If you’re waking up frequently throughout the night or waking up exhausted, sleep apnea may be to blame. Learn how to recognize the symptoms so you can finally get some rest.

By Nicole Clancy
Updated December 10, 2019
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Life is busy, and sometimes feeling tired simply is a normal part of your day. However, if you are routinely not sleeping well or continually waking up unrefreshed, it may signal a larger health problem like sleep apnea, a sleep disorder that affects about 22 million Americans. Sleep apnea can lead to serious health issues such as inflammation and organ dysfunction, and even memory problems and depression if left untreated.

“Sleep is vital for maintaining so many aspects of our mental health, including learning, memory, mood, and motivation. Sleep also supports immune system functioning and recovery from physical injury, exercise, and illness,” says Carissa Chambers, Ph.D., licensed psychologist. “Chronic lack of sleep or lack of quality sleep can lead to depression, increased physical pain, and even hallucinations.”

The first step to feeling better is knowing how to spot the symptoms and connecting with your care provider. Use this primer to get started.

Dera Burreson

What is Sleep Apnea?

Sleep apnea is more than just loud snoring. Apnea is considered a form of sleep-disordered breathing and can become debilitating. In some cases, the tongue or other soft tissues fall back and block the airway; in others, the airway is only partially obstructed and breathing is shallow. Either way, oxygen levels drop and throat muscles contract as the person struggles to breathe. The sleeper may gasp or let out a snort as air rushes down the now-open throat, the person wakes, and then oxygen levels return to normal and they fall back asleep. This cycle can repeat dozens of times each hour. Most people have no memory of snorting or snoring. Others may remember a restless night or a sudden awakening.

“If you suffer from sleep apnea, your brain and body are not receiving normal oxygen flow during sleep. This can lead to sleep interruptions, nonrestorative sleep, and in serious cases, oxygen-deprivation death," Chambers says.

Sleep Apnea Symptoms

Loud snoring is the most common symptom of sleep apnea, but some indicators are more vague and subtle. “Other signs and symptoms include excessive daytime sleepiness, mental fog, and daydreaming,” says Camilo A. Ruiz, D.O., FACOI, FAASM. Notable impaired performance at work and sleep-related accidents should be clues that your body is not rejuvenating itself through sleep as it should, he adds.

Types of Sleep Apnea

There are three types of sleep apnea. According to the Mayo Clinic, about 84% of apneics have obstructive sleep apnea, which happens when the throat muscles relax and tissues block the airway during sleep. “Obstructive sleep apnea is a very common condition. Approximately upward of 25% of the United States population suffers from obstructive sleep apnea. Unfortunately, many of them are not diagnosed or aware,” says Ruiz, medical director of Choice Physicians Sleep Center and spokesperson of the American Academy of Sleep Medicine.

There’s also central sleep apnea, which happens when your brain isn’t sending the right signals to your muscles in charge of breathing. This means breathing stops intermittently during the night or becomes very shallow. Central sleep apnea may happen as a result of other medical conditions, such as heart issues. The Mayo Clinic says men are affected more than women and most are adults age 65 or older. Symptoms to watch for include abrupt waking with shortness of breath, morning headaches, chest pain at night, insomnia, mood changes, and difficulty concentrating.

Complex sleep apnea includes components of both obstructive and central sleep apnea. Suffering repeated central apnea (more than 5 episodes, or instances of stopped breathing, per hour), while also using CPAP. Symptoms of complex sleep apnea are similar to the other types of sleep apnea.

How is Sleep Apnea Diagnosed?

If you’re waking up a lot at night without explanation or you don’t feel rested after sleeping, it’s time to consider undergoing a sleep study. “The best course of action is to get evaluated by a sleep specialist who can give specific recommendations,” says Sarah Kate McGowan, Ph.D., health sciences assistant clinical professor at David Geffen School of Medicine. Your doctor can make a diagnosis through either clinical or at-home sleep tests. He or she will examine such things as the quality of your sleep, your heart rate, how many times your breathing slows or stops in an hour, and whether your blood oxygen levels are low.

Sleep Apnea Treatment

The good news is that there are ways to sleep soundly once again. “Depending on how severe the sleep apnea is, there can be several options for treatment; however, the gold standard treatment is PAP, or positive airway pressure,” McGowan says. PAP through a machine is called Continuous Positive Airway Pressure (CPAP). This is a form of oxygen supplementation via a face mask or a nose mask worn while sleeping; the pressure keeps airways open so you breathe without interruption. There are also mouth-piece type of devices that may be recommended. In severe cases, surgery like a tonsillectomy or adenoid removal may be warranted.

There are also a few key lifestyle changes that may help. Ruiz says losing weight, about 20% of your body weight, can effectively ease obstructive sleep apnea symptoms. Not drinking alcohol may also help. “Drinking alcohol relaxes the throat muscles, which can worsen obstructive sleep apnea," McGowen explains. Sleeping on your side is another thing to try. "For some individuals, their sleep apnea occurs primarily when they sleep on their backs," McGowen says. "Positional pillows or other devices that help people to sleep on their sides can be beneficial for managing sleep apnea."

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