Sleep apnea—particularly obstructive sleep apnea (OSA)—is one of the most prevalent sleep disorders in the world. In the US, 25 million people are expected to have the disorder; worldwide, estimates reach nearly one billion. Despite it being one of the most common disorders, 80 percent of those who suffer from sleep apnea remain undiagnosed and untreated.
On top of being especially common, sleep apnea is also detrimental to one’s overall health and wellness. Not only does the disorder often lead to a decline in everyday functioning, but it is also associated with a number of chronic health conditions, including the following:
- Heart disease
- High blood pressure
Because sleep apnea can have such a significant impact on one’s health, accurate diagnosis and excellent treatment are absolutely essential. That’s why it’s so important for everyone to recognize the signs of OSA. While you likely know that those with OSA often snore, there are also quieter signs that are no less telling. Let’s dive into five sneaky signs that you—or someone you know—could be suffering from OSA.
Taking Middle-of-the-Night Bathroom Breaks
Waking to urinate throughout the night, also known as nocturia, occurs in nearly half of people with OSA. Normally, the body releases an antidiuretic hormone as you sleep that prevents the kidneys from filling up. However, studies have shown that those with sleep apnea don’t release enough of this hormone, as OSA can affect the way this hormone is released. In response, the kidneys continue to fill up and require bathroom breaks throughout the night.
While it’s normal to wake up once or twice during the night to urinate every once in a while, many patients with OSA report going as many as six times in a single night. Many people also mistakenly attribute nocturia to a urinary infection or an overactive bladder. This means they commonly report the problem to their urologist or gynecologist, therefore failing to treat the root cause of their frequent urination.
If you frequently wake up to urinate throughout the night, consider reaching out to your medical provider; it could be just one of the signs of OSA you’re experiencing without realizing it.
Feeling Moody without Knowing Why
OSA has more than just physical effects: It also impacts a person’s mental health. For example, research has shown that people with OSA are more likely to experience both anxiety and depression. Along those lines, one of the biggest signs of OSA that often goes unnoticed is moodiness. Studies have shown not only structural changes in the brain due to OSA but also chemical changes that impact how the brain functions.
In one study, researchers considered levels of two brain chemicals—glutamate and gamma-aminobutyric acid (GABA)—involved in the regulation of emotions and thinking, as well as physical functions like perspiration and blood pressure. GABA acts as a mood inhibitor, helping people keep calm, while glutamate has the opposite effect, activating the stress response. The study found that those with OSA not only had high levels of glutamate but also lower levels of GABA. This suggests that OSA could lead to a reorganization of the brain’s function, causing irregular mood regulation.
Similarly, lack of sleep can cause you to feel exhausted throughout the day, leading to less patience, an inability to focus, and irritability. Sleep apnea can even begin to disrupt your partner’s sleep, possibly decreasing intimacy—especially if you have to sleep separately. These feelings can all interfere with your daily life, affecting your overall mood and making it harder to feel happy and motivated every day.
Waking with a Sore Throat, Dry Mouth, and/or Headaches
Many people with OSA tend to feel bad when they wake up. For example, it’s common for individuals to experience a dry, sore throat as they awake, even after sleeping a full eight hours. This is because the respiratory system can be irritated by OSA symptoms, not only because of snoring but also because many people with the sleep disorder tend to sleep with their mouths open. As they struggle for each breath, opening their mouth to breathe can help them open their airway; however, it can also dry out the throat and cause it to be sore.
Along those lines, the poor sleep caused by OSA can also lead to the development of headaches. In fact, it’s estimated that 50 percent of people who wake with headaches have a form of sleep apnea. This could be because when an individual experiences frequent pauses in breathing throughout the night, oxygen levels in the brain stay relatively low. Along those lines, deoxygenated air—full of harmful carbon dioxide—becomes trapped in the lungs and builds up in the bloodstream, causing vessels in the brain to swell. These headaches can continue to build up until they take on the intensity of a migraine.
Experiencing Brain Fog
Cognitive impairment is one of the most common signs of OSA. Memory loss, slower reaction times, and impaired reasoning are just a few indicators of affected cognition, all of which are associated with OSA. While brain fog can be hard to pin down, there are a few things that people can experience when they experience this sensation, including the following:
- Poor concentration
- Feeling “out of it,” confused, or “spacy”
- Having difficulty finding the right word
- Being easily distracted
- Feeling excessively tired
- Needing more time to complete simple tasks
- Emotional detachment
The chronic sleep deprivation caused by OSA prevents the brain from getting the rest it needs to function properly. Some studies have shown that a lack of oxygen in the brain can even affect the cerebral cortex, where most information processing occurs. This ultimately impacts thinking and memory. If you’re experiencing these sensations, it could be because you aren’t getting enough sleep every night because of a sleep disorder like OSA.
Feeling Excessively Tired Nearly Every Day
Perhaps one of the more obvious signs of OSA, fatigue and excessive sleepiness are telltale symptoms of the disorder. It’s normal to experience the occasional rush of daytime fatigue; however, feeling constantly exhausted during the day could be a sign of OSA or another sleep disorder. Those who experience excessive daytime sleepiness typically find themselves struggling to stay awake throughout the day—often to the point that they can’t finish their work.
You may be wondering, “How can I tell if I’m just sleep deprived or have something more serious like OSA?” Well, if you have OSA, your fatigue will likely be accompanied by the signs we’ve talked about here, as well as the following symptoms:
- Loud snoring
- Pauses in breathing
- Gasping for air during sleep
- Abrupt awakenings accompanied by choking
- Restless sleep
If you often experience these symptoms, it may be worth speaking to your doctor about the possibility of OSA.
While obstructive sleep apnea is one of the most common disorders in the world, it often goes undiagnosed and untreated. However, treatment is absolutely essential to improving the wellbeing of patients with the disorder, as well as ensuring they can lead happier, healthier lives. This is why it is so important to be able to notice the signs of OSA: The disorder can affect nearly every area of an individual’s life, including their mood, pain levels, ability to sleep throughout the night, cognition, and energy levels.