The Sneaky Symptoms of Sleep Apnea
Often times, things aren't as they seem on the surface. As a doctor, I am continually faced with this. A symptom may translate to something much deeper, perhaps more significant at its root cause. Sometimes, the symptom and the bigger cause are seemingly unrelated and random (a rash as a herald of a smoldering liver cancer, for instance). Perhaps the most common and significant way that I see this manifest is with sleep apnea, a problem that, when addressed, can completely transform a person's life back to normalcy.
Sleep apnea affects upwards of 7% of the adult population. These rates are higher among those who are obese, male, smokers, alcohol users, or menopausal. Rates also tend to increase with age. Over recent years, the prevalence of sleep apnea is increasing, likely due to the growing obesity epidemic. It's still debated whether overall body mass index increases risk or the girth of the neck itself, which comes with increasing weight. Studies have found that a neck circumference greater than 16 inches in a woman and 17 inches in a man increases the risk of sleep apnea.
Sleep apnea, though a big problem, often persists without being detected, "under the covers" (bad pun). It is estimated that 80% sleep apnea cases are undiagnosed. Part of this stems from the fact that the overt symptoms of sleep apnea are present during sleep. Though people go through the persistent cycle of sleep-obstruction-low oxygen (suffocation)-awakening numerous times per night, they have no recollection of this nightly ordeal. Often, people sleep alone so there aren't any witnesses. Other times, they're simply labeled as having a snoring problem. Sometimes, bed partners make a fuss about the problem or worries that the person is choking or suffering in their sleep, only to have the concerns dismissed.
Sleep apnea robs a person of quality rest. Because of the cycle mentioned above, that deep, restorative sleep cannot be achieved. A person may invest eight hours in sleep, but get no more than a few hours of good sleep. This begins to add up quickly night after night. People suffering from sleep apnea deal with a lack energy, they are frequently somnolent, and they often find themselves dozing off during the day. Many times, this occurs during a sedentary time or after a meal, but has also occurred during vigilant times like when driving. Usually, sleep apnea patients simply reset their norm as that of a chronic fatigued state. In a sense, they forget what it is like to be well-rested.
Problems arise and are often treated without consideration of the underlying cause of sleep apnea. Medications are prescribed to treat the symptoms or the numbers that are outside the norm without properly factoring in the sleep apnea at the source.
High Blood Pressure: Many people diagnosed with hypertension have high levels due to the effects of sleep apnea. When the problem is effectively addressed and treated, the blood pressure normalizes.
Stroke: Having sleep apnea increases the risk of stroke over three times that of the general population. Stroke can be devastating, leaving a person permanently disabled.
Heart Rhythm Disturbance: The waxing and waning oxygen deprivation during sleep causes an excessive tax on the heart muscle and its electrical impulses that give normal, continuous rhythm to the heart. As such, rhythm disturbances (most commonly atrial fibrillation), can occur. If not corrected or treated, heart dysrhythmias can be fatal.
Depression: The constant deprivation of sleep can have a profound impact on mood. Chronic sleep apnea leads to depression and emotional fatigue. Medication has little impact on the depressed mood when the ultimate cause isn't identified, allowing the sleep loss to continue to accumulate.
Muscle Pain/Fibromyalgia: An unrested body is an achy body. Muscles become chronically sore and can lower the threshold for spasm leading to fibromyalgia syndrome.
Headaches: Muscle tension headaches can be part of the achy muscles of sleep deprivation. Or, those prone to migraine headaches can lower their threshold, increasing the frequency and severity of these troublesome headaches.
Sleep deprivation is a form of torture outlawed by the Geneva Convention! Yet, too many people suffer from the direct sleep deprivation and the indirect wakeful health problems caused by sleep apnea. If you have any of the symptoms, see your doctor to consider testing. I've found the website below to be useful as an introductory screen for sleep apnea.