Sleep apnea is a well-known yet misunderstood condition.  For the elderly, sleep apnea can be a severe problem. It is estimated that  10-20% of adults in the US suffer from sleep apnea, leading to many health problems.

Read on to learn the symptoms and treatments for sleep apnea.

What is Sleep Apnea?

Sleep apnea is a condition in which breathing is interrupted during sleep. The most common type of sleep apnea, obstructive sleep apnea (OSA), occurs when the muscles in the back of the throat fail to keep the airway open during sleep. This causes breathing to stop or become very shallow. 

Each time breathing starts again, there is a loud snort or choking sound. This reaction can happen many times throughout the night, causing loud snoring and periods when you stop breathing.

OSA  episodes can repeatedly occur through the night, causing frequent waking and gasping for air. It can make it hard to get a good night’s sleep, leading to daytime sleepiness, irritability, and difficulty concentrating. As you can imagine, OSA can affect a person’s health and well-being.

Sleep apnea is also linked to other serious health problems, such as:

  • High blood pressure
  • Heart disease
  • Stroke
  • Metabolic syndrome (a combination of high blood sugar, high blood pressure, and obesity) 

All of these health problems are more common in older adults. Sleep apnea can make these conditions worse. It’s important to treat sleep apnea so that it doesn’t lead to other health problems. Now, let’s look at types of sleep apnea.

Types of Sleep Apnea

Sleep apnea is not a one-size-fits-all disorder; there are three recognized types of sleep apnea. Let’s examine each: 

1. Obstructive Sleep Apnea (OSA)

OSA is the most common form of sleep apnea and occurs when your airway becomes blocked during sleep. 

2. Central Sleep Apnea (CSA)

Unlike OSA, CSA does not involve a blockage of your airway. Instead, it’s caused by a problem with your central nervous system that prevents your brain from sending signals to your muscles to keep you breathing.

3. Complex Sleep Apnea 

Also known as treatment-emergent sleep apnea, complex sleep apnea is a type of sleep apnea that occurs when there are pauses in breathing during sleep. These pauses can last for a few seconds to minutes and may happen dozens of times throughout the night. 

Complex sleep apnea is more common in older and overweight adults and is more likely to occur if you have heart failure or another type of heart condition.

Now we know the three types of sleep apnea, let’s learn the symptoms of this debilitating disorder.

Symptoms of Sleep Apnea

There are many signs and symptoms of sleep apnea, ranging from mild to severe, which can include:

  • Loud snoring. The sounds of snoring are caused by air vibrating through the soft palate (roof of the mouth) and uvula (the small fleshy lump at the back of the throat). A partially blocked airway is the cause of this symptom.
  • Gasping or choking during sleep. When your brain senses that you’re not getting enough oxygen during sleep, it signals your body to wake up and take a breath. People with sleep apnea will gasp and choke when waking.  
  • Waking up with a headache or sore throat. If you have sleep apnea, you may wake up with a headache or a sore throat. This is because your body is not getting enough oxygen when you breathe.  
  • Daytime fatigue. One of the most common symptoms of sleep apnea is feeling tired during the day. If you have sleep apnea, you may not get enough deep sleep, making you feel groggy and unwell during the day. 
  • Episodes where you stop breathing during sleep. With sleep apnea, your breathing is interrupted and repeatedly interrupted during sleep. They often occur 5 to 30 times an hour. Typically, normal breathing starts again with a loud gasp or snort. 
  • Insomnia. It is common for people with sleep apnea to have difficulty falling asleep and staying asleep. One theory is the brain registers the episodes of breathlessness during the night caused by sleep apnea as a possible danger and seeks to prevent people from sleeping to avoid the hazard. 
  • Irritability. Sleep apnea sufferers often experience irritability as a result of sleep deprivation. They may also suffer from depression, anxiety, and difficulty concentrating.
  • Daytime sleepiness. Because sleep apnea episodes disrupt sleep, people are often sleepy and lethargic during the day.
  • Lack of attention during wakefulness. During the day, people with sleep apnea may have difficulty paying attention. They may also feel very sleepy during the day and may even fall asleep unintentionally.

Now that you’re equipped to recognize the signs and symptoms of sleep apnea, let’s look at some of the causes of this disorder.

Causes of Sleep Apnea

The causes of sleep apnea differ depending on the type of sleep apnea we are considering.

The cause of obstructive sleep apnea is thought to be a combination of anatomic and functional abnormalities. 

  • Anatomic abnormalities may include airway blockage due to such things as enlarged tonsils, obesity, or a deviated septum. 
  • Functional abnormalities may include problems with the muscles that keep the airway open or with nerve signals that control these muscles. 

Whatever the cause, oxygen levels drop as you struggle to get air through your restricted airways. Your brain is alerted and goes into survival mode, rousing you from your sleep so you can breathe much-needed air. 

This cycle of sleep-wake-sleep is so fleeting you may not remember it, but it can happen up to 30 times nightly, significantly interfering with your sleep cycles.

Central sleep apnea is believed to be caused by several factors, such as:

  • A problem with the brain’s ability to send signals to the muscles that control breathing 
  • Narrowing of the airway due to excess weight or other physical changes
  • Use of certain medications 

With CSA, you will likely awaken when you stop breathing and have trouble getting back to sleep or staying asleep, disrupting your sleep cycles. So, who is most at risk for developing sleep apnea? Let’s take a look.

Who is at Risk for Sleep Apnea?

Anyone can have sleep apnea, but it is more common in certain groups of people. Here are those at greatest risk for obstructive sleep apnea.

At Risk for Obstructive Sleep Apnea

People who are overweight or obese. People with a body mass index (BMI) of 30 or greater are at increased risk for sleep apnea as they are more likely to have soft tissue in the back of their throat that can block their airways.

  • Men. Males are three times more likely to develop sleep apnea because They are more likely to have thicker necks, which can narrow the airway. 
  • Elderly or older people. The risk of sleep apnea increases with age because as we get older, our airways become narrower and less flexible. This makes it more likely for them to collapse during sleep.
  • People with large necks. As we discussed above, people with larger neck circumferences are at greater risk because they have more tissue around their airways, which can collapse during sleep. 
  • Family history of sleep apnea. People with family members who have sleep apnea are more susceptible to the disease because it can be hereditary. 
  • Smokers. Smokers are more likely to get sleep apnea because smoking irritates the airway. When this happens, the airway becomes narrower, making breathing harder.
  • People with diabetes. People with diabetes are especially prone to sleep apnea because high blood sugar can damage the nerves that control the muscles in the throat.
  • Narrowed airway. Some people, including children, develop sleep apnea due to narrowed airways. This can result from tonsils or adenoids that block their trachea and make breathing difficult during sleep.
  • Alcohol and medication. People who use alcohol, sedatives, or tranquilizers are more prone to sleep apnea because these substances can relax the muscles in the throat and cause a temporary airway blockage. 
  • Nasal congestion. People with nasal congestion are at a higher risk of developing sleep apnea because it can block the airflow through the nose, forcing them to breathe through their mouth and throat.
  • Medical conditions. People with medical conditions are more likely to develop OSA because they are more prone to obesity and likely to take medications that can cause sleep apnea (such as sedatives).

 Let’s look at who is most at risk for developing central sleep apnea (CSA).

At Risk for Central Sleep Apnea

  • You are older. You may be more prone to getting central sleep apnea if you are older because your breathing muscles can weaken as you age. This may cause air to leak from your lungs during sleep and make it harder for you to keep your airway open.
  • Being male. Due to their higher body weights and larger necks, males are at greater risk of developing CSA than females.
  • Heart Disorders. If you have a heart disorder, you’re at higher risk for sleep apnea. That’s because conditions that damage the heart and its ability to pump blood can also cause disruptions in your breathing during sleep.
  • Medications. Narcotics, opioids, and long-acting pain meds like methadone can increase your risk of getting sleep apnea because These medications can cause your throat muscles to relax and block your airway. 
  • Stroke. If you’ve suffered a stroke, you may develop CSA due to disrupting breathing muscles and the central nervous system.

Now we’ve covered risk factors, let’s move on and discuss complications you may experience due to sleep apnea.

Complications from Sleep Apnea

Difficulty breathing is just one symptom of sleep apnea. Other complications can arise from this disorder, such as:

  • Fatigue. Fatigue is a common complication of sleep apnea. When you don’t get enough rest, you may be too tired to function during the day. 
  • Heart problems. Untreated sleep apnea has been linked to an increased risk of heart attack, stroke, and irregular heartbeat.
  • High blood pressure. Because it decreases the oxygen levels in your blood, sleep apnea can lead to heart problems, which can strain your heart and lead to high blood pressure.
  • Type 2 diabetes. Unfortunately, people with untreated sleep apnea are more likely to develop insulin resistance, which can lead to type 2 diabetes.
  • Metabolic syndrome. Metabolic syndrome is linked to sleep apnea because both disorders share common risk factors, such as obesity and insulin resistance. 
  • Surgery. Surgical complications can arise from sleep apnea because of the need for frequent surgeries to treat the condition. 
  • Taking medication. The elderly can expect medication-related complications from sleep apnea because many medicines can cause or worsen sleep apnea. 
  • Liver issues. Liver disease can sometimes be a complication of sleep apnea because of the constant stress on the organ from the lack of sleep and breathing difficulties.
  • Adverse effects on a partner. A less talked-about but severe complication of sleep apnea is a sleep-deprived partner. When one person suffers from sleep apnea, it can have a severe ripple effect on their partner’s sleep.

We’ve explored possible complications of sleep apnea, and now let’s examine treatment options. 

Treatment for Sleep Apnea

There are several possible treatments and therapies for sleep apnea, including:

  • Continuous positive airway pressure (CPAP): A machine delivers air through a hose to a mask worn during sleep. The air pressure keeps your airway from collapsing.
  • Other airway device alternatives. Other devices include: 
    • The Bi-Level Positive Airway Pressure device (BPAP). The device has two settings, one for inhalation and one for exhalation. 
    • An ASV is an Adaptive Servo Ventilator.  This newer machine automatically adjusts to your breathing patterns and provides just the right amount of air pressure. 
  • Oral appliances: These devices, which look like mouthguards, are fitted by dentists or other specialists and adjust your lower jaw and tongue to help keep your airway open.
  • Weight loss: Losing weight can often help reduce sleep apnea.
  • Avoidance of alcohol and smoking: Alcohol and smoking can contribute to sleep apnea. Avoiding or quitting these habits may help lessen the severity of sleep apnea.
  • Treat underlying medical problems. Often sleep apnea is a symptom of another untreated medical problem; if you treat the underlying cause, you will also treat the sleep apnea. 
  • Supplemental oxygen. Using supplemental oxygen can help sleep apnea patients find relief by providing them with the much-needed oxygen their bodies lack during an apnea episode.
  • Surgery. Surgery options for sleep apnea sufferers include: 
    • Removing the excess tissue in the back of the throat or the tonsils at the back of the tongue.
    • Adjusting both the upper and lower jaws forward to open up the airway.
    • Nerve stimulation to keep the airway open.
    • Using heat destroys the tissue in the back of the throat blocking the airway.
    • As a last resort for people who have not responded to other treatments, an opening is created in the neck, and a tube is inserted to help to breathe, called a tracheostomy.
  • There are many possible treatments for sleep apnea, depending on the type and cause of the disease. Talk to your doctor to determine which course of treatment is right for you!

Get Better Sleep

Sleep apnea affects not only the sufferer’s quality of life but also the quality of life of their loved ones. This guide explains the signs, symptoms, complications, and possible treatments of sleep apnea in hopes you can get a diagnosis sooner and find your way back to more restful nights and alert days.

If you need help caring for a loved one struggling with sleep apnea, check with your Medicaid provider to see if they offer the Consumer Directed Personal Assistance Program (CDPAP) in your state.

CDPAP aims to provide services like home care to those struggling with conditions that affect their everyday lives. Reach out to your Medicaid provider today, and see if you qualify. Don’t wait; get the help you need if you suffer from sleep apnea.

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