How Can I Tell if I Have Sleep Apnea?

Does my snoring mean I have sleep apnea?

Almost everybody snores from time to time. Snoring takes place when a person's breathing gets obstructed during sleep, and it can happen for a few reasons. Some people owe their snores to their mouth or nose anatomy, while others experience temporary snoring from alcohol consumption, sleep deprivation, or simply sleeping on their backs. But for some individuals, snoring along with daytime fatigue can be a sign of an underlying condition called sleep apnea.

It’s estimated that about 22 million Americans suffer from sleep apnea, a common condition that occurs when a person experiences breathing interruptions during sleep. While sleep apnea causes a number of impairing symptoms, doctors also have many ways to treat it, from addressing underlying medical issues to devices that help keep the airway open at night.

Snoring alone does not necessarily mean you have sleep apnea, but if people notice you look like you’re choking when sleeping, or you feel tired during the day no matter how much sleep you get, it may be time to talk to your doctor about your risk for sleep apnea. In some cases — especially sleep apnea that’s left untreated — the condition can increase the risk of other potentially serious health problems. For that reason, it’s important to get symptoms checked out by a healthcare provider.

Read on to learn more about sleep apnea.

In general, sleep apnea happens for two reasons: the airflow is blocked during sleep (known as obstructive sleep apnea) and the brain doesn’t send the muscles signals to breathe (known as central sleep apnea).

Obstructive sleep apnea

Everyone has muscles in the back of their throat that support the soft palate (the back, muscular part of the roof of the mouth), the piece of tissue that hangs from the palate (uvula), the tonsils, and the side walls of the throat and tongue. When these structures relax while you are sleeping, the airway can narrow and obstruct breathing. Apnea episodes (usually reported by a witness) are incidents during which you stop breathing for a period of time. When your breathing is impaired, your oxygen levels decrease, while your hydrogen and carbon dioxide levels increase. When these levels reach a critical point, they will trigger your respiratory drive, forcing the body to wake up so the airway can open and take in air. This momentary wake-up can cause snorting or gasping, and it may occur several times throughout the night without the individual ever noticing.

Certain people are more at risk for sleep apnea than others. Common risk factors for sleep apnea include:

• Being overweight
• Having a thicker neck
• Enlarged tonsils or adenoids (more common in children)
• Drinking alcohol or taking sleep aids
• Smoking
• Nasal congestion from allergies or anatomical problems
• Certain medical conditions, such as congestive heart failure, Type II diabetes, and chronic lung diseases

Central sleep apnea

Central sleep apnea happens when a person’s brain doesn’t send signals to the muscles the body uses to breathe, which can lead to brief lapses in breathing or waking up with shortness of breath. While it’s less common than obstructive sleep apnea, central apnea comes with unique risk factors, such as:

• Old age
• Congestive heart failure
• Taking opioid medications
• A previous stroke or brain damage

Rarely, people experience both types of sleep apnea due to various risk factors, so they may experience more severe symptoms.

Both types of sleep apnea can cause symptoms during sleep and during the day, which may range from mild to severe depending on the case. Common sleep apnea symptoms that occur during sleep include:

• Loud snoring
• Gasping for air
• Reduced breathing (usually, reported by another person)

Because sleep apnea interferes with a person’s ability to breathe well at night, it can also cause daytime symptoms, such as:

• Sleepiness
• Fatigue
• Dry mouth
• Sore throat
• Irritability
• Difficulty focusing
• Headaches
• Decreased sex drive

Sometimes, people with sleep apnea — especially women — report experiencing depression or anxiety.

If left untreated, severe sleep apnea can also lead to heart disease and stroke.

While loud, persistent snoring may be a sign of obstructive sleep apnea, it’s important to note that not everyone who snores has sleep apnea. Snoring can stem from temporary conditions like nasal congestion or even a night of drinking. People with sleep apnea often have risk factors specific to the condition and often experience more symptoms than snoring alone.

If you think you may have sleep apnea, think about whether you experience signs besides snoring. Do you wake up exhausted every day, or experience morning headaches? Do you find it difficult to focus on work or school no matter how much sleep you get? If so, you may want to talk to your primary care provider about sleep apnea.

Along with reviewing your symptoms and medical history, your provider may use sleep apnea screening questionnaires, such as the STOP-BANG or the Epworth Sleepiness Scale, to assess your risk of sleep apnea. If your primary care provider thinks you are at high risk for sleep apnea, they may order a sleep test called a polysomnography, that can often be done from the comfort of your own home. The home sleep test monitors your breathing, oxygen level, and heart rate. In some cases, a sleep test needs to be performed in a lab to capture additional information such as brain waves. While this is helpful for complicated presentations of sleep apnea and other sleep disorders, most people will benefit just from a home sleep study.

If a sleep apnea diagnosis is confirmed, your healthcare provider may offer differing treatment depending on the severity of your symptoms. Common treatments for sleep apnea include any combination of the following:

• Healthy lifestyle changes, like weight loss or quitting drinking or smoking
• Treating underlying problems, such as heart failure or diabetes
• A breathing device called a continuous positive airway pressure (CPAP) machine that keeps the airway open during sleep
• Oral appliances that keep the throat open at night

In severe cases where other treatments aren’t working, a doctor may recommend surgery to correct the underlying problem, such as removing enlarged tonsils or adenoids or shrinking tissue in the back of the mouth.

Sleep apnea is difficult enough to deal with on its own, but when left untreated, can lead to more serious health problems, like high blood pressure, heart problems, or even a stroke. So whether a partner’s tired of your snoring or you’re experiencing constant fatigue during the day, make sure to talk to a doctor if you think you may have sleep apnea.