Do I have Sleep Apnea? How undiagnosed OSA can lead to heart disease and more

Understanding Obstructive Sleep Apnea and Its Complications
Obstructive sleep apnea (OSA) is one of the most common sleep disorders. It occurs when the airway repeatedly collapses or closes during sleep, causing pauses in breathing and a drop in blood oxygen levels that can last from a few seconds to over a minute.

How does sleep apnea occur?
When the body falls into a deep sleep, the muscles around your throat (pharyngeal muscles) relax. Sometimes the tongue muscle relaxes as well and falls back. Both of these can cause an obstruction in the airway, and block your breathing. This results in a drop in your oxygen levels causing your brain to wake you up just enough to reverse this relaxation of your pharyngeal muscles and open up the airway to restore breathing. This happens subconsciously and often, patients are not aware of these mini-interruptions in their sleep, though they do prevent deep sleep. These interruptions can happen dozens or even hundreds of times per night, preventing the deep, restorative rest your body needs.

How OSA Affects the Body
While loud snoring and daytime fatigue are the symptoms most people recognize, OSA has wide-ranging effects on overall health. Each pause in breathing triggers a stress response: oxygen levels drop, the brain briefly wakes the body to reopen the airway, and the cycle repeats. Over time, this constant strain can contribute to serious complications.

1. Cardiovascular Problems
OSA is strongly linked to high blood pressure, heart disease, arrhythmias, and increased risk of heart attack and stroke. Repeated drops in oxygen put significant pressure on the cardiovascular system.

2. Daytime Fatigue and Cognitive Impairment
Poor-quality sleep leads to excessive daytime sleepiness, difficulty concentrating, memory problems, and a higher risk of car accidents.

3. Metabolic and Weight-Related Issues
OSA is associated with insulin resistance and type 2 diabetes. It also makes weight management harder, creating a cycle in which excess weight worsens airway obstruction.

4. Mood and Mental Health Concerns
Untreated OSA may contribute to irritability, anxiety, and depression. Restorative sleep is essential for emotional balance.

How do I know if I have OSA? Try this quick OSA Self-Screening Test

Answer Yes or No to the following questions:

1. Do you snore loudly (loud enough to be heard through a closed door or to disturb others)?

2. Do you often feel tired, fatigued, or sleepy during the daytime?

3. Has anyone observed you stop breathing or gasping/choking during your sleep?

4. Do you have high blood pressure (treated or untreated)?

5. Is your BMI over 35?

6. Are you over age 50?

7. Is your neck circumference large (over 16" for women, 17" for men)?

If you answered “Yes” to 3 or more questions, you may be at increased risk for obstructive sleep apnea. This is not a diagnosis, but a helpful screening tool, so talk to your doctor about getting a sleep study. There are many treatments available including CPAPs with varying types of masks, nasal pillows, mouth devices and even surgery. Talk to your doctor if you think you may have sleep apnea and they will guide you in the right direction.

As always, stay well,

Sandra Koehn DO