Sleep Apnea Symptoms

Snoring is a primary tell-tale symptom of sleep apnea. However, not everyone who snores needs to see a sleep specialist. Dr Robert Owens of the Sleep Disorders Research Program at Brigham asserts "Most people who snore don't have obstructive sleep apnea, but most people who have sleep apnea snore."¹

In Australia, it is estimated that 1 in 5 adults who snore have sleep apnea, with 1 in 3 of those suffering from severe obstructive sleep apnea (OSA)².  Breathing stoppages or 'apneic events' can occur hundreds of times each night and often last upward of >40 seconds at a time, unknown to the sufferer.

Therefore, like snoring, sleep apnea is often first witnessed by a bed partner or family members, or friends while on vacation or work trips.

If you don't have someone to alert you to it, check for the following symptoms of apnea.

Waking to feel tired or unrested is a common symptom and red flag indicator of sleep apnea.

Each time an apneic event (cessation of breathing) occurs, the brain registers excessive carbon dioxide in your system.  This causes the sympathetic nervous system to wake you briefly to resume breathing and restore oxygen flow.⁴

These brief awakenings, known as micro-arousals, disrupt your sleep cycle, reducing or preventing the deep, resorative sleep needed for good health and wellbeing.

Most OSA sufferers are not consciously aware of the micro-arousals, which happen hundreds of time each night.  The sympathetic nervous system wakes the sufferer only enough to restore breathing, then they fall back asleep without being aware of waking. 

This is why sleep apnea sufferers often wake feeling exhausted, when that is when they should feel most refreshed.  Instead of getting a full night's sleep, they are actually getting hundres of short naps.

Obstructive Sleep Apnea (OSA) is a particularly significant cause of excessive daytime sleepiness⁵.  

However, many sufferers don't make the connection between excessive daytime sleepiness and sleep apnea.

Sleep apnea events disrupt normal sleep patterns, leading to reduced quantity and quality of sleep.

In particular, rapid eye movement (REM) dream sleep and deep, restorative non-rapid eye movement (NREM) are the sleep stages most affected.  These cause the most significant impact on daytime sleepiness.

"If [the sufferers] have had apnea for a long time, they may have developed compensatory mechanisms (such as sugary food, caffeine, or energy drinks to avoid an afternoon crash) and not realize how tired they are all the time"⁶ asserts Dr Nancy M. Holekamp, Vitreoretinal Surgeon and Associate Professor of Clinical Ophthalmology and Visual Sciences at Washington University, St. Louis.

Individuals with excessive daytime sleepiness risk increasing their chances of being involved in motor vehicle and job-related accidents and have poorer health than non-sufferers.⁷

Moderate daytime sleepiness (such as the desire to take an afternoon nap) doesn't necessarily mean you have sleep apnea. However, consistently feeling very sleepy is a strong indicator of OSA.  

Dr J Pagel states, "the evaluation and management of excessive daytime sleepiness are based on the identification and treatment of underlying conditions, particularly obstructive sleep apnea."⁸ This is especially important if you're living alone and not sharing sleeping space with someone else that would otherwise notice the apparent signs.

Complete the online Sleep Apnea Risk Test to learn your risk profile and how to improve your sleep health and wellbeing.  Feel free to get in touch if you have any questions. 

Morning headaches for sleep apnea sufferers are caused by significant changes within the bloodstream as a result of airway obstruction and increased carbon dioxide in the system due to apnea events during sleep.

As the sufferer awakens, breathing returns to normal with the lungs moving air in and out of the lungs, returning carbon dioxide levels to normal. Sleep apnea headaches usually resolve within thirty minutes of awakening.

Sleep apnea headaches are usually on both sides of the head rather than just one side. Unlike some other types of headaches, sleep apnea headaches are not usually accompanied by nausea or sensitivity to light and sound.⁹

Waking choking or gasping for air is one of the strongest indicators of sleep apnea. 

Apnea events occur after exhalation.  Ultimately, the build up of carbon dioxide in the blood causes the sympathetic nervous to jolt the sufferer awake to resume breathing.¹⁰.  This is often accomanied by a gasping inhalation. 

Waking while choking is consciously experienced by some OSA sufferers but not all. Most OSA sufferers are completely unaware that they have woken and immediately fall back to sleep once breathing resumes.

When a human is unable to get the required amount of undisturbed sleep, there are unavoidable impacts on concentration, coordination, memory, and mood. Many studies have shown that without adequate restorative sleep, brainpower is reduced. Obstructive sleep apnea (OSA) typically leads to deficits in executive functions, attention, and memory.¹¹

The average adult aged between 18-64 years requires 7-9 hours of sleep per night. It is important that this age group not receive less than six hours or more than ten hours of sleep in a night for good sleep health and cognitive function.¹²

Poor sleep quality is one of the major causes of slow metabolism. Other influencing factors include genetics, hormones, age, exercise, diet or medications.¹³

Metabolism refers to the body's chemical processes that regulate the body's most basic functions, such as breathing, blood circulation, digestion, and building/repairing cells. Each person's metabolism is unique to them.¹⁴

A slow metabolic rate burns fewer calories to perform the body's functions than a fast metabolic rate, which is why people with fast metabolism tend not to gain weight easily.

Research studies suggest that sleep deprivation can cause a sluggish metabolic rate due to the body saving energy as a result of lost or poor quality sleep. Prolonged periods of sleep deprivation have been shown to slow the average metabolic process by as much as 8% over a five-week period.¹⁵

The three key ways to boost your metabolism are by getting good restorative sleep, understanding your hormones and making sure you are eating enough food.  If your metabolism is slow due to any of these factors, fixing the underlying cause will help with weight control and improved sleep quality.¹⁶

Numrerous studies suggest diabetes and sleep apnea are strongly associated with one another. Clinical research shows as many as 48% of people diagnosed with type 2 diabetes have also been diagnosed with sleep apnea.¹⁷

Even more striking, researchers believe that 86% of obese type 2 diabetic patients suffer from sleep apnea.¹⁸ Although these statistics don’t necessarily prove that diabetes causes sleep apnea (or vice versa), it’s clear that there’s a real medical connection here.

Sleeping problems are common as a result of unchecked diabetes, as the sufferer may need to urinate more frequently during the night. Whenever blood glucose levels rise, the kidneys attempt to eliminate any additional sugar by increasing urination, requiring the sufferer to get up more frequently to use the bathroom, further disrupting their natural sleep cycle.¹⁹

Compounding things further, the average person with type 2 diabetes is typically overweight.  Fatty tissue in the upper airway can restrict airflow and reduce oxygen intake while asleep.¹⁹

If type 2 diabetes is a problem you experience, checking for sleep apnea makes sense.  Treatment of any apnea will assist in the treatment of type 2 diabetes. 

Nocturia (frequent nighttime urination) is strongly linked to obstructive sleep apnea. 

Mary Umlauf, a professor and noted nocturia researcher, said, "many healthcare providers and ordinary people think of Nocturia as a urological or gynecological problem. They don't understand that sleep apnea can cause the body to produce too much urine at night." She adds, "People who wake up to urinate shouldn't assume that "it's my prostate," or "I'm just old," she said.²⁰

Dr Barry Krakow at the Sleep & Human Health Institute asserts, "I see patients all the time who think they're waking up to urinate because they have prostate trouble or a small bladder. About 80 percent of the time, we discover that apnea is the cause of their problem.²⁰

Dr Vishesh Kapur, Medical Director of the Sleep Institute at the University of Washington in Seattle, has noted that nocturia tends to occur when obstructive sleep apnea is severe. "When a sufferers' breathing is disrupted, it puts pressure on the heart. This, in turn, affects a hormone that normally controls urine production in the kidneys.²¹

Studies suggests that a common treatment for sleep apnea - positive airway pressure (PAP) therapy - can reduce symptoms of nocturia, thereby improving sleep and preventing debilitating falls among elderly people who get out of bed at night to use the bathroom.²⁰

Questions?  Call us today on 1300 246 637 for a cost and obligation-free chat.  Otherwise, please consult your doctor immediately.

Researchers examining the relationship between libido (sex drive) and sleep apnea discovered that male apnea sufferers produce lower testosterone levels, leading to reduced sex drive and sexual activity². 

Furthermore, people who suffer from untreated sleep disorders can experience poor moods, mental health issues, not to mention exhaustion - robbing both partners of the desire to be intimate and the ability to have sex.

"Poor sleep may make us more selfish as we prioritize our own needs over our partner's," said Amie Gordon, lead investigator and psychologist at the University of California. Research data evaluating poor sleep and its impact on marital relationships suggest that interrupted sleep leaves couples less attuned to the needs and sensitivities of their partners.²³

"Therapeutic intervention of sleep apnea could become a recommended remedy for certain forms of sexual dysfunction," offers Prof. Rephael Luboshitzky, an endocrinologist at the Technion-Israel Institute of Technology. "It is our hope that in the future, by correcting nighttime breathing patterns, we will be able to stimulate hormone production and thereby raise libidos." ²²

Showing that you appreciate your significant other will go a long way too.

Recent studies estimate 60 percent of people with Obstructive Sleep Apnea (OSA) have chronic acid reflux, also known as gastroesophageal reflux disease (GERD).²⁴

GERD occurs when the lower esophageal sphincter opens, allowing gastric acid to backflow into the esophagus.

GERD's typical signs consist of chest pain, heartburn, a sour taste in the mouth, and halitosis (bad breath). Nevertheless, it is possible to have GERD and not experience symptoms at all.²⁵

During an apnea event, the respiratory effort of the diaphragm pulling to inspire creates a negative pressure in the chest. This negative pressure can be significant and leads to turning the esophagus into a straw pulling stomach contents up through the esophagus and throat, creating the acid burning of gastric reflux in the chest and throat.²⁶

Researchers studying the association between GERD and OSA, while evaluating the effect of treatment on GERD symptoms, concluded that treating apnea also helped in treating GERD.²⁴

Sleep bruxism involves repetitive jaw-muscle activity during sleep, often characterised by teeth grinding or clenching.²⁷ Tooth grinding or bruxing is not itself abnormal, but apnea induced bruxism is characterised by high frequency and intensity.²⁸

Although it is still unclear whether there is causation or only correlation, studies show that many sufferers have both obstructive sleep apnea (OSA) and sleep bruxism, with OSA being one of the main risk factors for sleep bruxism.²⁷

Studies suggest that OSA causes sleep bruxism due to the physiological threats caused by pauses in breath (apneica events). When the respiratory tract constricts, the mouth muscles (associated with chewing) assist in reopening the airway to resume breathing.

Another hypothesis is that jaw movement aids in lubricating the back of the throat, which can dry from laboured breathing due to OSA. Nevertheless, studies suggest that sleep bruxism helps the body to protect itself from the adverse health effects of OSA.²⁷

A detailed study conducted with a patient who suffered from both severe OSA and sleep bruxism found that while using CPAP overnight, ‘most breathing abnormalities were eliminated and a complete eradication of the tooth grinding events was observed.’²⁹

The results of this study strongly indicate that sleep bruxism is related to apnea/hypopnea, and the successful treatment of these breathing abnormalities may eliminate sleep bruxism.²⁹

Multiple health risk factors, i.e. heart disease, hypertension, diabetes or stroke, have an accumulative effect on cardiovascular disease. The more risk factors a person has, the higher the risk of developing cardiovascular disease.³⁰

Several behaviours increase the degree of each risk factor, including an unhealthy diet, not getting enough physical activity, drinking too much alcohol and smoking.³¹

Untreated obstructive sleep apnea (OSA) is also a factor that significantly increases the risk of cardiovascular disease.³² In fact, OSA is found in 47% to 83% of people with cardiovascular disease, 35% of people with hypertension, and 12% to 53% of people with heart failure, atrial fibrillation (a heart rhythm abnormality), and stroke.³³

Insufficient or poor-quality sleep due to conditions like sleep apnea denies the cardiovascular system vital healing time, increasing the incidence of heart disease, hypertension and stroke.³¹

Sleep expert Dr Phyllis Zee asserts, "good-quality sleep decreases the work of your heart as blood pressure and heart rate go down at night."³⁴ 

It's important to watch for cardiovascular symptoms and discuss any concerns with your doctor.

High blood pressure (hypertension) is strongly connected to obstructive sleep apnea (OSA). Research studies indicate as many as 50% of individuals struggling with high blood pressure also suffer from sleep apnea.³⁵

When an apnea event occurs, the upper airway constricts, causing blood oxygen levels to drop. This triggers the heart to work harder (raising blood pressure) to pump oxygenated blood through the body.³⁶

Over time, raised blood pressure can harm your heart, blood vessels, kidneys and other parts of your body³⁷, eventually leading to serious health problems such as cardiovascular disease.³⁸

Research studies indicate that treating OSA can significantly improve health for those struggling with high blood pressure. One research study, led by Dr Claudia Korcarz of the University of Wisconsin's Atherosclerosis Imaging Research Program, studied the effect CPAP (continuous positive airway pressure) has on hypertension. The results revealed CPAP treatment drastically decreased high blood pressure in adults with OSA.³⁶

The good news is that hypertension is extremely treatable by engaging in simple lifestyle changes such as following a healthy diet plan, getting 7-9 hours of quality sleep per night, and regular exercise. If your BP does not respond to lifestyle changes (or medication in some cases), undergoing a sleep test to check for an undiagnosed OSA condition is essential.³⁶

OSA is a common but under-recognised risk factor for stroke. OSA doubles the threat of stroke for middle-aged and older males and increases the stroke threat in middle-aged and older females.³⁹ It is believed that men with sleep apnea may have a higher risk of stroke because they develop apnea at a younger age than women.

When an apnea event occurs, the sufferers' airway constricts, causing oxygen levels to fall. Brain receptors are triggered that send messages to the blood vessels to increase oxygen to the heart and brain. The boost in blood circulation increases pressure on the capillary walls.³⁹

Over time, this can lead to uncontrolled high blood pressure and a heart condition called atrial fibrillation (A-fib). Both are known cardiovascular risk factors, increasing the chances of a heart attack or stroke.⁴⁰ 

The threat of stroke is relative to the severity of an OSA condition. One study discovered men with moderate to severe OSA were three times more likely to have a stroke than those men suffering from mild OSA or without OSA.³⁹

Dr Danny R. Rose Jr., a neurologist with Norton Neuroscience Institute, insists "if you or a loved one has issues with excessive daytime sleepiness, snores loudly or gasps for air during the night, you should be screened by a health care provider for sleep apnea."39

Determining the origin of your daytime sleepiness, waking tiredness and other OSA symptoms begins with understanding your Sleep Apnea Risk Profile. Our unique scientifically validated online quiz will quickly assess your potential OSA condition and provide recommendations relative to your particular results, cost and obligation-free. 

Or contact us on 1300 246 637 for a chat with a friendly Care Coordinator for honest reliable advice.