“Why am I so tired all the time?”
If you’ve asked this question and ruled out the usual suspects — going to bed too late, stress, medication side effects — it’s time to ask your doctor about obstructive sleep apnea (OSA).
OSA is one of the most common causes of daytime sleepiness, affecting an estimated one in four adults — yet at least 80% of people who have OSA go undiagnosed. While it is commonly thought of as a men’s condition, it is only slightly more prevalent in men.
OSA causes breathing interruptions continuously during sleep. These disturbances spur partial awakenings that often go unnoticed but leave you less rested in the morning. In addition to daytime fatigue, OSA has been linked to an increased risk of serious chronic conditions, including hypertension, stroke, arrhythmia, metabolic syndrome, brain fog, and automobile accidents due to fatigue.
Learn to identify the signs of OSA and how to get diagnosed.
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About Sleep Apnea
In people with obstructive sleep apnea, the upper airway becomes narrowed or blocked repeatedly during sleep, when the muscles in the upper throat or tongue relax too much. Breathing is interrupted, and the lack of oxygen causes them to wake, often just enough to trigger breathing again. With OSA, breathing and sleep are continually disrupted, though the patient may not notice many of these disturbances.
The repeated oxygen deficit associated with OSA, coupled with chronic sleep deprivation, affects many organ systems in the body, from the circulatory to the neurological.
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What Contributes to Sleep Apnea
Certain factors can put you at increased risk of OSA, including:
- Weight gain. The risk of OSA increases as your weight rises, largely because excess fat deposits can narrow airways. One study found that a 10% increase in weight was associated with a six-fold increase in OSA risk.
- Age. Sleep apnea is more common in older adults for a variety of reasons, including decreased muscle tone in the airway.
- Menopause. Estrogen and progesterone may protect against OSA, so when hormone levels drop, risk increases.
- Certain hormonal conditions like polycystic ovary syndrome (PCOS), low thyroid hormones, and high levels of insulin.
- Drinking alcohol and smoking cigarettes can raise the risk of OSA.
- Family history. Researchers have found that people who have a close family member with OSA are at a higher risk of developing the condition.
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You Might Have OSA If …
You should pursue a diagnosis if you have any of these symptoms:
- You snore. Snoring is not required to merit an OSA diagnosis. But if you do snore, and you wake up tired, it may be a sign of OSA.
- Your partner notices that you gasp or catch your breath through the night.
- You feel like you can never get enough sleep.
- Your sleep feels choppy at the beginning or end of the night.
- You find yourself suddenly wide awake in the middle of the night or waking up throughout the night to urinate.
- You have brain fog or feel unfocused.
- You have insomnia.
- You wake up with a headache.
- You have mood changes, including increased irritability.
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How to Get Diagnosed
A home test is a convenient and effective way to diagnose most straightforward cases of OSA. While sleeping at home, you’ll wear a small device one night that measures your heart rate, blood oxygen level, and breathing patterns. These tests are covered by many insurance providers and, in some cases, can be sent to you in the mail.
Some people with complicating factors such as other health conditions or concerns about additional sleep disorders may require polysomnography, a sleep study conducted overnight in a sleep lab. Considered the “gold standard” of sleep tests, this study is more thorough than a home test, and it monitors breathing, heart rate and rhythm, and sleep stages.
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How Sleep Apnea Is Treated
The most common treatment for OSA is a device called a CPAP (continuous positive airway pressure) machine. It’s a mask you wear on your face at night that gently pushes air into your mouth or nose to keep your airway open. The CPAP is often uncomfortable at first; it can take some getting used to, and some trial and error is often required to find a mask that feels comfortable. It is extremely effective when used consistently.
For those who find the CPAP uncomfortable, an alternative is a specialized mouth guard that your dentist fits to your mouth. It repositions your lower jaw to help keep the airway open while you’re sleeping. It also requires a period of adjustment.
Other OSA treatments are aimed at reducing your risk of sleep apnea. If you have obesity, losing a significant amount of weight may reduce or eradicate the apnea. Tirzepatide, a GLP-1 medication, has been approved to treat OSA in the United States. Quitting smoking and reducing alcohol intake can also help reduce symptoms and risks associated with OSA.
