Sleep apnea is a sleeping disorder, that is defined by on average 10 failed air intakes per hour during sleep. The most common form of sleep apnea is obstructive sleep apnea (OSA) which is caused by an obstruction of the airway when the muscle tone relaxes during sleep. Soft tissue in the airway collapses and together with e.g. a large tongue, enlarged soft palate and excess fat in the neck press on the airway and block it.
Only 4% of people with sleep apnea suffer from central sleep apnea (CSA) which is caused by the brain giving insufficient signal to the muscles to initiate the breathing movement. Both forms are considered a serious medical condition which needs to be treated as soon as possible. The reason for this are the very common complications caused by it:
Heart Health
Cardiovascular problems.
When the blood oxygen level suddenly drops during an apnea the blood pressure increases (trying to offset the drop). That can be en enormous strain on the cardiovascular system. OSA increases the risk of high blood pressure by two or three times. The more severe the sleep apnea, the higher is the risk of high blood pressure. Independently from the presence of high blood pressure, sleep apnea strongly increases the risk of stroke.
With a condition of heart disease, the frequent oxygen undersupply in the blood (hypoxia or hypoxemia) might lead to a cardiac event and sudden death. In several studies links between OSA/CSA and an increased risk of atrial fibrillation, congestive heart failure and other vascular diseases have been shown. And OSA is closely linked to heart diseases and in the majority of the cases is at least a contributing cause of it. CSA in contrast, more often is the result of an existing heart disease.
Daytime fatigue/Sleep Deprivation.
Sleep apnea leads to repeated awakenings and an overall shallower sleep during night, which does not allow for a restful sleep. It is no surprise that this leads to extensive daytime drowsiness and lack of concentration. It also leads to moodiness and irritability due to this overall fatigue. Fatigue often is present when driving a car (which imposes another severe risk) or when concentrating on (school-)work (which ultimately leads to worse performance in school or at work). People with OSA or CSA may also complain of memory problems, morning headaches, mood swings or feelings of depression.
Complications with surgery and certain medication.
Patients with OSA can be more likely to have complications after surgery because they are likely to have breathing problems when sedated and lying on the back. Also the recovery after surgery is hardened through the breathing problems with sleeping aids. Undiagnosed sleep apnea is a huge risk for surgery. In case of diagnosed OSA/CSA it has to be discussed with the doctor before surgery.
Sleep-deprived partners.
Everybody who snores will experience this at some point. People in the same room are usually disturbed by the noises and don't get sufficient sleep themselves. This might actually disrupt a relationship over time to a point where partners can not sleep in the same room anymore.
Nocturia.
With the oxygen level decreasing and carbon dioxide increasing the blood is more acidic, the heart rate drops and heart vessels contract. The body signals it's problem to the brain and the patient wakes up. By now, the heart rate is very high and the heart falsely signals excess fluid. This is done by a protein that does not know better then telling the body to get rid of sodium and water.
Impotence/Sexual Dysfunction (ED).
Due to recent studies there is a clear connection between ED and sleep apnea. Initially it was thought to be the result of oxygen deprivation during the night that harms the cardiovascular system. Recent studies also suggest, that the erections men naturally have during deep REM sleep help maintain the erectile function. OSA/CSA in most cases prevent extended REM stages. However, ED is also often found in obese men and obesity is the single most important risk factor for OSA.
Gastroesophageal reflux disease (GERD)
A recent study has shown a strong link between obstructive sleep apnea and acid reflux. Almost 50% of the patients with OSA experienced GERD. With these symptoms being especially worse at night doctors suggested that the back of up of stomach acid in GERD may produce spasms in the vocal cords (larynx), blocking the flow of air to the lungs and causing apnea. So far no clear proof of OSA being treated via a cure of acid reflux could be found. On the other hand the apnea itself may cause pressure changes in the throat and airway that trigger GERD. Just like ED, GERD is often found in connection with obesity which again often causes OSA. It is therefore not clear if a direct connection is actually present.
