You May Be Sleeping All Night and Still Not Be Getting the Rest Your Body Needs
Many people with obstructive sleep apnea have no idea they have it.
They go to bed. They sleep for seven or eight hours. The alarm goes off in the morning, and somehow, they still feel exhausted.
Maybe they blame stress. A busy work schedule. Getting older. Or simply not being a “morning person.”
But sometimes, the problem is not how long you are sleeping. The problem is what is happening to your breathing while you sleep.
Obstructive sleep apnea, often called OSA, is a common sleep disorder in which the upper airway repeatedly narrows or becomes blocked during sleep. According to the National Heart, Lung, and Blood Institute, these interruptions can cause breathing to stop and restart many times throughout the night and may prevent the body from getting enough oxygen.
The difficult part is that many of these breathing events happen while the patient is asleep.
You may not remember them in the morning.
What Actually Happens During Obstructive Sleep Apnea?
When you are awake, muscles in the throat help keep the upper airway open. As you fall asleep, those muscles naturally relax.
For someone with obstructive sleep apnea, the airway becomes too narrow or temporarily blocked. Airflow decreases or stops, even though the body is still trying to breathe.
The brain recognizes that something is wrong and briefly disrupts sleep. This allows the airway to reopen and breathing to resume.
Then the patient falls back asleep.
The process may happen again and again throughout the night.
In moderate or severe cases of sleep apnea, breathing interruptions can occur many times per hour. This can lead to fragmented, nonrestorative sleep, even when a person believes they slept through the night.
The Signs of Sleep Apnea Are Not Always Obvious
Loud snoring is one of the most recognized symptoms of obstructive sleep apnea, but snoring is not the entire story.
Common Sleep Apnea Symptoms May Include:
- Loud, persistent snoring
- Witnessed pauses in breathing
- Gasping or choking during sleep
- Excessive daytime sleepiness
- Morning headaches
- Dry mouth upon waking
- Difficulty concentrating
- Problems with attention or mental clarity
- Frequent nighttime awakenings
- Sleep that never feels refreshing
Sometimes, the first person to notice a problem is not the patient.
It is a spouse or bed partner.
If someone has told you that you stop breathing, gasp, or appear to struggle for air while sleeping, that information should be taken seriously.
Why Do Some People Develop Sleep Apnea?
There is no single cause of obstructive sleep apnea.
The structure of the jaw and upper airway can play a role. The size or position of the tongue may contribute. Age, enlarged tonsils, and other anatomical factors may also affect how easily the airway stays open during sleep.
Obesity is another recognized risk factor. The NHLBI notes that increased fat deposits around the neck may narrow or block the upper airway in people with obesity.
However, you do not need to have obesity to have sleep apnea.
We cannot look at someone’s body type and determine whether they have OSA.
Thin patients can have severe sleep apnea. Patients who do not snore loudly can still have a sleep disorder.
The only way to properly understand what is happening during sleep is through an appropriate medical evaluation and, when indicated, sleep testing.
Sleep Apnea Is About More Than Feeling Tired
It is easy to think of sleep apnea as a snoring problem or an energy problem.
The medical conversation is much larger.
The NHLBI has established links between sleep apnea and serious health conditions including obesity, type 2 diabetes, high blood pressure, stroke, and heart disease.
Repeated breathing interruptions may also cause drops in blood oxygen levels. NIH funded research has examined how these oxygen changes may contribute to increased cardiovascular risk in people with obstructive sleep apnea.
This does not mean every person with sleep apnea will develop these conditions.
It does mean that untreated sleep apnea should not simply be dismissed as annoying snoring.
How Is Obstructive Sleep Apnea Diagnosed?
A sleep medicine evaluation usually begins with a detailed discussion about your symptoms, sleep habits, medical history, and what may be happening during the night.
A sleep study may be recommended when obstructive sleep apnea is suspected.
Depending on the individual patient and clinical situation, sleep testing may involve a home sleep apnea test or an overnight sleep study performed in a sleep center.
The purpose is to collect objective information about breathing during sleep.
How frequently are breathing events occurring?
Are oxygen levels changing?
How severe is the sleep apnea?
The answers help guide appropriate treatment decisions.
Sleep Apnea Treatment Is Not the Same for Every Patient
Many patients hear the words “sleep apnea” and immediately think of CPAP.
Positive airway pressure therapy is an important and effective treatment for many patients with obstructive sleep apnea. However, sleep apnea treatment should be based on the individual patient and the severity and characteristics of the sleep disorder.
Treatment approaches may include positive airway pressure therapy, oral appliance therapy, weight management, positional therapy, or other interventions when clinically appropriate.
The goal is to determine which approach is appropriate based on the patient’s diagnosis and individual sleep health.
When Should You See a Sleep Medicine Specialist?
If you are experiencing persistent snoring, witnessed pauses in breathing, gasping during sleep, excessive daytime sleepiness, or sleep that consistently leaves you feeling exhausted, it may be time to look more closely at what is happening at night.
Dr. Edward Mezerhane and the team at Sleep Medicine Specialists of South Florida evaluate and manage obstructive sleep apnea and other sleep disorders.
A proper sleep evaluation can help determine whether breathing interruptions are occurring and what the appropriate next steps may be.
Sleeping for eight hours does not always mean you are getting eight hours of healthy sleep.
Sometimes, the first step is finding out what is happening while you are asleep.
Medical Sources and Further Reading
National Heart, Lung, and Blood Institute: Sleep Apnea
National Heart, Lung, and Blood Institute: Sleep Apnea Causes and Risk Factors
National Heart, Lung, and Blood Institute: Sleep Apnea Research
This article is intended for general educational purposes and does not replace individualized medical advice, diagnosis, or treatment.