6 Signs You Might Have Sleep Apnea

Snoring can be more than just annoying to a partner — it can also be a sign that you have sleep apnea.
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Snoring is fairly common, with nearly half of adults doing it occasionally, per Johns Hopkins Medicine. But if you saw wood regularly and loudly, and you always seem to wake up feeling tired, you might have sleep apnea.

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Sleep apnea is a sleep disorder marked by breathing that repeatedly stops and starts, and it can have serious effects on your health. There are three main types, according to the Mayo Clinic:

  • Obstructive sleep apnea,​ the most common form, happens when the throat muscles relax during sleep.
  • Central sleep apnea​ arises when your brain doesn't send the proper signals to the muscles that control breathing.
  • Complex sleep apnea syndrome​ is when someone has a combination of both obstructive and central sleep apnea (also called treatment-emergent central sleep apnea).

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People of all ages, including babies and children, can have sleep apnea, although it's more common in older adults. Overall, a quarter of people assigned male at birth (AMAB) and about 10 percent of people assigned female at birth (AFAB) are affected by the disorder, according to the Cleveland Clinic.

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Here are seven symptoms of sleep apnea to look out for, which is especially important if you have one or more of the risk factors linked to the condition.

Risk Factors for Sleep Apnea

According to Stephanie M. Stahl, MD, director of the Sleep Medicine Fellowship Program at Indiana University Health, these include:

  • Having a body mass index higher than 30
  • Being older than 50
  • Having other family members with sleep apnea
  • Having high blood pressure
  • Having a large neck circumference (greater than 16 inches in people AFAB and 17 inches in people AMAB)

1. Snoring With Pauses in Breathing During Sleep

Pauses in breathing during sleep and loud snoring are the top two symptoms of sleep apnea.

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If your partner or someone else notices that you snore loudly or stop breathing in your sleep, you may have sleep apnea. "Loud, frequent snoring or witnessed pauses in your breathing should raise high concern for obstructive sleep apnea," Dr. Stahl says.

According to the Mayo Clinic, with obstructive sleep apnea, snoring is usually loudest when you sleep on your back and quieter when you sleep on your side. While not all snoring is a sign of sleep apnea, loud and disruptive snoring accompanied by pauses in your breathing are a reason to talk to your doctor.

2. Waking Up Suddenly and Feeling Like You're Choking or Gasping

With sleep apnea, the throat muscles relax more than they should and block your airways, per the Texas Heart Institute.

When your airways become blocked, your breathing pauses or stops altogether. And your body's natural reaction is to wake you up suddenly, which leads to feeling like you are choking or gasping.

3. Feeling Tired a Lot

Another sign of sleep apnea is restless sleep. You might feel tired even after a full night in bed because sleep apnea is causing you to wake up constantly (even if you don't remember doing so) or keeping you from sleeping as deeply as you should. And not getting enough sleep has long- and short-term effects.

According to a May 2017 review in Nature and Science of Sleep, the short-term effects of disrupted sleep include:

  • Emotional distress
  • Performance issues related to attention span, memory and decision-making
  • Chronic stress
  • Mood disorders, like depression and anxiety

While long-term effects include an increased risk of:

  • High blood pressure
  • Obesity
  • Type 2 diabetes
  • Cancer

4. Frequent Nighttime Urination

It's normal to urinate one to two times a night, but people with untreated sleep apnea can make as many as six or more trips to the bathroom a night, according to the American Sleep Apnea Association.

This happens because the airways become closed off, triggering physical reactions like a drop in oxygen levels, heart rate and the constriction of blood vessels in the lungs. Basically, your body enters panic mode and releases an overload of fluid, which sends you to the bathroom all night.

5. Morning Headaches

Morning headaches are one of the less common sleep apnea symptoms but still something to keep your eye on.

Researchers of a September 2014 review in ​Cephalagia​ estimated that 12 to 18 percent of middle-aged people with obstructive sleep apnea experience morning headaches. (About 5 to 8 percent of people in the general population had achy heads in the a.m.)

The exact cause of sleep apnea-related morning headaches is unknown, but it may be linked to having multiple instances of paused breathing while you sleep, according to a January 2020 study in Brain Sciences.

6. Memory Loss

There is a link between sleep apnea and memory loss. A May 2015 study in ​Neurology​ found that older people with sleep apnea had mild cognitive impairment an average of 10 years earlier than those without the condition.

If you or a loved one are experiencing other signs of sleep apnea along with memory issues, it's important to let your doctor know.

What Are the Effects of Sleep Apnea?

According to Dr. Stahl, some potential adverse effects linked to sleep apnea include:

  • An increased risk of stroke and heart attack
  • Irregular heartbeat
  • High blood pressure
  • Diabetes
  • Cancer
  • Motor vehicle accidents (due to sleepiness)
  • Dementia

When to See a Doctor

"If you have symptoms of obstructive sleep apnea or if you have risk factors for this condition, you should see your doctor for further evaluation," Dr. Stahl says.

Your doctor will determine if you have sleep apnea using a sleep study that can either be done at home or in a sleep laboratory by a trained professional. The sleep study monitors and records bodily functions like brain activity, eye movements, heart rate and breathing activity.

"During a sleep study, the number of times per hour that someone stops breathing or nearly stops breathing is evaluated," Dr. Stahl says. And if there are more than five pauses or near-pauses in breathing per hour, you'll receive a diagnosis of sleep apnea.

There are several treatment options for obstructive sleep apnea, including weight loss and oral devices, Dr. Stahl says, but the most common and effective is positive airway pressure (PAP) therapy, which helps open the upper airway during sleep via pressurized air.

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