Breathing Trouble at Night? It Could Be Sleep Apnea

Sleep is essential for overall health, yet many people suffer from sleep disorders that disrupt rest and significantly impact well-being. One such condition is Obstructive Sleep Apnea (OSA), a potentially serious sleep disorder that causes breathing difficulties at night due to a blocked airway. On World Sleep Day, the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, raised awareness about the risks of OSA, a disorder affecting more than a billion people globally.

This article explores the causes, symptoms, risks, and treatment options for sleep apnea, with expert insights from PGIMER’s ENT specialists, Dr. Jaimanti Bakshi and Dr. Sandeep Bansal.

Understanding Obstructive Sleep Apnea (OSA)

Obstructive Sleep Apnea (OSA) is characterized by repeated interruptions in breathing during sleep due to partial or complete airway blockage. These interruptions, called apneas, often last several seconds to minutes, reducing oxygen supply to vital organs and causing sleep disturbances.

OSA leads to poor sleep quality, frequent awakenings, and gasping for breath. Over time, it can contribute to serious health problems, including cardiovascular diseases, metabolic disorders, and mental health issues.

How Common Is Sleep Apnea?

• More than 1 billion people worldwide suffer from OSA.
• In India, the prevalence rate is approximately 11%.
• Men are twice as likely as women to develop OSA.
• However, postmenopausal women face an increased risk.
• Children between 2 to 8 years are also vulnerable, but many cases remain undiagnosed.

Symptoms of Obstructive Sleep Apnea

Recognizing the symptoms of OSA is crucial for early diagnosis and treatment. Some common signs include:

1. Loud and persistent snoring (often noticed by a partner).
2. Gasping or choking during sleep.
3. Excessive daytime sleepiness (falling asleep at work or while driving).
4. Morning headaches due to oxygen deprivation.
5. Difficulty concentrating, poor memory, and mental fog.
6. Mood swings, irritability, and depression.
7. High blood pressure and heart issues.
8. Restless sleep and frequent nighttime awakenings.

If left untreated, these symptoms can escalate into serious health conditions.

What Causes Sleep Apnea?

Several risk factors contribute to the development of OSA, including:

1. Obesity and Excess Weight

• Fat accumulation around the neck and throat narrows the airway, making breathing difficult.
• Studies show that a 5-10% weight reduction can improve OSA symptoms.

2. Age and Gender

• Middle-aged and older adults are at higher risk.
• Men are more prone to OSA than women, but postmenopausal women face an increased risk due to hormonal changes.

3. Genetics and Family History

• People with a family history of OSA are more likely to develop the condition.

4. Smoking and Alcohol Consumption

• Smoking increases inflammation and fluid retention in the airway.
• Alcohol relaxes the muscles of the throat, making it easier for the airway to collapse.

5. Nasal Congestion and Sinus Problems

• Chronic nasal congestion reduces airflow, increasing OSA risk.

6. Anatomical Factors

• A narrow throat, large tonsils, or a small jaw structure can obstruct airflow.
• In children, enlarged tonsils and adenoids can cause pediatric sleep apnea.

Serious Health Complications of Sleep Apnea

Untreated OSA is not just a sleep disorder—it has severe long-term health consequences.

1. Cardiovascular Diseases

• OSA increases the risk of high blood pressure, heart disease, stroke, and irregular heartbeats (arrhythmias).
• It can lead to sudden cardiac arrest due to fluctuating oxygen levels during sleep.

2. Type 2 Diabetes and Metabolic Disorders

• OSA is linked to insulin resistance and high blood sugar levels, increasing the risk of diabetes.

3. Mental Health Issues

• Sleep deprivation leads to depression, anxiety, mood swings, and cognitive decline.
• Studies show that people with severe OSA are at a higher risk of Alzheimer’s disease.

4. Daytime Fatigue and Accidents

• OSA causes excessive daytime sleepiness, leading to:
  • Workplace accidents
  • Road accidents (drowsy driving is a leading cause of fatal crashes).

5. Poor Quality of Life

• Constant fatigue reduces productivity, focus, and energy levels.
• Relationships are affected due to irritability and mood swings.

Diagnosis and Treatment of Sleep Apnea

How Is Sleep Apnea Diagnosed?

Doctors diagnose OSA through:

1. Sleep Studies (Polysomnography) – Conducted in a sleep lab, this test monitors brain waves, oxygen levels, heart rate, breathing, and muscle movements during sleep.
2. Home Sleep Tests – Portable devices track oxygen levels and airflow for diagnosing moderate OSA.

Treatment Options for Sleep Apnea

Effective treatments for OSA depend on severity and individual needs.

1. Lifestyle Changes

• Weight loss – Losing 5-10% of body weight can reduce OSA symptoms.
• Exercise – Improves lung function and reduces airway obstruction.
• Avoiding alcohol and sedatives – Prevents excessive throat muscle relaxation.
• Sleeping on the side – Reduces airway collapse compared to sleeping on the back.

2. Continuous Positive Airway Pressure (CPAP) Therapy

• CPAP is the gold standard treatment for moderate to severe OSA.
• A CPAP machine delivers continuous airflow to keep the airway open during sleep.
• Studies show CPAP therapy significantly reduces cardiovascular risks and improves sleep quality.

3. Oral Appliances

• Custom-made mouthguards reposition the jaw and tongue to prevent airway blockage.
• Best for mild to moderate OSA cases.

4. Surgery for Severe Cases

• Uvulopalatopharyngoplasty (UPPP) – Removes excess throat tissue.
• Adenotonsillectomy – Recommended for children with enlarged tonsils or adenoids.
• Maxillomandibular advancement surgery – Repositions the jaw to expand the airway.

Raising Awareness and Seeking Help

On World Sleep Day, PGIMER doctors emphasized the importance of early diagnosis and treatment. Many OSA cases go undiagnosed due to a lack of awareness, leading to serious health complications.

• Loud snoring, choking, and daytime fatigue are common signs of OSA.
• Untreated OSA increases the risk of heart disease, stroke, diabetes, and mental health disorders.
• Lifestyle changes, CPAP therapy, and surgery can effectively manage the condition.
• If you or a loved one experiences symptoms, consult a sleep specialist for proper evaluation.

Sleep is not a luxury—it’s a necessity for good health. Addressing sleep apnea can help you breathe better, sleep better, and live better!