleep apnea. On the breathing stops can also be traced back to the meaning of the word sleep apnea: “apnea” comes from the Greek and means “wind stillness”.
Causes of obstructive sleep apnea
Obstructive sleep apnea is often (but not always) accompanied by snoring. As a result of the mouth and throat muscles becoming slack during sleep, the tongue falls back and partially or completely closes the posterior palate, and thus the upper airway. The effort to take a breath through the narrowed airways leads to the typical nocturnal sounds. This can have serious consequences: During snoring, fewer transmitter substances are released that are needed to drive breathing. As a result, breathing stops – for up to two minutes and up to 400 times per night. Only when the carbon dioxide concentration in the blood rises does the brain intensify its brainwaves, stimulating the respiratory center to resume its activity. This results in an endogenous wake-up reaction (arousal), which often manifests itself as a particularly loud inhalation, but is usually not noticed or remembered by the affected person.
Obstructive sleep apnea: symptoms
Obstructive sleep apnea is often difficult to recognize for affected persons themselves. Possible symptoms of sleep apnea are:
- (Loud) snoring, although this symptom is often absent in women
- Short pauses in breathing
- Clear gasping for air or inhalation following the breathing stops
- Frequent awakenings (including to go to the bathroom)
- Shortness of breath and palpitations upon awakening
- Night sweats
- Shallow breathing (hypopnea)
Often, these signs are not noticed by sufferers themselves, as they do not remember the nighttime symptoms in the morning. Therefore, it is often the partners who alert sufferers to the symptoms. In addition, the constant interruption of sleep and the recurring lack of oxygen as a result of interrupted breathing also have an impact on how people feel during the day. This is because people with sleep apnea are unable to fall into the deep sleep phase, which is important for recovery, and therefore often feel as if they are exhausted during the day. The resulting symptoms can therefore provide further important clues to the presence of sleep apnea.
Consequences for everyday life
The impaired sleep quality caused by sleep apnea leads to numerous health consequences, so that the symptoms of sleep apnea also occur during the day. These include, for example:
- Chronic daytime sleepiness
- Morning headache
- Decreased performance and difficulty concentrating
- Irritability and aggressiveness
- Depressive moods or depression
- Momentary nodding off (microsleep)
- Impotence
Sufferers are less resilient and not a few of the accidents caused by microsleep are due to nocturnal apnea.
What are the risks of sleep apnea?
The pauses in breathing during sleep last up to two minutes and are quite stressful for the body:
- The oxygen content of the blood decreases
- Stress hormones are released
- Blood pressure rises
- It comes not infrequently to cardiac arrhythmias
High blood pressure affects about half of sleep apnea sufferers; they are therefore at significantly increased risk of heart attacks and strokes. Conversely, a sleep-related breathing disorder such as sleep apnea can be found in about 60 percent of all stroke patients. Sleep apnea is therefore a potentially life-threatening condition. In addition to the increased risk of cardiovascular disease, it also increases the risk of developing depression or type 2 diabetes. In addition, the quality of life of those affected is reduced. In addition, microsleep can lead to dangers in road traffic. Test: Do you suffer from obstructive sleep apnea?
Risk groups: Who is particularly at risk
Men in particular are often affected by obstructive sleep apnea; in women, the syndrome usually occurs after menopause. In both sexes, the risk increases with age, but children can also be affected. People who are overweight also belong to the risk group. In addition, smoking, taking sleeping pills, and consuming alcohol or drugs before bedtime can promote the occurrence of sleep apnea. Similarly, sleeping on one’s back is considered a factor that increases the risk of OSA. Also at particular risk are:
- Snorers
- Diabetics (especially type 2 diabetes)
- Overweight children
Why this is so, we explain below.
Snorers: increased risk
About half of Germans snore. Experts believe that about four percent of adults in this country suffer from sleep apnea and are thus exposed to serious health risks. Snorers are up to 10 times more likely to suffer strokes than “non-snorers,” and sleep apnea patients have a greatly increased risk of cardiovascular disease. Presumably, many strokes and heart attacks would be preventable with early diagnosis and treatment.
Diabetes and sleep apnea
Diabetes and sleep apnea are a dangerous duo: both increase the risk of stroke and heart attack, and in combination, the risk of secondary diseases is significantly greater. Men and people who are overweight are particularly at risk for sleep apnea and diabetes. Diabetics who have their sleep apnea treated are also more adjustable.
Overweight children
Overweight children often suffer from sleep apnea, a Royal London Hospital study also showed. Sleep apnea can significantly affect children’s academic performance. The health consequences enormously complicate the daily lives of affected children, such as chronic daytime sleepiness, headaches and irritability. Persistent poor sleep leads to an overall loss of zest for life.
Diagnosis: How is sleep apnea diagnosed?
If sleep apnea is suspected, a doctor should be consulted. because proper sleep apnea diagnosis is critical to selecting treatment. If you or your partner suspect that you suffer from sleep apnea, first talk to your family doctor, he may still refer you to an ear, nose and throat or lung specialist. Initially, a preliminary outpatient diagnosis can be made. For this purpose, you will be given a small portable measuring device that you attach to your body with several measuring points before going to bed, as instructed. The device records the pulse and snoring sounds, for example. If the measured values confirm the suspicion of sleep apnea, the final diagnosis is made in a sleep medicine center (“sleep laboratory”). There, the severity of sleep apnea is also determined.
What to do about sleep apnea? 4 tips!
First, implement the various ways to prevent snoring itself. How to improve snoring:
- Often already a weight loss shows a measurable success: in a Finnish study snored after a weight loss a quarter of the patients no longer at all.
- Refrain from a late dinner, as well as alcohol and smoking before bedtime; as well as sedatives, sleeping pills and antihistamines (allergy drugs) – these relax the muscles and thus also those in the mouth and throat.
- As for all other sleep problems, the same applies here: Follow the rules for good sleep hygiene – provide a quiet environment, ventilate your bedroom sufficiently, maintain regular sleep patterns.
- Sleep with your upper body elevated and avoid the supine position (tip: have a tennis ball sewn into the back of your pajamas).
What therapies are available?
In central sleep apnea, the underlying disease should always be treated. However, in obstructive sleep apnea, therapeutic measures aim to keep the airways clear. A special mask can be used to treat obstructive sleep apnea, but surgery is also a possible option for treating the nocturnal breathing cessations. Learn more about the options for treating obstructive sleep apnea below.
Aids from the medical supply store
In the medical supply store you can get various aids against snoring, for example, a sleep vest, chin bandage, bite splint, nose plaster or clip – get advice. These aids work in different ways. For example, the mandibular advancement splint (also known as an anti-snoring splint) moves the tongue forward and can be used in mild to moderate cases. Whether it is suitable in individual cases depends mainly on the condition of the teeth.
Sleep apnea: treatment by CPAP mask.
If the snoring does not improve and there is actually sleep apnea, you should have it treated: very good success can be achieved with respiratory therapy devices. Above all “nasal overpressure devices” are used, with which oxygen-rich air is conveyed by means of overpressure into the airways during the sleep over a respiratory mask (connected with the therapy device). The airways are thus “splinted” from the inside, i.e. they do not collapse as a result of the flaccid muscles, but remain open. These masks are called nCPAP therapy or nasal CPAP therapy (CPAP: Continuous Positive Airway Pressure). The applied pressure of the sleep mask is determined individually for each patient. The device is prescribed by the physician. However, the CPAP mask takes some getting used to, as some sufferers find it disturbing and uncomfortable. As a result, sufferers often seek alternatives and prefer treatment without a mask.
Sleep apnea: surgery can help
There are several surgical therapies that can be used to treat sleep apnea. These surgeries are basically divided into two types:
- Inpatient surgery
- Outpatient surgery
As a rule, the operations involve the removal of parts of tissue in the mouth and throat to facilitate breathing. How effective the procedure is and how long an improvement from surgery lasts depends on the surgical method and the individual circumstances of the patient.
Tongue pacemaker for sleep apnea
There is also the option of implanting a so-called tongue pacemaker, which keeps the airways clear by stimulating the tongue muscles at night. This method achieved good results in studies and is therefore considered an alternative to the CPAP mask when people with sleep apnea cannot cope with this device.
