Snoring, stopping breathing or choking during the night can be a strong indicator of obstructive sleep apnea. But even if you don't, chances are you at least know someone who does. This is because this is one of the most common sleep disorders. Surveys by the Instituto do Sono indicate that in the city of São Paulo, 32% of people have some level of apnea. This is an alarming number as it means that one in three people have this disease!
Sleep apnea is a condition caused by total or partial obstructions to the passage of air in our upper airways (at the level of the throat, more or less). Everyone can have some of these obstructions at night, and this can happen without any problems occurring. However, sleep apnea starts to be a problem when you observe at least five of these obstructions per hour (in severe cases you can see more than thirty obstructions per hour). It is precisely these obstructions that cause snoring and choking, the main observable manifestations of sleep apnea at night.
Causes of apnea
These obstructions occur due to several factors. First, there is a physiological cause: it is normal that when we sleep, our muscles get weaker and weaker, especially in REM sleep (we call this muscle atony). This lack of strength also applies to the muscles of the throat, making it more prone to close and obstruct. However, this atony alone is not enough to cause apnea; note that this is normal sleep and happens to everyone. For apnea to occur, some other factor must occur, increasing the chance of apnea. Some of these factors are:
• Obesity: Overweight people are much more prone to sleep apnea. This is because in these cases, the weight added to the lack of muscle strength can make obstructions more easily occur. It is now known that this is the main risk factor for apnea.
• Gender and hormones: Sleep apnea is much more common among men than among women. There are many causes for this, but a good explanation lies in female hormones. Progesterone is a great respiratory stimulant, protecting women from apnea during their adult life. However, this is exactly what explains why sleep apnea ends up being more common in women after menopause: as these hormones no longer have an effect, the protection that women had is no longer there. Thus, menopausal women have an almost equal chance of having apnea as men.
• Aging: The older we are, the more likely we are to have apnea. The main cause is that aging normally leads to decreased muscle strength, making these obstructions more easily occur.
• Large tonsils: In children the main cause of apnea is enlarged tonsils. Depending on their size, they can obstruct the air passage, causing apnea to manifest.
Since these stops in breathing happen when we go deeper into sleep and relax our muscles, there is only one way to regain our breathing: by waking up or by shallowing sleep, so that the breathing muscles regain their strength.
Step by step of the night of a person with apnea
The person begins to sleep > Sleep deepens and muscles relax > Apnea occurs! > Sleep is shallowed > The person breathes again > and the cycle continues
Thus, the sleep of the person with apnea throughout the night ends up being very fragmented and superficial. This makes apnea a chronic disease: it is not an obstruction of breathing or isolated choking that puts the person's life at risk, but the fact that this occurs over years, without anyone knowing or seeking treatment.
With this also usually appear the main symptoms of apnea. The first are behavioral: because they don't sleep well, people with apnea are very sleepy during the day, inattentive and fatigued. This greatly affects professional performance. As an example, work and car accidents are much more common in people with apnea, precisely because the person is unable to stay awake and alert. In addition to these, people with apnea may have memory impairment and more chance of developing depression.
Apnea also affects our physical health! And one of the most affected organs is the heart. Keep in mind that every time our breathing stops, our heart needs to work faster and harder to use what little oxygen we have left. With this, throughout the night, the heart of a person with apnea does not rest! This is exactly what explains why apnea causes hypertension and increases the chance of having a heart attack, stroke and other cardiovascular problems. And this is just one of a huge list of problems related to apnea (which includes diabetes, metabolic problems, sexual dysfunction, etc).
If you have or know someone who has apnea, seek treatment as soon as possible! It is very common for people not to know or believe they have apnea, because it happens just when they are sleeping, but if you have ever seen a friend or family member snoring a lot or choking in their sleep, let them know and encourage them to seek treatment .
SleepUp can certainly help you with this, especially in the behavioral part, ensuring that you have good sleep habits and manage to reduce the effects of sleepiness. However, in the case of apnea, the treatment cannot be restricted to our application. You should look for a specialized sleep medicine professional or service. There are several options for treatment, but only a proper clinical evaluation can indicate the best case for you!