Obstructive sleep apnea (OSA) is the most common sleep disorder relating to sleep and abnormalities in breathing. It most commonly occurs in males but can affect any sex, even young children. It is estimated that over 900 million people in the world have OSA. OSA does vary by race, being more common in black people than white people. The prevalence of OSA is increased as more people are being diagnosed with OSA and the increase in obesity as well.

What Increases My Risk of Having OSA?

There are a few common factors that can increase your risk of having OSA. These include older age, male, obesity, abnormalities in the upper throat or facial anatomy, smoking, family history of OSA, nasal obstruction, and a few others.

  • OSA increases from young adulthood and will then level off after the age of 70.
  • OSA is about 2-3 times more common in men. However, once women reach menopause, the risk becomes similar to men.
  • The risk of OSA is higher in those with a BMI >30.
  • Factors such as the atypical size of the upper and lower jaw, wide craniofacial base, and enlarged tonsils and adenoids can increase the risk of developing OSA.
  • Smoking can increase the risk and worsen OSA. There is a higher prevalence of OSA in smokers vs. nonsmokers. Smoking can also cause upper airway inflammation making it more prone to collapse during sleep.
  • A genetic predisposition to OSA can be due to inherited abnormal craniofacial structures.
  • Nasal obstruction and/or congestion can be seen in those with OSA. However, even if the obstruction or congestion is resolved, it’s possible that it wouldn’t improve the OSA.

What Are The Typical Body Characteristics of Someone With OSA?

As mentioned before, OSA is more commonly found in people who are overweight and obese. In people with this type of body habitus, the upper airway usually is crowded due to the extra weight in that area. Furthermore, OSA is more prevalent in someone with a large neck and/or waist. Specifically, if the neck is larger than 17 inches in men and 16 inches in women, this will predispose you to OSA.

However, it is possible for crowding in the upper airways to be present. This could be due to a genetic predisposition. Signs of a crowded airway include small chin, receding chin, large tongue, large tonsils, long or large uvula, high arched or narrow palate, deviated septum, nasal polyps, enlarge turbinates.

What Other Health Conditions is OSA Associated With?

OSA is associated with a variety of medical conditions including but not limited to heart disease, congestive heart failure, pulmonary hypertension, chronic pain/fibromyalgia, reflux disease, and elevated hemoglobin levels. In addition, Down’s syndrome, obesity, hypoventilation syndrome, high blood pressure, kidney disease, lung disease (asthma, COPD), stroke, pregnancy, acromegaly, thyroid disease, PCOS, Parkinson’s disease, and insomnia are also associated with OSA.

What Are The Warning Signs And Symptoms of OSA?

The most common complaints of someone with OSA are snoring, stopping breathing during sleep, choking, gasping, snorting, waking up frequently during the night, being very tired/sleepy during the day and morning headaches.

First, there’s a difference between daytime sleepiness and daytime fatigue. These both can occur in someone with OSA. Daytime sleepiness is the inability to stay awake and fully alert during the day. Fatigue relates to having low energy or feeling exhausted that interferes with normal daily activities. People will fall asleep watching TV/movies, reading a book, laying down to rest, during meetings, while at work, during church, etc. Some people will even fall asleep while driving. People will often complain of brain fog, memory problems, not thinking clearly, etc. In addition, people will complain that they can sleep eight or more hours and still feel exhausted when they wake up. They also complain of disrupted sleep – tossing/turning, feeling restless. Because of this, the patient will drink a lot of caffeine to combat sleepiness/fatigue.

A common scale used to help determine if someone is overly sleepy/tired is the Epworth Sleepiness Score. A score >9 signifies that you should probably receive an evaluation for your sleepiness/fatigue.

More Warning Signs And Symptoms of OSA To Be Aware Of

In addition to daytime sleepiness and daytime fatigue, there are more symptoms and signs of OSA to be aware of. Snoring, gasping, and stopped breathing episodes are common signs in someone with OSA. It’s often the bed partner or family member complaining of these than the one who has the OSA.

Headaches that occur specifically in the morning and resolve a few minutes after waking up are a sign of OSA. Sometimes headaches associated with nausea and sensitivity to light and/or sound is a sign of OSA. The headaches can sometimes last several hours after awakening. The cause of these headaches is due to inadequate breathing during sleep. For instance, low oxygen levels, high carbon dioxide levels, blood vessels reacting to breathing abnormalities, elevated intracranial pressure, and poor sleep quality are all examples of inadequate breathing.

An unusual warning sign of OSA is an increased amount of urination during sleep. People often complain of waking up during the night to urinate. They’re not sure if they woke up because they had to urinate or woke up and then decided to go to the bathroom. This symptom might be a sign in someone with OSA to also be aware of.

Putting it All Together

In conclusion, OSA is a very common sleep disorder. A multitude of medical conditions, especially cardiac disease, are also associated with OSA. The most common signs and symptoms include snoring, gasping, choking, daytime sleepiness/fatigue. If you think you or someone you know has OSA, I highly encourage you to get tested. OSA treatment will improve sleep quality and daytime functioning. More importantly, it will help improve cardiovascular health.

I hope you found this helpful. Feel free to comment or leave a question. I hope you have a good night’s sleep!

-Twilight Sleep Doc, get your Sleep Study Today!