Sleep Apnea

Risk factors
Sleep apnea may occur if you’re young or old, male or female. Even children can have sleep apnea. But certain factors put you at increased risk:

Obstructive sleep apnea

  • Excess weight. Fat deposits around your upper airway may obstruct your breathing. However, not everyone who has sleep apnea is overweight. Thin people develop the disorder, too.
  • Neck circumference. The size of your neck may indicate whether or not you have increased risk of sleep apnea. That’s because a thick neck may narrow the airway and may be an indication of excess weight. A neck circumference greater than 17.5 (44 centimeters) is associated with an increased risk of obstructive sleep apnea.
  • High blood pressure (hypertension). Sleep apnea is not uncommon in people with hypertension.
  • A narrowed airway. You may inherit a naturally narrow throat. Or, your tonsils or adenoids may become enlarged, which can block your airway.
  • Being male. Men are twice as likely to have sleep apnea as women are. However, women increase their risk if they’re overweight, and the risk also appears to rise after menopause.
  • Being older. Sleep apnea occurs two to three times more often in adults older than 65.
  • Family history. If you have family members with sleep apnea, you may be at increased risk.
  • Use of alcohol, sedatives or tranquilizers. These substances relax the muscles in your throat.
  • Smoking. Smokers are three times more likely to have obstructive sleep apnea than are people who’ve never smoked. Smoking may increase the amount of inflammation and fluid retention in the upper airway. These risk likely drops after you quit smoking.

Central sleep apnea

  • Being male. Males are more likely to develop central sleep apnea than are females.
  • Heart disorders. People with atrial fibrillation or congestive heart failure are more at risk of central sleep apnea.
  • Stroke or brain tumor. These conditions can impair the brain’s ability to regulate breathing.

Complex sleep apnea

  • The same risk factors for obstructive sleep apnea are also risk factors for complex sleep apnea. In addition, complex sleep apnea may be more common in people who have heart disorders.

Complications
Sleep apnea is considered a serious medical condition. Complications may include:

  • Cardiovascular problems. Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain the cardiovascular system. If you have OSA, your risk of high blood pressure (hypertension) can be up to two to three times greater than if you don’t. The more severe your sleep apnea, the greater the risk of high blood pressure. If there’s underlying heart disease, these multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death from a cardiac event.

In contrast, central sleep apnea usually is the result, rather than the cause, of heart disease.

Obstructive sleep apnea also increases the risk of stroke, regardless of whether you have high blood pressure.

  • Daytime fatigue. The repeated awakening associated with sleep apnea make normal, restorative sleep impossible. People with sleep apnea often experience severe daytime drowsiness, fatigue and irritability. You may have difficulty concentration and find yourself falling asleep at work, while watching TV or even when driving. You may also feel irritable, moody or depressed.
  • Complications with medications and surgery. OSA is also a concern with certain medications and general anesthesia. People with sleep apnea may be more likely to experience complications following major surgery because they’re prone to breathing problems, especially when sedated and lying on their backs. Undiagnosed sleep apnea is especially risky in this situation.
  • Sleep-deprived partners. Loud snoring can keep those around you from getting good rest and eventually disrupt your relationships. It’s not uncommon for a partner to go to another room, or even on another floor of the house, to be able to sleep. Many bed partners of people who snore are sleep deprived as well.

People with sleep apnea may also complain of memory problems, morning headaches, mood swings or feelings of depression, a need to urinate frequently at night (nocturia), and impotence. Gastroesophageal reflux disease (GERD) may be more prevalent in people with sleep apnea.