Do you often feel sleepy during the day? Do you feel exhausted in the mornings, despite the amount of sleep you get? Do you snore constantly? If you answered yes to these questions, you may be at risk for obstructive sleep apnea (commonly referred to as OSA).
In this article, I will discuss exactly what obstructive sleep apnea is, how you can know whether you are at risk, and what you can do about it. So let’s get started!
What is Obstructive Sleep Apnea (OSA)?
Obstructive sleep apnea (OSA or simply, “sleep apnea”) is a condition that occurs when your airway becomes intermittently blocked while you are sleeping, preventing you from getting enough air into your lungs. This results in low oxygen levels in the blood which can end up affecting your health in many ways—one of which is chronic fatigue and daytime sleepiness. When sleep apnea is left untreated, it can cause or worsen your high blood pressure and heart condition and further increase your risk of a stroke or a heart attack.
Symptoms of OSA
The main symptom of obstructive sleep apnea is daytime sleepiness. This may feel different than just general tiredness. When you have daytime sleepiness from sleep apnea, you may find yourself falling asleep during the day while in the middle of important tasks, such as working or driving. Other symptoms of OSA are:
- Poor concentration and mental functioning during the day
- Not feeling refreshed upon waking up in the morning, no matter how much sleep you get
- Morning headaches
- Feeling depressed or irritable during the day
Warning Signs of OSA
The most common warning sign that suggests that you are at risk of having obstructive sleep apnea is chronic snoring that tends to be loud and constant. Other warning signs of sleep apnea are:
- Choking, snorting, or gasping while asleep
- Pauses in breathing during sleep
- Waking up at night feeling short of breath
- Going to the bathroom frequently during the night
Obstructive Sleep Apnea: Are You at Risk?
Certain people are more at risk of having OSA than others. These are people who are either anatomically prone to airway blockage or have lifestyle habits that contribute to it. Ask yourself if you have any of these risk factors for obstructive sleep apnea:
- Being overweight or obese. This is because fat around the neck can put pressure on the airway.
- Drinking alcohol in the evening. Alcohol not only relaxes the supporting muscles around your airway, but it also makes your brain less responsive to an apnea episode.
- Taking sedative medicines such as sleeping pills or muscle relaxants.
- Having enlarged tonsils.
- Sleeping on your back rather than on your side.
- Smoking cigarettes
Obstructive Sleep Apnea Risk
Ask yourself the following questions and answer with YES or NO:
- Do you snore loudly (louder than talking or loud enough to be heard through closed doors)?
- Do you often feel tired, fatigued, or sleepy during the daytime?
- Has anyone ever noticed that you stop breathing during your sleep?
- Do you have or are you being treated for high blood pressure?
- Is your body mass index (BMI) higher than 35 kg/m2?
- Are you over 50 years old?
- Is your neck circumference greater than 16 inches (40 cm)?
- Are you male?
How many times did you answer YES?
0 – 2: You are at low risk for OSA
3 – 4: You are at intermediate risk for OSA
5 – 8: You are at high risk for OSA
Daytime Sleepiness Assessment
Ask yourself: How likely are you to doze off in these situations?
0 = no chance of dozing
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
- Sitting and reading
- Watching TV
- Sitting in a public place (a meeting or a movie theater)
- Sitting as a passenger in a car for more than 1 hour
- Lying down and resting in the afternoon
- Sitting and talking to someone
- Sitting quietly after a lunch (without alcohol)
- While driving and stopped in traffic or at a red light
What is your score?
1 – 6: Mild sleepiness
7 – 8: Average sleepiness
9 and up: Extreme sleepiness
If you scored a 9 or above on the Daytime Sleepiness Assessment, I would strongly encourage you to have a talk with your health care professional about your symptoms. If your doctor suspects that you may have obstructive sleep apnea, the next step would be to see a sleep specialist and to get a sleep study. There are different types of sleep studies, some of which are performed overnight in a clinic, others which can be done at home with special medical equipment. If you are diagnosed with OSA, your doctor will then discuss with you your treatment options.
Obstructive Sleep Apnea: What You Can Do About It
While the mainstay of OSA treatment is to use a continuous positive airway pressure (CPAP) breathing machine at night, there are some things that you can do to help reduce your risk and improve the severity of your symptoms:
- Avoid alcohol, sleeping pills, or muscle relaxants. These substances decrease the muscle tone in the back of your throat, which puts more pressure on your airway. By avoiding them, you will be eliminating one factor that contributes to a blocked airway.
- Stop smoking. Cigarette smoke irritates your tissues, causing swelling in the airway that can worsen symptoms.
- Treat your allergies. If you also suffer from seasonal allergies, your nasal passages and airways are already irritated and inflamed. By getting your allergies under control, you will not only improve your symptoms but will feel better overall.
- Lose weight. If you are overweight or obese, studies have shown that weight loss can significantly decrease symptoms caused by obstructive sleep apnea.
In addition to lifestyle habits, the manner in which you sleep can also affect your symptoms. By optimizing your sleeping habits, you can also help to improve the severity of your symptoms:
- Sleep on your side. Some people only experience sleep apnea when sleeping on their back. This is because lying on your back makes it easier for your tongue and oral soft tissues to obstruct your airway. If you find yourself rolling onto your back during sleep, use the Tennis Ball Trick: Sew a tennis ball into a pocket onto the back of your sleeping shirt. This will prevent you from inadvertently turning onto your back during the night.
- Prop your head up. Elevate the head of your bed four to six inches by propping blocks under your bed. Alternatively, you can elevate your body from the waist up by using a foam wedge or special cervical pillow. This method also helps to improve heartburn symptoms.
- Open your nasal passages. Use a nasal saline spray or irrigation system (neti pot) before going to bed or consider wearing a nasal strip while sleeping.
By doing your part to optimize your lifestyle and sleeping habits, you will not only help improve your symptoms of fatigue, but you will be helping your overall health.
Here’s to better breathing for a good night’s sleep!
*The information presented in “Obstructive Sleep Apnea (OSA): What You Need to Know” can be found in Being Empowered for a Healthy Heart: A personal guide to taking control of your health while living with chronic conditions, by Phoebe Chi, MD, MPH.