Sleep apnea results when your airway narrows as you sleep. Learn what causes sleep apnea — if untreated, the condition can lead to serious complications.
Muscles in the back of your throat support the soft palate, tonsils, uvula (the triangle-shaped tissue hanging from the soft palate), your tongue, and the side walls of your throat. If those muscles relax too much when you sleep, your airway closes or narrows and you can’t breathe adequately - causing obstructive sleep apnea (OSA).
Obstructive sleep apnea is the most common type of sleep apnea, followed by central sleep apnea (CSA), which results from irregularities in the brain’s normal signals that tell the body to breathe. Most people have a combination of these types of apnea, according to the National Institute of Neurological Disorders and Stroke (NINDS).
Sleep apnea symptoms
If you have sleep apnea, you likely make choking, snoring, or gasping sounds in your sleep. That’s because when your airway is narrowed, your brain perceives you are having difficulty breathing and wakes you. You then gasp and reopen your airway.
These waking moments may be frequent — five to 30 times an hour. While the interruptions are so brief you likely won’t remember they occurred, you may find you don’t feel rested in the morning. This common symptom of sleep apnea is often the result of blood levels of oxygen being lower than normal due to the condition.
In fact, daytime sleepiness is a hallmark warning sign of sleep apnea, according to the NINDS. Other sleep apnea symptoms include morning headaches, irritability, forgetfulness, behavior or mood changes, anxiety, and depression. Of course, these symptoms can be caused by many other conditions.
But if you have risk factors for sleep apnea and you experience any of these symptoms, it makes sense to talk to your doctor.
Sleep apnea causes
There are some risk factors for sleep apnea you can’t change. For example, men are twice as likely to have sleep apnea, both OSA and CSA, than women. Increasing age also raises the risk for sleep apnea, and so does having a family history of the condition. You can inherit a naturally narrowed airway leading to sleep apnea, too.
Obstructive sleep apnea causes
- Obesity and being overweight. Increased fat deposits in the neck can block the upper airway during sleep, the National Heart Lung and Blood Institute (NHLBI) explains.
- Enlarged tonsils or adenoids. Sleep apnea in children is often caused by tonsil or adenoid problems – but enlarged, airway-blocking tonsils or adenoids can cause apnea at any age.
- Nasal congestion. Anatomical problems or chronic allergies can cause OSA by blocking airways during sleep.
- Neck circumference. People with thicker necks may have narrower airways that cause sleep apnea. The risk goes up for men if the neck circumference is 17 inches (43 centimeters) or more. In women, the risk increases if neck circumference is 15 inches (38 centimeters) or larger.
- Smoking. Smoking triples the risk of obstructive sleep apnea, compared to people who are non-smokers. Smoking may cause OSA by triggering inflammation and fluid retention in the upper airway. However, this risk may drop if you quit smoking, according to the NHLBI.
- Alcohol, sedatives, or tranquilizers. Alcohol and certain prescription drugs relax the muscles in your throat, resulting in obstructive sleep apnea.
Sleep apnea causes due to disrupted brain signals (CSA)
- Cardiovascular disorders. People with congestive heart failure are at especially high risk for central sleep apnea.
- Narcotic pain medications. Opioid drugs, particularly long-acting ones, increase the risk of central sleep apnea.
- Stroke. People who've had a stroke have an increased risk of central sleep apnea.
Complications of sleep apnea and treatment
Sleep apnea is considered a serious medical condition. If undiagnosed or untreated, it can result in health complications, including heart attack, glaucoma, diabetes, cancer, and cognitive and behavioral disorders, according to the NHLBI.
If you have signs and symptoms of sleep apnea, talk to your doctor about being tested and, if diagnosed with sleep apnea, treated.
The Centers for Disease Control and Prevention (CDC) notes lifestyle changes, including weight loss, and gentle air pressure administered during sleep through a nasal continuous positive airway pressure device are often effective therapies. Treating causes of sleep apnea, such as enlarged tonsils and allergies, is also important.
June 13, 2018
Janet O’Dell, RN