The alarm rings and you feel horrible again. You can’t believe that it’s already 6:30, but the clock never lies, and it’s time to prepare for work. Climbing out of bed, you experience your daily head rush, and nearly walk into the wall on your way to the bathroom. After a quick doze in the shower, a pot of coffee helps wake you up, but it’s fleeting relief. By 10:30 your palms have already caught your head twice, and you’ve even snuck in a five minute nap when nobody was looking. Sure, it’s Tuesday, but you just can’t understand why you feel this bad.
For people with sleep apnea, mornings like this are frustratingly common. Those with severe sleep apnea feel like this nearly every morning, and neither going to bed early nor sleeping in offers any panacea. To help sleep apnea sufferers understand why this happens, we’re going to dive into the science behind apneas, discussing why people get them and what’s preventing them from getting that elusive good night’s sleep.
Upper Airway Collapse
More than 90% of patients with sleep apnea suffer from obstructive sleep apnea, or OSA. Most commonly, OSA occurs when the soft tissue that lines the upper airway collapses. This can happen for a number of reasons: overweight people and athletes with large necks often exert more force upon their diaphragm during sleep than the tissue can withstand, while others have narrow airways or other genetic predispositions to apneas.
These obstructions make it difficult for people to breathe. The body never stops trying to breathe, but the obstruction prevents the flow of air. This causes people to gasp for oxygen – the source of the loud snoring, sleep apnea’s defining characteristic – which can happen upwards of 100 times per night. As you might imagine, the lack of inflowing air causes a number of problems in the body: oxygen levels plummet and CO2 rises. Over time this can lead to a number of debilitating health conditions, including heart attack and stroke.
Why You Don’t Remember Waking Up
Oftentimes, patients are shocked when they discover that their sleep apnea has caused them to wake up frequently throughout the night. Sleep apnea sufferers often have no recollection of waking, and wonder how they can possibly wake up so often. The answer is simple. When a person sleeps, they progress through different stages and levels of sleep. When a person is “awoken” by an apnea they don’t completely wake up: they simply revert back to a previous stage of sleep.
Primarily, this occurs as the patient drifts into REM sleep
. During REM, the body becomes completely paralyzed and muscles become less responsive. This makes it difficult for the patient to keep their airway open. As the neck muscles collapse, the size of the airway restricts, causing the patient to wake up slightly in an effort to get air. This lifts them out of the much-needed REM sleep, essentially re-starting their sleep cycle. Without adequate REM, people are unable to get into the deep sleep the body requires for reinvigoration.
If these symptoms describe your life, there are a few things you can do to get your life back. For those who are a bit heavy, a diet and regular exercise can help you shed some weight and potentially take pressure off of the soft tissue muscles in the throat. Some patients also experience some relief with a new pillow, or by sleeping on their side instead of their stomach or back. Sleep apnea can also occasionally go away entirely without reason, although this normally happens to younger people.
Usually, you’ll need to try a more lasting form of therapy. Some patients opt for some form of surgery on their throat or jaw, and in certain cases, these operations can prevent the onset of apneas. Frequently, however, these surgeries are painful and expensive and don’t solve the fundamental problem or treat the symptoms patients are experiencing.
In most situations though, use of a continuous positive airway pressure (CPAP) machine and mask offer the most reliable form of sleep apnea therapy. By comparison to surgery, CPAP is inexpensive and un-obtrusive. It may take patients a little while to adjust to therapy, but it is a tried and true solution to sleep apnea. In use for three decades, CPAP has been studied time and time again, and proven to be a reliable form of therapy. If you need help for your sleep apnea, consider using CPAP for a new lease on life.