Sleep Apnea | Symptoms, Causes, Risks, Treatment
When most people get a physical exam, the doctor typically checks their heart and blood pressure and might ask about their diet and exercise. However, two neuroscientists pointed out that a common question primary care providers often overlook is, “How well do you sleep?”
Erika Yamazaki, a Ph.D. candidate in neuroscience at Northwestern University, and Ken A. Paller, a professor of psychology and director of the Cognitive Neuroscience Program at Northwestern University, say that even though they study sleep and memory, their own doctors do not ask them about how well they sleep.
Sleep should be a top priority for everyone—including doctors—because so many problems can develop when you’re not getting enough adequate sleep.
In an article on The Conversation website, Yamazaki and Paller point out that one of the most common sleep problems is sleep apnea, which can affect nearly every part of the body, but especially the brain and cardiovascular system. Sleep apnea occurs when your breathing repeatedly stops and starts during sleep. The sleep disorder affects an estimated 1 billion people worldwide, and the number continues to rise.
Obstructive sleep apnea is the most common type of sleep apnea, according to the neuroscientists. With obstructive sleep apnea, the throat muscles relax too much, causing breathing to repeatedly stop and start and the upper airway to be repeatedly blocked during sleep. Obstructive sleep apnea often causes daytime sleepiness, headaches, snoring, or a combination of these symptoms. In the long term, obstructive sleep apnea can increase the risk of cardiovascular disease.
The neuroscientists contend that many people who have sleep apnea are never diagnosed because patients may not fit the stereotypical profile of the condition: Older males trending toward obesity. In addition, some people may feel that their sleep issues are overlooked during wellness checkups.
“These are missed opportunities for gathering critical health information that is important for diagnosis,” Yamazaki and Paller wrote in their article. “Sleep apnea thus remains undiagnosed far too often in women and also in other groups.”
However, the neuroscientists note that more medical professionals are becoming aware of sleep apnea, and more screening tools have helped in diagnosing the problem as well. Nonetheless, the number of diagnosed cases is increasing due to a rise in obesity rates and an aging global population, they said.
Sleep Apnea Is Not Just About Sleep
While apnea happens during sleep, Yamazaki and Paller explained that the disorder is about more than sleep.
“While it manifests when you are sleeping, with repeated partial or total pauses of breathing during sleep—termed hypopneas and apneas—its effects extend far beyond the night,” the neuroscientists wrote.
Sleep apnea, in a way, starts a chain of events. First, apnea and hypopnea events happen more than 100 times per hour and last about 20 seconds, on average, the neuroscientists said. These episodes lower oxygen levels in the brain and body. Then, the low oxygen levels cause increased heart rate and blood pressure, which places a strain on the cardiovascular system. The person with sleep apnea has no idea what’s going on.
“Despite brief awakenings that can occur after a person with sleep apnea stops breathing, by the morning, they usually don’t remember ever pausing their breathing,” Yamazaki and Paller wrote.
Sleep Apnea Risks
If sleep apnea isn’t treated, it can increase the risk of serious heart problems like high blood pressure, heart failure, and stroke. The sleep disorder can also heightening the risk of developing dementia, such as Alzheimer’s and other neurodegenerative diseases.
And that’s not all. Sleep apnea has been linked to a reduced quality of life, a higher risk for motor vehicle accidents, and increased medical costs for individuals, societies, and governments, the neuroscientists pointed out.
Solutions To Sleep Apnea
The good news is that obstructive sleep apnea is a treatable and manageable disorder. The Continuous Positive Airway Pressure, also known as CPAP, is the standard treatment for obstructive sleep apnea. The bedside machine, which has a hose and a mask, prevents airway collapse by delivering a stream of air through the mouth or nose. While it may be effective, many people say the equipment is bulky, noisy, and inconvenient.
However, Yamazaki and Paller noted that there are other effective treatments for the sleeping disorder, such as:
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• Implantable nerve stimulation devices
• Oral appliances that shift the jaw forward and open the airway
• Positional therapies to avoid back-sleeping
• Myofunctional training to strengthen the tongue and throat muscles
Although there are several alternatives to CPAP machines, the neuroscientists say that new treatments are still needed. One of the latest approaches to treating obstructive sleep apnea involves using tirzepatide – the active ingredient in the GLP-1 drugs Mounjaro and Zepbound. Tirzepatide works by reducing body weight since being overweight is linked to the disorder.
Although sleep apnea is a common disorder, Yamazaki and Paller contend that it’s not being diagnosed and treated the same way for everyone. According to the neuroscientists, the traditional screening tools used for sleep apnea do not take into account symptoms that women often experience, which are different from those of men, such as:
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• Headaches
• Insomnia
• Depression
• Hormonal changes throughout a woman’s life
• Different anatomy of the airway
• Differences in sensitivity to higher levels of carbon dioxide in the blood compared to men
These “all suggest that more research and better tools are needed to improve healthcare for women with sleep apnea,” Yamazaki and Paller wrote.
What Can You Do About Sleep Apnea?
If you believe you suffer from sleep apnea, Yamazaki and Paller recommend talking to your doctor, who can refer you to a specialist. Also, don’t worry about having to undergo a sleep study in a hospital because the neuroscientists say sleep studies that diagnose sleep apnea can now be done at home.
While talking with your doctor, Yamazaki and Paller advise bringing up any daytime symptoms, such as excessive sleepiness or headaches, and any nighttime symptoms, such as frequent urination, waking up short of breath, snoring, or insomnia.
“Starting the conversation may be the first step toward diagnosis and treatment – and to better health and well-being,” Yamazaki and Paller wrote.
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