Dr.Sumit Chattopadhyay

Breathless Nights: A Deep Dive into Sleep Apnea


Sleep apnea is a serious sleep disorder that causes breathing to stop repeatedly during sleep.  

You might have sleep apnea if you have loud snoring or feel tired even after a whole night’s sleep. 

Sleep apnea can affect anyone but is most common in older men who are overweight or obese. 

If left untreated, sleep apnea can cause severe health problems, including hypertension, stroke, cardiomyopathy (enlargement of heart muscle tissue), heart failure, diabetes, and heart attacks. 

Untreated sleep apnea can also disturb the lifestyle, leading to job impairment, motor vehicle accidents, and more. 

3 Types of Sleep Apnea 

Obstructive Sleep Apnea: It is the most common type of sleep apnea in which the airways repeatedly become completely or partially blocked. This makes you breathe with loud gasps or jerk your body affecting your sleep, lowering oxygen flow to the vital organs, and leading to abnormal heart rhythms. 

Central sleep apnea: In this type, your brain cannot signal your muscles to breathe due to issues in your respiratory control center (central nervous system). This often happens in people with neuromuscular diseases and other heart, kidney, or lung diseases. 

Complex sleep apnea syndrome: It is considered treatment-emergent central sleep apnea, which happens when you have both obstructive and central sleep apnea. 

Sleep Apnea Symptoms 

A person with sleep apnea is unaware of their symptoms, but another person may notice these symptoms- 

  • Stops breathing for a while 
  • Noisy breath 
  • Gasping for air 
  • Loud snoring 

The individual may experience- 

  • Fatigue 
  • Insomnia or restless sleep 
  • Difficulty concentrating 
  • Waking up at night to urinate 
  • Headache and irritability due to lack of sleep 
  • Awakening with sore throat or dry mouth 
  • Night sweats 

Sleep Apnea Causes 

Sleep apnea occurs in 25% of men and 10% of women. It can affect people of all ages, but more in people over 50 and overweight. 

Some clinical and physical features common in patients with sleep apnea include-  

  • Being overweight 
  • Having a large neck 
  • Low-hanging soft palate 
  • Nasal obstruction 
  • Enlarged tonsils 
  • Small jaw with an overbite 

Risk Factors of Sleep Apnea 

  • Overweight/Obesity: Fat deposits around your upper airway can obstruct breathing. 
  • Neck circumference: People with thicker necks tend to have narrow airways. 
  • Narrowed airway: Inherited tonsils or adenoids can also enlarge and block the airway, especially in children. 
  • Sex: Men are 2-3 times more likely to develop sleep apnea than women. 
  • Being older: Sleep apnea occurs more often in older adults. 
  • Family history: Family members with a history of sleep apnea increase your risk. 
  • Smoking: Smoking increases the risk of sleep apnea 3 times more. 
  • Use of alcohol and sedatives: These substances relax the muscles in your throat and worsen sleep apnea. 
  • Nasal congestion: People with difficulty breathing through the nose are more likely to develop sleep apnea. 
  • Other medical conditions: Heart failure, hypertension, type 2 diabetes, and Parkinson’s disease. Polycystic ovary syndrome (PCOD), hormonal disorders, stroke, and chronic lung diseases can also increase risk of sleep apnea. 

Exams and Tests for Diagnosing Sleep Apnea 

The doctor will check your mouth, neck, and throat and ask about your daytime sleepiness, how well you sleep, and other bedtime habits. 

You will require a sleep study to confirm the diagnosis. This testing can be done at home or in a sleep lab. 

Other tests  

  • Arterial blood gases 
  • Electrocardiogram (ECG) 
  • Echocardiogram 
  • Thyroid function studies 

Sleep Apnea Treatment 

The goal of treatment is to ensure airflow is not obstructed during sleep.  

Weight loss Management 

Weight management and exercise are recommended for people with Sleep Apnea.  

Although it may not completely cure the condition, it has been shown to decrease the severity of sleep apnea. 

Weight loss also reduces blood pressure and improves your quality of life. 

Sleep Apnea Continuous positive airway pressure (CPAP) 

This is the first line of therapy for treating sleep apnea, administered through a face mask during the night. 

This sleep apnea mask face mask delivers positive airflow to keep the airways open during the night.  

It is a highly effective treatment for sleep apnea. 

Bilevel-positive airway pressure (BPAP) 

Bilevel-positive airway pressure (BPAP) machines help treat sleep apnea if CPAP therapy is not effective. 

BPAP machines deliver two pressures in response to your breathing- inhaled pressure and exhaled pressure. 

Sleeping on your side 

In some people, sleeping on the back can make sleep apnea worse. Hence, positional therapy is used to help you sleep on your side. 

Sleep Apnea Surgery 

You may consider surgical therapy if CPAP, BPAP machines, or an oral appliance are ineffective. 

Surgical treatment may be the most effective way to correct obstructing lesions of the upper airway. 

Lifestyle and Home Remedies for Sleep Apnea  

Self-care is the most appropriate way to deal with obstructive sleep apnea.  

  • Lose weight  
  • Exercise regularly 
  • Limit alcohol and avoid medications such as anti-anxiety pills or sleeping pills 
  • Sleep on your side or stomach  
  • If you have nasal congestion, use a saline nasal spray to keep your nasal passages open.  

Talk to your doctor about using nasal spray or drops because some medications are recommended for only short-term use. 

Sleep apnea, Heart Disease, and Metabolism 

Evidence suggests the association between sleep apnea and other medical conditions like type 2 diabetes, stroke, heart attacks, and even shortened lifespan.  

Why this connection? 

For instance, obesity is common in sleep apnea patients. 

Obesity increases the risks of diabetes, stroke, and heart attack. 

However, it is necessary to note that everyone with sleep apnea is not obese. 

The Link Between Weight Control and Sleep Apnea 

Weight control is essential for sleep apnea patients. 

Many studies suggest that losing weight can completely cure sleep apnea or make it less severe. 

Sleep Apnea: Myths to Know 

Myth: Everyone who snores has sleep apnea 

Fact: Some people may just have “simple snoring” and not sleep apnea. 

Also, some people who do not snore can also have sleep apnea with other symptoms like gasping for air, choking, and waking up with a headache, dry mouth, or raspy throat. 

The strongest sign is witnessed sleep apnea (if someone tells you they have seen you stop breathing during sleep).  

Seeking timely diagnosis and treatment for sleep apnea can help improve the quality of life and reduce the risk of serious health complications.