Stages of Sleep Apnea

Snoring is the most obvious event associated with sleep apnea and results from turbulent air flow in a narrow airway. Airway collapse (apnea) is caused by negative air pressure (vacuum). This vacuum develops when air moves through a restricted space at high speed. The more severe the restriction, the louder the snoring becomes and the more likely apnea is to occur. When the throat collapses like a pinched straw on inhalation, carbon dioxide levels raise and oxygen levels decrease, resulting in arousal. The patient will simply lighten their sleep for a few seconds (arousal), open the airway to breathe and return to sleep, only to resume snoring and repeat the apnea cycle shortly thereafter. The bed partner can become aware of this problem because of pauses in air flow that are followed by gasping. 

Effects of Obstructive Sleep Apnea

Sleep apnea is a progressive disease. Mild snoring converts gradually to sleep apnea as more negative pressures are created because of weight gain, aging, etc. Initially this may be only a few apneas per night. As the number of apneic events increases, both physical and mental symptoms develop. These are usually not noted until there are at least 50 or more events per night.

Symptoms Possibly Indicative of Apnea

• Weight gain
• Fitful sleep
• Tired appearance
• Loud snoring
• Mumbling in sleep
• Drooling on the pillow
• Frequent urination at night
• Sweating in sleep

These cognitive (mental) dysfunctions may be present:

• Poor concentration
• Inappropriate asleep
• Poor memory
• Increased irritability
• Chronic fatigue
• Decreased libido
• Some depression
• Claustrophobia
• Rapid sleep onset
• Avoidance of social events
• Awakening with a headache

Long-Term Effects of Sleep Apnea

• Increased risk of cardiovascular disease, heart attack, stroke, angina pectoris (chest pains) and hypertension.
• Impaired performance at work and home – OSA individuals are more likely to have sexual impotence and develop diabetes.
• A majority of stroke victims also suffer from OSA.
• OSA patients have a much greater chance of having depression.

Symptoms may vary among patients, but most will have several of the above complaints. These problems are generally reversible with treatment.