Symptoms
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Contents
Denial and Awareness
The symptoms of sleep apnea (stopped or reduced breathing during sleep) can be very subtle and easily attributed to other factors. How can you tell what you do while you’re sleeping? It’s not unusual to be unaware of having sleep apnea, a nighttime respiratory disorder. You probably think you are sleeping well. You may be in denial of the condition and unaware of its serious health risks. Your bed partner or family may be more aware of a potential problem than you are. Fifty percent or more of people with sleep-disordered breathing (SBD) remain undiagnosed. (Carl E Hunt MD p. xi in Johnson’s Sleep Apnea – The Phantom of the Night). Other estimates are that only 5% of people with SBD have been diagnosed. Most physicians do not routinely screen for sleep apnea, and may treat resulting conditions such as high blood pressure or depression, without discovering the root cause - SBD. Most people are unaware of the symptoms and risk factors. What is needed is early detection before heart damage or falling asleep at the wheel.
Untreated sleep apnea can lead to high blood pressure, stroke, heart attack, congestive heart failure, cardiac arrhythmia, depression, glaucoma, obesity, diabetes, and a host of other medical problems. Other risks are driver fatigue, poor judgment, poor memory, and sleepiness leading to car crashes, wrongful death and injury.
The Most Important Symptoms of Sleep Apnea
- loud and frequent snoring (often but not always)
- periods of not breathing (apnea) during sleep, snorting, gasping, or choking during sleep
- need to urinate during the night (nocturia) See [1]
- high blood pressure
- morning headaches
- awakening tired in the morning, daytime or evening fatigue or lethargy
- daytime or evening sleepiness when sitting or inactive, drowsy driving or falling asleep while driving
- performing actions automatically or by rote, limited attention, memory loss
- poor judgment, personality changes
- weight gain, severe leg swelling
- especially in children, hyperactive behavior.
National Institute of Health Sleep Apnea Links
Possible Risk Factors
- decreased size of the airways in the throat, nose, or mouth due to anatomy or allergies. Family history of sleep apnea, large adenoids or large tongue, short lower jaw which causes the tongue to position itself further back in the throat
- overweight with a body mass index (BMI) of 25 or more
- neck size for a man of 17 inches or more or for a woman of 16 inches or more
- male gender, or being a menopausal or postmenopausal woman. Both genders and all ages from infancy onward may have this condition.
- smoking and use of alcohol or sedatives
Sources: adapted from the journal Sleep, National Institutes of Health, and James C. O’Brien MD.
More Possible Indicators of Sleep Apnea
- COPD (chronic obstructive pulmonary disease), asthma
- heart abnormalities, stroke
- high blood pressure that doesn’t respond to medication
- acid reflux or GERD
- diabetes
- deviated septum (cartilage separating the nostrils going off midline)
- bruxism (teeth grinding)
- insomnia
- adult bed wetting
- irritability, mood changes, anxiety, depression
- procrastination, difficulty acting on plans or finishing projects, diminished work performance
- social withdrawal, neglected relationships
- less interest in sex, sexual dysfunction
- persistent recurring dreams of struggle and failure
- the ability to fall asleep two or three hours after getting up in the morning, and/or long naps in the afternoon, and/or sleeping nine or more hours a night
Assessment Quizzes
If you suspect a sleep problem, take at least the first quiz listed below. The quizzes are designed to build awareness and create dialog with your doctor, not to diagnose. Discuss the quiz results and your symptoms with your primary care physician, or a sleep doctor, pulmonologist (breathing specialist), cardiologist, ENT (Ear/Nose/Throat) doctor, or other specialist. If indicated by symptoms, the doctor may suggest a sleep study to rule out sleep apnea or other diagnostic procedures.
A very comprehensive but easy quiz looks at a wide variety of symptoms to help detect sleep apnea in the appendix of Sleep Apnea – The Phantom of the Night , a book by T. Scott Johnson MD, William A. Broughton MD, Jerry Halberstadt, a patient. Here is the quiz:
Other sleep apnea quizzes
- Epworth Sleepiness Scale Widely used by sleep doctors for a before-and-after treatment comparison (looks only at sleepiness)
The Boiled Frog Analogy
Maybe you’ve heard this story. If you put a healthy frog into a pot of hot water, it will quickly jump out. If you put a frog into a pot of lukewarm water, and very gradually increase the temperature, it will stay in the pot until boiled. In the hot water, the frog noticed instant discomfort and danger and took action. In the tepid water, it was lulled into complacency until unaware or unable to take action. How does this translate to sleep apnea? Have you unconsciously adapted to fatigue and eventually daytime sleepiness because its progression was so long and gradual? Have you found other reasons for fatigue, while making the best of circumstances? Are those reasons valid? You can find out by consulting a physician, taking informal sleep quizzes and, if indicated, getting a sleep study in a sleep lab. When you find the real reason for your fatigue, you can crawl out of the pot to change, improve, or reverse the condition.
Sources: Based on personal experience with obstructive sleep apnea and gleaned from the collective wisdom of cpaptalk.com contributors.
Want more?
Here are some links to relevant information from member posts on the CPAPtalk.com Forum.
- More consequences scroll down for the post from member "neversleeps"
- How SA affects life and health scroll down for the post by member "countrygent"
- See the peer coaching articles at http://smart-sleep-apnea.blogspot.com on Sleep Study Tests, Introduction to Sleep Apnea, More Sleep-Related Web Sites, and CPAP Machine Choices.
Not written by healthcare professionals. The information and opinions offered are not intended or recommended as a substitute for professional medical advice. © Mile High Sleeper, May 2006-2008. Permission to use for free educational purposes.