Ziad R. Mattar, MD
Pulmonary, Critical Care and Sleep Medicine
Orlando Health
It’s hard to function when you aren’t getting good sleep. As many as one in three Americans struggles with sleeping because of a sleep disorder – and many don’t know they have it.
Of all the sleep disorders, sleep apnea is among the most common. If it affects you, it most likely shows up when you’re in your late 30s or early 40s. After you’ve turned 65, you are much less likely to develop sleep apnea.
Symptoms of Sleep Apnea
- Nonrestorative sleep where you wake up not feeling rested or refreshed
- Excessive daytime sleepiness
- Falling asleep during the day, whether at work or behind the wheel
- Difficulty staying asleep no matter what you do. However, it is normal to wake up once or twice during the night, especially if you are in your 50s or older.
- Difficulty falling back asleep after waking up at night
- Your bed partner witnesses a pause in your breathing; as soon as the carbon dioxide builds up, your brain prods you awake and you gasp
- Snoring
- Leg cramps or restless leg syndrome
- Night sweats
- Sensation of cold feet or cold extremities
- Acid reflux
Do You Have Sleep Apnea?
One of the most common ways that you might discover that you have sleep apnea is if your doctor or specialist refers you because of one of several conditions.
- Atrial fibrillation or arrhythmia
- High blood pressure
- Frequent urination, as sleep apnea can alter the sensation in the bladder, causing you to feel a constant need to use the bathroom
The Most Common Symptom: Snoring
Snoring is one of the biggest indicators of sleep apnea: Every patient with sleep apnea snores, but not every snorer has sleep apnea. Snoring can be caused by the physical makeup of your throat and nasal passages, affecting how you breathe when you’re sleeping.
Types of Sleep Apnea
- Obstructive sleep apnea
With this type, something is obstructing your airway during sleep. You stop breathing for roughly 10 seconds, sometimes as often as five times an hour. - Central sleep apnea
This occurs when your brain fails to tell your lungs to breathe, resulting in pauses in your breathing. This can be severe and debilitating. - Complex sleep apnea
This is a combination of both types of sleep apnea.
Is It Insomnia or Sleep Apnea?
Not all sleep problems are because of sleep apnea. You may have insomnia, defined as trouble falling or staying asleep, which will also lead to excessive daytime sleepiness. Women are more prone than men to insomnia, as are people with certain psychiatric conditions. When diagnosing insomnia, sleep apnea must be ruled out first.
How Sleep Apnea Is Diagnosed
There are two types of sleep studies, and both are done overnight. Most can be completed at home.
However, the evaluation will need to be done in the lab if you have certain conditions, including:
- Heart failure
- Advanced lung disease
- History or suspicion of seizures or a neuromuscular disease
Sleep apnea is evaluated on a mild, moderate or severe scale. A measurement around the neck is also taken, with a result greater than 17 inches for a man or 16 inches for a woman indicating a higher likelihood of sleep apnea.
Sleep Diary
Your doctor will also most likely require a sleep diary, recorded over two weeks and tracking several data points.
- What time you go to bed
- How many times you wake up during the night
- How long before you fall back asleep
- What time you wake up in the morning
- Whether you nap and for how long
Results
Within 24 to 48 hours of the sleep study’s completion, your doctor will have the results and will share your diagnosis with you. The entire process typically takes six to eight weeks from the initial visit.
In general, sleep apnea is underdiagnosed. People tend not to suspect that they may have sleep apnea. Instead, they often ignore symptoms, attributing them to overworking, too much stress or excessive drinking. It’s also easy to think that sleep naturally worsens as we age, but that simply isn’t true. At any age, you should wake up refreshed, and if you don’t, you should talk to your doctor immediately.
Most importantly, sleep apnea is treatable, so if you worry you may have this condition, talk to your doctor about next steps.
Source: Orlando Health, www.orlandohealth.com
