Snoring may seem like a harmless nighttime noise that most people experience at some point. Many think of it as a natural part of sleeping, while others often joke about it or ignore it. 

However, some snorers—particularly those with breathing disturbances known as sleep apnea—should raise concerns that something more serious is happening. If left untreated, this kind of noise during sleep may have significant health implications.

So, what is sleep apnea, and why should you be concerned about it? Here, we’ll answer your questions and provide solutions on how professionals can help you treat it.  

What is Sleep Apnea?

Definition and Overview

Let’s start by answering the question of what it actually is. The word ‘apnea’ in the medical world means the transient cessation of breathing. Hence, sleep apnea is when your breathing stops or gets restricted during sleep. This condition may occur more than 5 times to more than 30 times per night and last from seconds to minutes. 

Types of Sleep Apnea

• Obstructive Sleep Apnea (OSA): This is by far the most common type of sleep apnea. In OSA, the airway collapses repeatedly during breathing because it cannot counteract the negative pressure formed by the narrowed airway, causing a partial or complete obstruction. The narrowed airway is mostly caused by obesity in adults or large tonsils in children. 

• Central Sleep Apnea (CSA): The primary distinction between CSA and OSA lies in its mechanism. Apnea occurs when the brain fails to signal to the muscle that controls breathing, causing a lack of effort to breathe. Factors affecting CSA may include the use of narcotics, high altitude, and cardiovascular problems. 

Signs and Symptoms of Sleep Apnea

Unless you record yourself during sleep, chances are you need someone else to tell you whether or not you are a ‘loud’ sleeper. The most common signs your sleep partner can observe of sleep apnea are: 

• Loud snoring
• Gasping or choking during sleep

Meanwhile, you may also experience any of these sleep apnea symptoms relating to the sleep disturbance we mentioned earlier: 

• Nighttime awakenings
• Morning headaches
• Excessive daytime sleepiness
• Easily irritated
• Difficulty concentrating and memory issues
• Morning headaches and dry mouth

Causes and Risk Factors of Sleep Apnea

Physical and Lifestyle-Related Causes: 

• Excess Weight: This is the most common factor for OSA in adults. With excess weight, there will usually be fat buildup in the neck around the airway structures, blocking the airway.  

• Airway Structure: People with specific anatomic features that affect the airway, such as a larger tongue or shorter jaw, are more prone to obstructing their airways and developing OSA. 

• Nasal Congestion: If the nasal airway gets congested, people will automatically breathe through the mouth. When they do, the airway may risk collapsing during sleep, leading to OSA symptoms. 

• Alcohol Use: Consuming alcohol, especially before bedtime, may increase the risk of both OSA and CSA. In OSA, alcohol relaxes the airway muscles, making them easily collapse; meanwhile, in CSA, alcohol slows down and impairs the breathing signal between the brain and respiratory muscles. 

Medical and Genetic Factors:

• Family History: Sleep apnea, both OSA and CSA, can be inherited. Genes passed on from parents will determine the shape of the upper airway, skull, and face prone to OSA, like cleft palate or mandibular hypoplasia. In other cases, genetic syndromes that affect how the brain controls breathing, such as congenital central hypoventilation syndrome, increase the risk of CSA.

• Hormonal Disorder: Some people with hormone-level disorders, such as hypothyroid (low thyroid hormone), polycystic ovary syndrome (PCOS), or high levels of insulin, have a higher risk of OSA. 

• Age: As people age, changes in how the brain controls breathing may increase the risk of CSA. As for others, the buildup of fatty tissue around the tongue and neck during aging can cause OSA.

• Gender: Both OSA and CSA are more common in men than women. 

The Dangers of Untreated Sleep Apnea

Beyond restless nights, ignoring sleep apnea can seriously affect one’s health and well-being. Sleep apnea disrupts breathing throughout the night, severely impacting daily life. One may lack oxygen when one’s breathing is disturbed, even for a few seconds repeatedly during the night. 

In the short term, oxygen deprivation will disrupt your sleep by triggering arousal, eventually causing drowsiness and fatigue even though you have slept properly. Because of that, you may lose focus and energy, which can decrease productivity and increase the likelihood of making mistakes or, worse, accidents. 

Chronic low oxygen may even affect your body’s health in the long run. A study published in the Sleep Journal even found sleep apnea to be a risk factor for stroke, dementia, and epilepsy. People with prolonged oxygen deprivation due to sleep apnea also have a higher risk of heart failure, coronary heart disease, hypertension, or metabolic disorders like diabetes. 

How Sleep Apnea is Diagnosed

Professional Sleep Study (Polysomnography)

Polysomnography, known as PSG, is currently the most comprehensive way to diagnose sleep apnea and is the current gold standard. This test is done at a sleep clinic like WISH, where sleep specialists monitor your breathing using nasal airflow sensors, respiratory effort belts around the chest and abdomen, oxygen levels using an oximeter, brain activity using EEG, heart rate using ECG, and muscle movements using EMG devices while you sleep. 

The collected data helps specialists determine how often the breathing shallows or stops, how long it lasts, and how it affects the oxygen levels. The result is interpreted using the Apnea-Hypopnea Index (AHI), which categorizes sleep apnea based on severity: 

• Mild: 5-15 breathing interruptions per hour
• Moderate: 15-30 interruptions per hour
• Severe: More than 30 interruptions per hour

Home Sleep Apnea Test (HSAT)

Unlike polysomnography, HSAT is done while you sleep in your bed at home, so you won’t have to stay overnight at the clinic. During the test, you’ll be asked to wear devices such as nasal cannulas and finger probes to monitor breathing patterns and oxygen levels. Some may also include chest straps or belts to monitor respiratory movements.

The sleep specialist will use the test results to determine whether you have sleep apnea, how severe it is, and what treatment options you can try. 

Consulting a Sleep Specialist at WISH

Identifying this particular sleep problem early is crucial; if left untreated, it can have serious long-term implications for one’s health and well-being.  

So, if your sleep partner complains about you being a ‘loud’ sleeper and/or you experience the symptoms yourself, consulting with a sleep specialist at WISH is the right first step toward diagnosis and treatment. When consulting, our specialist will:  

• Evaluate your medical history and symptoms
• Recommend the most appropriate sleep test
• Interpret the results and provide a tailored treatment plan

Treatment Options for Sleep Apnea

Lifestyle Modifications

In the mild case of sleep apnea, we usually recommend that you modify your lifestyle, especially if your lifestyle seems to be the common culprit behind your sleep apnea. 

Combining these steps with other medical treatments can be beneficial, even if yours is moderate to severe. The most common lifestyle changes recommended include: 

• Weight loss: Losing even a small amount of weight may improve breathing during sleep, especially if you’re overweight or obese. 
• Changing sleep position: Sleeping on one side can help keep the airway open. The easiest way is to use a tennis ball on the back of your T-shirt. 
• Avoiding alcohol or other sedatives: Try to avoid these substances as they relax the airway muscles, which makes them prone to collapse. 
• Regular exercise: Strengthening airway muscles through activities like yoga or breathing exercises may help reduce apnea episodes.

Medical Treatments

When what you have is considered moderate to severe sleep apnea, medical interventions may be necessary:

• CPAP Therapy (Continuous Positive Airway Pressure): A CPAP machine that delivers air continuously with positive pressure helps open the airway during sleep. It significantly reduces the apnea episodes; this therapy should be done at least four hours every night.

• Oral Appliances: These are alternatives for individuals who cannot tolerate CPAP, as wearing a CPAP device overnight can be uncomfortable for some. An oral appliance resembling a mouthguard will help reposition your jaw and tongue to keep the upper airway open. 

• Surgical Options: If CPAP or oral appliances prove ineffective, your specialist may recommend these options based on the underlying cause of your sleep apnea.

How WISH Can Help You Manage Sleep Apnea

If you or a loved one experiences sleep apnea symptoms, WISH offers comprehensive management, starting with expert diagnosis using advanced diagnostic tools. After you’re diagnosed, you’ll receive tailored care based on your sleep apnea’s underlying cause and preference. Beyond that, we will ensure follow-ups and make necessary adjustments until your condition improves. 

Book an appointment with WISH today to get started.