The American Sleep Association (ASA) estimates that around 25 million Americans currently suffer from obstructive sleep apnea (OSA), a condition in which the body fails to breathe regularly during periods of subconsciousness. These apneic periods (i.e., lapses in breathing) can last 10 to 30 seconds and happen several times an hour. When these instances occur, the body must regain consciousness to resume breathing. This results in a reduction of REM sleep during the night, the period which is responsible for maintaining or restoring good memory and learning.
OSA affects more than just the external body; it affects the mind and internal processes. Let’s explore these areas in further detail.
OSA’s Causes and Symptoms
OSA has many potential causes. For one, anatomical differences, such as the size and positioning of an individual’s jaw, neck, tongue, and other tissue near the esophagus, can impact airflow. While scientists have pointed their fingers towards inherited traits in the past, recent studies show that the growth of our orofacial muscles and bone structure, or lack thereof, are lifestyle factors.
Western culture has resulted in a decrease in breastfeeding during infancy, the introduction of the soft food diet, and extended pacifier use. These habits can result in an underdeveloped orofacial structure, with the child showing signs of a narrow jaw, weak tongue, and high palate. Untreated, this can turn into OSA later in life.
Another cause of OSA is obesity. Excess weight contributes to an anatomically smaller airway, as it puts pressure on the throat, especially when the individual sleeps on their back. A study in the National Library of Medicine found that a 10 percent increase in body mass resulted in the individual’s risk for OSA increasing by up to 600 percent.
The use of sedatives or alcohol can also increase an individual’s risk for OSA, especially if abused, because these substances cause the tongue and tissues in the throat to relax and cause a partial or complete obstruction that cuts off airflow. The same goes for the use of narcotics.
Finally, nasal congestion and abnormalities in hormone production can lead to inflammation of the tissues in the respiratory system and contribute to the development of OSA.
In addition to harming the body’s oxygen saturation and contributing to the development of one or several comorbidities, symptoms of OSA include the following:
- Increased mental fog
- Headaches or migraines, especially in the morning
- Inefficiency during the day
- Daytime exhaustion
- Dry mouth
- Frequent urination during the night
- And more
There are many potential causes of OSA. It is the responsibility of our dentist, healthcare providers, and ourselves to understand the associated symptoms and effectively screen us for this sleep disorder early on.
Its Effect on the Body
There are many internal processes affected by OSA. It affects each one of our body systems. Let’s dive in.
For starters, individuals who suffer from mild-to-moderate OSA can cease respiratory activity several times per hour. This frequent disruption in breathing causes our oxygen saturation to drop and our carbon dioxide levels to rise.
The daytime level of oxygen in our blood is usually around 96–100 percent. During periods of rest, those levels can drop slightly to about 94 percent. These levels can drop below 90 percent for individuals with OSA, sometimes even into the 70th or 80th percentile if apneic periods become more frequent or last longer. This is dangerous and can worsen asthma symptoms and chronic obstructive pulmonary disease (COPD), making it more challenging to complete daily activities or exercise.
Studies show that individuals with OSA are much more likely to develop insulin resistance, resulting in type 2 diabetes. In this condition, the cells don’t absorb insulin, which leads to a spike in blood sugar. Sleep apnea also correlates with metabolic syndrome, which includes three or more of the following:
- High blood sugar
- Low levels of HDL cholesterol
- High levels of triglycerides
- High blood pressure
Metabolic syndrome is the gateway to heart disease, stroke, and other chronic diseases.
There is a correlation between OSA and fatty liver disease (i.e., when an excess of fat is present in the liver). While this is reversible in this stage, if left untreated, fatty liver disease can turn into cirrhosis, an irreversible condition that results in liver cancer, liver failure, and ultimately death. OSA can also result in increased heartburn, which has the potential to disrupt our sleep further and worsen our symptoms.
Circulatory and Cardiovascular Systems
High blood pressure and obesity are common in individuals suffering from mild-to-moderate OSA. These factors increase the strain on the heart and contribute to the development of atrial fibrillation, stroke, and heart failure.
Sleep apnea actually leads to a decrease in an individual’s sex drive. And in men, it might contribute to erectile dysfunction (ED).
Central Nervous System
A lack of oxygen for extended periods can lead to irreversible brain damage. Signs include memory loss, mental fog, difficulty concentrating, moodiness, frustration, and exhaustion.
Over one in 15 adults in the United States suffer from OSA. It has the potential to not only cause disruptions in your sleep but also put you at risk of developing several severe and life-threatening diseases.
The good news is that with proper screening and diagnosis, there are ways to reduce your symptoms and return to good health. If you suspect that you or someone you know might be suffering from OSA, speak to your dentist or healthcare provider. They are the front line of defense.
Once a proper diagnosis is made, there are many treatment options available, including the following:
- Nonsurgical, personalized oral appliance therapy
- Surgical implants, tissue removal, jaw repositioning, or tracheostomy
- APAP, BiPAP, or CPAP therapies
Your doctor may also recommend you partake in a number of lifestyle changes, including the following:
- Weight loss
- Regular exercise
- Consuming a diet rich in vitamins and minerals
- Reducing/eliminating alcohol, sedatives, and the use of narcotics
OSA affects the whole body. That said, it doesn’t have to run your life. In collaboration with your healthcare provider, you can find a treatment plan that is right for you, avoiding the harsh symptoms and comorbidities that may come later on in life. By educating ourselves and our patients, we are taking a step in the right direction and saving lives.