Sleep apnea occurs when someone temporarily stops breathing while they are sleeping. This can be due to the soft tissues of the airway causing a physical obstruction, or it may be due to an issue with the central nervous system’s control of breathing. Both types of sleep apnea increase in likelihood from a range of sleep apnea risk factors.
Obstructive sleep apnea occurs when the soft tissues of the upper airways sag, completely blocking the flow of air. A partial obstruction may manifest as snoring, and in fact snoring is an indication that sleep apnea may be occurring.
Being overweight is one of the biggest risk factors for obstructive sleep apnea. There are physiological changes that occur to the airways when the body stores fat. This can narrow the airways enough so that the relaxation that occurs during sleep causes a complete obstruction of airflow.
Drugs like alcohol, opiates, benzodiazepines and other depressants also increase the risk of obstructive sleep apnea.1 These substances cause increased relaxation of the muscles that prevent the airways from becoming obstructed. Unfortunately, some people use these drugs to help them sleep, increasing the risk of obstructive sleep apnea.
There are also simple physiological differences that increase the likelihood of developing sleep apnea. A congenitally narrow airway, a deviated nasal septum, and just being male are all sleep apnea risk factors.
In central sleep apnea, breathing isn’t physically obstructed, but rather is stopped due to an issue with the nervous system. The risk factors for central vs obstructive sleep apnea are different, as the underlying causes are different.
Central sleep apnea can occur in people that are at high altitude. This is due to an unstable breathing response to the lower density of oxygen.2 The body may respond to low blood oxygen levels by hyperventilating, which can cause the body to try to slow breathing down. In normal breathing, the desire to breathe is balanced by the desire to not breathe too much, or hyperventilate. If this balance becomes unstable, a complete apnea can occur.
The mismatch between the body’s desire to breathe with the drive to not hyperventilate also leads to central sleep apnea in patients with congestive heart failure. A similar cycle of hyperventilation and central apnea called Cheyne-Stokes respiration occurs in people with heart failure.
Yes, it is possible to live a normal, healthy life while having sleep apnea. There are treatments, such as CPAP therapy, that are used for both central and obstructive sleep apnea that can help manage the condition.4
If the immediate sleep apnea cause is due to drug use such as alcohol or opiates, it is possible that someone will not experience sleep apneas on nights when they do not consume these drugs. Also, if the sleep apnea occurs because of inflammation, such as from seasonal allergies or a sinus infection, then sleep apnea may come and go.5 However, people who have sleep apnea caused by non-transient reasons like sinus structure or obesity may experience sleep apneas every night, and even multiple sleep apneas every hour.
There are a number of sleep apnea symptoms that may indicate someone is periodically stopping breathing while asleep. Since obstructive sleep apnea disrupts the natural sleeping rhythm, someone may feel groggy and sleepy even after a full night of sleep. A medical diagnosis of sleep apnea requires a sleep study, in which a night of sleep is observed by medical professionals. There are a number of risk factors that can increase the chances that someone will develop sleep apnea. Simply being male, being overweight, and using drugs like alcohol and other depressants, all contribute to the possibility of developing sleep apnea.
Overweight men have the highest risk of suffering from obstructive sleep apnea. In fact, research has found that for every ten percent increase in body weight there is a six-fold, or six hundred percent increase in the incidence of sleep apnea.6
Sleep apnea symptoms in men and sleep apnea symptoms in women are generally the same. While men are more likely to develop obstructive sleep apnea, the signs and symptoms manifest identically.
© 2021 American Sleep Association.