Medically reviewed in December 2020
Updated on March 1, 2021
In September 2016, a train crashed into a station in Hoboken, New Jersey, killing one person and injuring more than 100. According to a CBS/AP news report, the 48-year-old driver said he arrived at work feeling fully rested. After the crash, the driver said he had no memory of the accident itself—only of waking up on the engineer cabin’s floor. He was later diagnosed with severe obstructive sleep apnea, a condition characterized by heavy snoring and where people stop breathing in their sleep multiple times per night. Sleep apnea often results in poor sleep at night, which can cause daytime drowsiness.
Is dying from sleep apnea a possibility?
Aside from causing daytime fatigue, untreated sleep apnea may shorten your life expectancy because it puts you at risk for a host of chronic illnesses. The condition has been linked to an increased risk of hypertension, stroke, irregular heartbeat and heart failure. That's not all. Severe sleep apnea raises your risk of early death by 46 percent, while even moderate sleep apnea can mean a 17 percent greater chance of dying early.
What is sleep apnea exactly?
When you sleep, throat muscles used for speaking, breathing and swallowing are relaxed and the throat becomes narrower. If you already have a narrow throat, these relaxed muscles may partially or completely block the airway. Enlarged tonsils, a small mouth, large tongue and obesity might compound the problem.
The blockage may cause snoring. A narrowing of the airway causes the top and bottom of the mouth to touch. Breathing causes the two sections to vibrate, resulting in the snoring and snorting sounds. If the blockage is severe enough to cause a stop in breathing or to reduce your ability to breathe, you’ll come out of a deep sleep and into a light sleep. You’ll often start breathing again with a loud snore, and you may wake up choking. In the most severe cases, this may happen up to 30 times per hour.
Why sleep apnea is dangerous
Sleep apnea is frequently packaged with other diseases. A 2008 Australian study of more than 60,000 people with sleep apnea who were admitted to the hospital found that these patients frequently had other conditions. The most common include:
- High blood pressure
- Obesity
- Diabetes
- Coronary heart disease
- Chronic obstructive lung disease (COPD)
- High cholesterol
You’re most at risk for sleep apnea if you’re male, overweight, age 40 or older or you smoke. Nearly 75 percent of the people in the Australian study were male, and there were more cases between the ages of 55 to 59 than any other age group. Others at risk include children. About 2 percent of children have the condition, usually caused by enlarged tonsils or adenoids, face or skull abnormalities and problems with throat muscles.
People who are older, overweight or have a family history of sleep apnea also have a higher risk of developing the condition.
Warning signs
Many people don’t know they have sleep apnea. An estimated 20 percent of American adults have obstructive sleep apnea, and 90 percent of those are undiagnosed. Often a spouse or partner will let you know that you’re snoring loudly and/or gasping for breath in the middle of the night.
Even if you don’t share a bed with someone, you may be able to look for clues. Snoring and daytime fatigue are two of the main signs. Others include:
- Headache upon waking
- Depression and irritability
- Frequent urination at night
- Dry mouth or sore throat upon waking
How it’s diagnosed
The next step is to see a healthcare provider. Your healthcare provider will take a medical history and may give you a physical examination, looking for a large uvula, soft palette or tonsils that may be obstructing the flow of air.
A sleep study is the best way to diagnose sleep apnea. You may have to go to a sleep center, but home sleep monitors are available, as well. A 2017 study published in Annals of Internal Medicine suggests home studies are just as effective as those in sleep centers. Sensors at a sleep study center record the amount of oxygen in your blood, air movement while you breathe, brain waves, chest movements and heart rate. The measurements of a home-based monitor may be more limited. Your healthcare provider reviews the results to determine how many times you either stopped breathing or your breathing was blocked. Between 5 and 15 is mild sleep apnea, between 16 and 30 is moderate, and over 30 is severe.
How sleep apnea is treated
People with sleep apnea have several options for treatment. For mild cases, lifestyle changes—such as weight loss, smoking cessation and avoidance of drugs and alcohol—may help reduce symptoms. Sleeping on your side and keeping your nasal passages clear might help, too.
Another option for mild sleep apnea is a mouthpiece that pulls the jaw forward and keeps your tongue from blocking airflow down your throat. A dentist or orthodontist can make one for you.
A continuous positive airway pressure (CPAP) machine is the most common treatment for moderate to severe sleep apnea. A CPAP machine forces air through your nostrils and mouth to keep airways open while you sleep. Research suggests they may do more than help you breathe better. Results from a 2018 Journal of American Heart Association study of 4.9 million Danish adults, including almost 40,500 with sleep apnea, suggest use of a CPAP machine can decrease your risk of heart failure. The 13-year study revealed the risk of heart failure was 38 percent higher among people ages 60 and older who did not treat sleep apnea with a CPAP machine. No matter what age, those not using CPAP had a slightly increased risk heart failure, according to the study.
The machine has interchangeable masks, from full-face to low-profile nose pillows that sit over your nostrils, and it may take some experimenting to find the one that’s right for you. Tell your healthcare provider if you find the CPAP machine uncomfortable, or if there are side effects like dry mouth or headaches.
Surgery is often a last resort, if you can’t or don’t want to wear a CPAP machine. It may take the form of resetting the lower jaw, shaving off parts of the uvula or soft palette, removing tonsils or adenoids, or some combination. There’s not enough evidence to conclude how well some forms of surgery work, while the success rate for other types of surgery averages only about 50 percent.
