Warning Signs of Sleep Apnea & What To Do About It

Written by Whitney DiFoggio BS, RDH 🔬 Evidence Based

Sleeping disorders often go undiagnosed until the symptoms are extremely severe. Unfortunately, untreated sleep apnea can seriously raise your risk of a major cardiovascular event or even death. Understanding what causes sleep apnea and what you can do to help manage your health condition is important for you and your family.

Recognizing the symptoms of sleep apnea will help you know when to reach out for help, where to go for treatment, and understand the best way to enjoy a healthier, happier lifestyle in the years ahead. And believe it or not, you can even get help for certain types of sleep apnea from your dental team!

3 Types Of Sleep Apnea

Not all types of sleeping disorders are the same. What causes sleep apnea can vary, depending on your specific circumstances. For example, some originate in your central nervous system and the way your brain communicates with the rest of your body, while others are due to physical tissue blockage that keeps air from flowing down into your lungs.[1]

A sleep study can help you know which specific type of sleeping disorder you have, as the symptoms and side effects often overlap one another. The great news is that nowadays you can actually have a sleep study conducted at home, so you don’t necessarily need to stay in a medical lab overnight.

If you think you have sleep apnea, here are the three types of the disorder that you’ll want to be familiar with:

1. Obstructive Sleep Apnea

Obstructive sleep apnea that originates in your mouth and at the back of your throat. Obstructive sleep apnea is a condition where there are physical tissues—you guessed it—obstructing your airflow. Airway obstruction can be due to weight gain, a large tongue, swollen tonsils, or your tongue slipping back against the back of your throat when you’re sleeping. You might be getting some oxygen in, but your airflow is still restricted. But don’t be fooled, even people who have a lower BMI can still be at risk of obstructive sleep apnea, depending on their oral anatomy. The good news is that your trained sleep dentist can help screen for symptoms of obstructive sleep apnea during your dental exam so that you can rule certain factors out or know what to do next. Obstructive sleep apnea (OSA) is the only type of sleep apnea that you can manage with an FDA-approved dental sleep appliance. [2]

2. Central Sleep Apnea

When your brain isn’t able to control the muscles responsible for breathing, it can lead to diminished oxygen intake. People with central sleep apnea (CNS) typically breathe more slowly or have much shallower breaths than someone without a sleeping disorder. Typically, what happens is that your brain doesn’t tell your muscles to breathe, so you don’t. Even though breathing is a natural “instinct”, it still requires central nervous system responses to manage when you aren’t conscious. It’s normal for someone with central sleep apnea to stop breathing at any moment during the night. The pause in breathing is usually at least 10 seconds or longer and occurs several times throughout the evening. According to the American College of Cardiology, patients with central sleep apnea make up less than 1 in 10 patients who are referred to sleep labs. Some experts say that central sleep apnea is only diagnosed in about 5% of people who actually have a sleep study conducted.[3]

3. Complex Sleep Apnea Syndrome

This mixed sleep apnea condition is a combination of both central sleep apnea and obstructive sleep apnea. It’s often referred to as “CompSAS”. As you might guess, it is incredibly more dangerous than one of the other types of sleep apnea by itself. If someone exhibits symptoms or warning signs of one condition over the other, it can be more challenging for your physician or specialist to get a firm diagnosis. In fact, there’s a lot of controversy around CompSAS and the best way to manage it, so make sure you work with a highly experienced sleep specialist if you suspect a complex sleeping disorder. [4]

Warning Signs & Symptoms for Sleep Apnea

Not everyone experiences the same symptoms of sleep apnea. Only one or two red flags may be all you need to make the connection that something is wrong with your sleep health. Some of the most common signs and symptoms for sleep apnea include conditions like:

Fatigue
Frequent headaches
Difficulty concentrating
Depression
Weight gain
Alcohol use
Flat, worn teeth and broken dental restorations
TMJ pain or disorder
Snoring
Pauses in breathing while you sleep
Waking up feeling tired
High blood pressure
Excessive daytime sleepiness
Inflammation
Falling asleep during the day
Diminished sex drive
Mood swings

One of the most common misconceptions about people with sleep apnea symptoms is that people with a sleeping disorder will almost always snore at night. But that’s not necessarily true. Plenty of people who snore do not have a clinical sleeping disorder, and not everyone with sleep apnea will snore when they go to bed at night.

The only way to know for certain if you have sleep apnea is to talk to your dentist or PCP about having a home sleep study or overnight test conducted to analyze your breathing and sleep health.

What Causes Sleep Apnea?

What causes sleep apnea or someone to develop a sleeping disorder? While anatomical issues and weight gain can physically block off someone’s airway, central nervous system disorders can also play a role in pauses in breathing when someone sleeps. Typically, the #1 cause of sleep apnea is attributed to weight gain.

How Do I Treat Sleep Apnea?

There are usually two major clinical treatment options for sleep apnea. One is using a Continuous Positive Airway Pressure (CPAP) machine and the other is a mandibular advancement device. CPAP machines physically force air into your lungs by using strong pressure delivered through a hose placed over your nose. With an oral sleep appliance, the device is fitted by a sleep dentistry provider and it positions your lower jaw (mandible) in a way that reduces the risk of airway blockage in the back of your throat. Oral appliances are FDA-approved for treating and managing symptoms of obstructive sleep apnea (OSA). However, they must be fitted by a dentist because they are technically dental appliances.

Prevention of Sleep Apnea

One of the best ways to help prevent sleep apnea or improve your symptoms is to get plenty of exercise and lose some weight. I know – no pressure, right? But you can also reduce your risk factors by avoiding alcohol right before bedtime since it relaxes your muscles and may put you at a greater risk of soft tissues collapsing in your upper airway.

Is Sleep Apnea Common?

At times it’s normal for almost all of us to experience sleeping problems. Like when we drink too much caffeine, have a lot of stress in our life, or take medications that keep us awake at night. But it’s estimated even given all of those other factors that somewhere around 50-70 MILLION Americans have an actual sleeping disorder. Other sources estimate it’s only between 20-25 million.[5] The American Journal of Epidemiology has issued data showing that obstructive sleep apnea diagnoses have skyrocketed as a result of the American obesity pandemic.[6] Oddly enough, the lack of quality sleep may contribute to being overweight or obese just as much as a person’s diet and exercise habits.

According to Johns Hopkins, around 3% of healthy-weight adults and 20% of overweight adults will have sleep apnea. Of those, men are more likely to experience symptoms and be diagnosed than women. But women’s risk for sleep apnea does rise significantly once they transition out of menopause.[7]

Unfortunately, it’s estimated that as many as 80% of cases involving moderate to severe obstructive sleep apnea go completely undiagnosed.

Sleep Apnea FAQ

Can you die from sleep apnea?

Although it’s not likely that you’ll see sleep apnea as the cause of death in someone’s medical report, we know for a fact that sleep apnea strains your cardiovascular system. Left untreated, someone with severe sleep apnea is at a much higher risk of suffering from a fatal heart attack or stroke. So yes, you could technically conclude that it’s possible to die from sleep apnea. In one study, people who died from a heart attack or stroke were twice as likely to have sleep apnea compared to the people who died and did not have a sleeping disorder.[8]

What are the warning signs of sleep apnea?

The most common warning signs of sleep apnea are the symptoms that tend to creep up and don’t go away very easily. Like problems concentrating on a day-to-day basis, recurring headaches, high blood pressure, weight gain, tooth wear, and even changes in your mood or activity level. Snoring is not and shouldn’t be the target symptom that tells you whether or not you have a sleeping disorder. It’s just one possible symptom of dozens.

How common is sleep apnea?

Sleeping disorders are more common than what a lot of people realize. But unfortunately, not everyone seeks out medical advice or treatment. In the United States, approximately 1 in 4 adults between the ages of 30-70 have clinical sleep apnea. When you consider other types of sleeping disorders like insomnia or conditions like snoring, as many as half of us are struggling to get a good night of sleep.

Do I need a breathing machine to treat sleep apnea?

Depending on the type of sleeping disorder you have, you may or may not need a “breathing” machine or CPAP. It also depends on the severity of your condition and your compliance or ability to use certain types of equipment. For example, plenty of people can use oral sleep appliances for obstructive sleep apnea (but not central sleep apnea) without needing a CPAP machine. Or they use it in combination with their CPAP. Other times, people manage to address secondary factors, such as their weight, and improve sleep apnea symptoms by developing healthier lifestyle habits. But breathing machines are crucial for managing symptoms of more aggressive sleep-disordered breathing conditions because they physically force oxygen into your lungs. Some people cannot survive without them.

Are there home remedies that help with sleep apnea?

Actual clinical sleeping disorders need to be treated by your physician or sleep dentistry team. Most prescription devices are for use at home, such as CPAP machines or mandibular advancement aids. But it’s best to not try to buy an over-the-counter snore mouthpiece or nasal strips and hope that they do the trick. Because even though those types of devices might help with the occasional snoring or nasal obstruction, they are not effective enough for managing a clinical obstructive or nervous-system based medical disorder.

What are the risks of not treating sleep apnea?

Untreated sleep apnea can leave you feeling tired and make it too difficult to concentrate when you’re working or trying to focus on something. Unfortunately, it also puts you at a clinically higher risk of having cardiovascular disease because of all of the strain on your body. Simply trying to get through the day is hard without any quality rest to “recharge” yourself. And then there are the more physically noticeable side-effects:

excessive daytime sleepiness
weight gain
airway pressure
high blood pressure
saggy bags under your eyes
worn tooth enamel from clenching your teeth all night long.

Even if sleep apnea doesn’t send you spiraling into a heart attack, your body will still take a toll from not getting the rest it needs.

Should I talk to a dentist or physician (or even a sleep specialist?)

If you’re experiencing symptoms of sleep apnea, definitely make plans to talk to a healthcare provider. For people who have flat teeth and jaw pain, be sure to chat with your dentist during your routine checkup. They can screen you for signs of obstructive sleep apnea and help you determine if you need a home sleep study. Some dental offices even offer take-home tests and oral appliance therapy with their dentist.

On the other hand, if you suspect central sleep apnea or any other type of sleep apnea, you can also get a referral from your PCP to visit a pulmonologist or sleep medicine practice. They’ll have you come in for an appointment, review your health history, and either send you home with a take-home study kit or arrange for you to take a test in their overnight lab.

Bottom line don’t wait to get help. Untreated sleep apnea could wind up putting you at an extremely higher risk of a heart attack or stroke.

Sleep Apnea Recap

For people with sleep apnea, it’s easy to overlook the symptoms if you’re used to struggling with them every day. But sleeping disorders can come with serious risk factors for your health (and life.) Understanding what causes sleep apnea and knowing when to take action can help improve your overall wellness, quality of life, and ultimately your life expectancy. Working with a sleep dentistry team or a sleep specialist can help you get a firm diagnosis on which type of sleep apnea you have so that you can take steps to address it before it’s too late. If you’re exhibiting any of the warning signs—even if it’s just one or two of them—talk to your physician or dentist about getting tested. It’s easier than you think it is, especially with the take-home tests that are available nowadays.

Whitney is a registered dental hygienist who is also known as the "Teeth Talk Girl" on social media. Whitney’s journey of spreading dental health awareness began on the YouTube platform — where she continues to create educational videos for the public. She is extremely passionate about sharing information regarding the importance of dental health. Published on 2022-07-22

Sources

teethtalkgirl content is medically reviewed and fact-checked by a licensed dentist or medical doctor to ensure the information is factual, current, and relevant.

Mayo Clinic. Sleep apnea. Mayo Clinic. 2020 Available at: https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631. July 22, 2022 National Heart, Lung, and Blood Institue. What Is Sleep Apnea?. National Heart, Lung, and Blood Institue. NaN Available at: https://www.nhlbi.nih.gov/health/sleep-apnea. July 22, 2022 American College of Cardiology Foundation. Basics of Central Sleep Apnea. American College of Cardiology Foundation. 2013 Available at: https://www.acc.org/latest-in-cardiology/articles/2014/07/22/08/25/basics-of-central-sleep-apnea. July 22, 2022 Patient Prefer Adherence. Complex sleep apnea syndrome. Patient Prefer Adherence. 2013 Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3704546/. July 22, 2022 The American Sleep Apnea Association. Sleep Apnea Treatment Options. The American Sleep Apnea Association. NaN Available at: https://www.sleepapnea.org/treatment/. July 22, 2022 American Academy of Sleep Medicine. Rising prevalence of sleep apnea in U.S. threatens public health. American Academy of Sleep Medicine. 2014 Available at: https://aasm.org/rising-prevalence-of-sleep-apnea-in-u-s-threatens-public-health/. July 22, 2022 The Johns Hopkins University. The Dangers of Uncontrolled Sleep Apnea. The Johns Hopkins University. NaN Available at: https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-dangers-of-uncontrolled-sleep-apnea. July 22, 2022 American Academy of Sleep Medicine. Study shows that people with sleep apnea have a high risk of death. American Academy of Sleep Medicine. 2008 Available at: https://aasm.org/study-shows-that-people-with-sleep-apnea-have-a-high-risk-of-death/. July 22, 2022