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What Sleep Apnea Causes?

Sleep apnea is a potentially serious sleep disorder in which an individual suffers from abnormalities in the depth and rhythm of their breathing while asleep. Most commonly, this can manifest as a period of shallow breathing or pauses in breathing throughout sleep. These pauses in breathing can occur multiple times per night and often last a few minutes.

Sleep apnea is often difficult to recognize, especially for the individual suffering. Those experiencing sleep apnea frequently report constant tiredness or fatigue. Sleep apnea disrupts the natural sleep cycle required for restorative sleep. Hence, despite being in bed and apparently ‘sleeping’ for the recommended eight hours, people with sleep apnea will often wake to feel unrested and groggy due to constant, and sometimes unknown, disruptions to their sleep throughout the night. Another common symptom of sleep apnea is loud, persistent episodes of snoring, snorting and gasping during sleep. Again, these signs often go unrecognized by the individual themselves, but are usually picked up by partners or family members!

Though the signs of sleep apnea may seem innocuous, the condition can lead to a number of serious health problems. For this reason, it’s important to visit a doctor if you are consistently experiencing any of the above symptoms. This article outlines some of the key health issues that can arise if sleep apnea is left untreated. 

Can Sleep Apnea Cause High Pressure?

High blood pressure, medically known as hypertension, is often referred to as the ‘silent killer’. Hypertensive individuals have blood pressure which is consistently too high, meaning that the heart has to work excessively hard to pump blood around the body. Sadly, high blood pressure often goes unnoticed, but ignoring the condition can lead to heart and circulatory diseases.

Blood pressure is increased during episodes of oxygen deprivation caused by shallow or paused breathing in sleep apnea. This creates an undue strain on the cardiovascular system. However, there’s a dangerous relationship between sleep apnea and high blood pressure, which could be referred to as a ‘vicious cycle’. Researchers have found that the two conditions almost come hand-in-hand; not only does sleep apnea induce elevations in blood pressure, but those already suffering with high blood pressure have a higher risk of developing sleep apnea.

However, it’s not all bad news. Although sleep apnea and blood pressure appear to be a dangerous pair, both are extremely treatable disorders. In fact, research has shown that simple interventions for sleep apnea (such as CPAP machines) which promote normal breathing during sleep, can have a significant effect in lowering blood pressure. Moreover, hypertension patients who have sleep apnea are able to manage their blood pressure through medication often find a reciprocal reduction in episodes of sleep apnea too. 

Sleep Apnea And Heart Disease

Over time, people who suffer from untreated sleep apnea will begin to experience dangerous physiological changes, especially in the cardiovascular system. In particular, untreated patients will often present with thickening of the heart walls (due to increased workload, caused by high blood pressure) and stiffening of the heart. These physical changes significantly impact the ability of the heart to function effectively and can lead to conditions such as arrhythmias.

Research has found that people suffering from obstructive sleep apnea are more likely to have heart attacks than the general population. This may be caused by episodes of low or deprived oxygen, or due to excessive stress put on the heart from waking up often after pauses in breathing.

Researchers have also shown elevated levels of cholesterol in people with sleep apnea. On its own, cholesterol isn’t a bad thing. In fact, cholesterol is a beneficial fatty-protein attached from proteins and helps with their transportation around the body. In particular, HDL (high-density lipoprotein) is thought to be a healthy form of cholesterol. However, you can have too much of a good thing, and higher levels of cholesterol are thought to be a contributor to heart disease. It’s yet to be discovered whether this is a primary cause or a small contributor. None-the-less, those with sleep apnea have abnormal levels of all types of cholesterol, which may, in part, explain the increased risk of heart conditions.

Sleep Apnea And Stroke

A stroke is a very serious and life-threatening condition in which blood supply to part of the brain is cut-off. Stroke is closely linked with heart disease, and so it comes as no surprise that sleep apnea can also increase the risk of experiencing a stroke if left untreated. Strokes can be caused by a variety of issues, such as narrow arteries (ischemic stroke) or high blood pressure (hemorrhagic stroke). Sleep apnea can increase the risk of both types of stroke due to the stress put on the heart during episodes of impaired breathing and inadequate oxygen intake. Sleep apnea also increases the risk of atrial fibrillation, a ‘fast, fluttering’ heartbeat, which is another large risk factor for stroke.

Sleep Apnea And Type 2 Diabetes

Type 2 diabetes is extremely common among patients with sleep apnea, with over 80% of patients having this as a co-morbid condition. Type 2 diabetes is a disease in which the body can’t regulate blood glucose (or sugar) levels appropriately.

It’s not yet known whether there is actually a causal link between sleep apnea and type 2 diabetes, but there is certainly a large correlation. Furthermore, there is a well-known and significant connection between inadequate sleep and type 2 diabetes. Research has shown that with on-going sleep loss, the body becomes unable to properly regulate hormones related to glucose metabolism and hunger; known as insulin and ghrelin, respectively. In particular, a stage of sleep known as ‘slow-wave’ or ‘deep’ sleep seems to be critical in maintaining insulin sensitivity and blood glucose control. Sufferers of sleep apnea often experience no ‘slow-wave’ sleep and very little REM (rapid eye movement) sleep; which could be the reason for the much higher incidence of type 2 diabetes in these patients.

Because the hormone ghrelin also gets thrown out of sync in this condition, it can lead to overeating and the craving of carbohydrate-rich, sugary foods. Of course, this can wreak havoc on your body-weight. Incidentally, obesity is a major risk factor for both type 2 diabetes and sleep apnea. Identifying sleep apnea as the root cause and treating it with fostering the best sleep quality possible is a sure-fire way to improve overall health. 

Can Weight Gain Cause Sleep Apnea?

We’ve just discussed how lack of quality sleep can lead to dysregulation of blood glucose levels, increase unhealthy cravings and cause weight gain. Sleep disruption caused by sleep apnea can lower our metabolism too, meaning calories aren’t burned off as quickly. This could result in weight gain even without overeating. Moreover, the low energy levels caused by sleep apnea are not conducive to the want or desire to exercise, meaning many sufferers skip out on this too.

Unfortunately, this seems to be another vicious cycle, as obesity is one of the biggest risk factors for sleep apnea. The condition is much more common in those who are overweight. This is due to excessive pressure applied to the throat and respiratory system due to the extra weight carried around the face, neck, and jaw. Luckily, we can attack this issue from both sides; by restoring good quality sleep with treatment for sleep apnea and naturally reducing risk by improving nutrition and exercise habits.

With all of the above conditions, you may have noticed a theme: all of these conditions are clustered together and interlinked. These conditions all have clear cause-and-effect links with each other, which appear to cause a vicious cycle of increasingly poor health. Importantly, many of these conditions are known risk factors for sleep apnea and they are thought to be caused or have their severity exasperated by sleep apnea. This is why many scientists now believe sleep apnea might be grouped in with a condition known as ‘metabolic syndrome’. Metabolic syndrome is characterized by abdominal obesity, arterial hypertension, increased blood triglycerides (‘bad’ cholesterol), decreased HDL ‘good’ cholesterol and increased blood glucose. This condition is particularly dangerous to health, decreases the quality of life and life expectancy. Doctors and scientists now think that treating sleep disruptions like sleep apnea may actually be the key in helping people improve and even cure this syndrome and associated illnesses.

Sleep Apnea Memory Loss

While you’re asleep the body undergoes a vast amount of process which helps to clear toxins from your brain, strengthen your immune system and, importantly for learning, consolidate memories. Current research supports the theory that sleep plays an active role in memory consolidation. Recent research has uncovered the critical roles for both deep or ‘slow-wave sleep’ and rapid-eye-movement (REM) sleep in transforming recently learned material into long-term memory.

These two phases bookend the stages of sleep, with deep sleep occurring in the first few hours and REM occurring in the later stages. Shortening these phases at either end can have detrimental effects on memory, but also attention, alertness and even creativity throughout the waking day. Since those suffering from sleep apnea often don’t even experience slow-wave sleep and have extremely impaired REM sleep, untreated patients will often experience deficits in memory, poor concentration, impaired attention. Sometimes, this can result in extremely dangerous situations. A lack of sleep drastically slows your reaction time and makes tasks such as driving extremely dangerous. Hence, early diagnosis and treatment is important for your own health, but also for the safety of others.

Recent research from neuroscience has started to reveal links between long-term sleep deprivation or disruption and Alzheimer’s disease. This is thought to be because the usual processes of ‘flushing toxins’ from the brain during sleep can’t be properly conducted. When these toxins build up, they are thought to aggregate and form so-called ‘plaques’, these are one of the physiological hallmarks of Alzheimer’s and Parkinson’s disease, along with conditions like dementia.

Sleep Apnea And Depression

Depression is one of the most common and debilitating mental health conditions in the global population. The disorder can be difficult to treat, and sadly, can result in suicide.

There’s a well-known correlation between lack of sleep and depression. However, scientists have found it difficult to untangle cause-and-effect. Many patients with depression find the onset of sleep conditions at the same time, while others experience sleep deprivation before experiencing depression. Research has shown that insomnia has the highest correlation with depression and anxiety, compared to all other medical conditions. A more recent study has also shown that around 46% of patients with obstructive sleep apnea also suffer from depression.

Sleep Anxiety And Anxiety

Sleep apnea episodes jerk the individual awake and disrupt good quality sleep. Recent research from neuroscientists has shown that the so-called ‘sleep-debt’ (a consistent reduction in quality and amount of sleep) can actually make it more difficult for the brain to cope with stress in daily life. It’s thought that this is caused by long-term alterations in a variety of neurochemicals that control our stress response and overall mood. It’s also been shown that people lacking just 2 hours of sleep per night over an extended period of time have significantly higher levels of the stress hormone ‘cortisol’. This means that their body is physiologically primed for threat, and is on a state of ‘high alert’. This process is physically and mentally taxing and can often contribute to anxiety.

A lack of sleep can also completely change your perception of the world in a negative way. Psychological studies of people who are consistently sleep-deprived have shown that their perception of the world actually becomes more negative. For example, compared to someone who has had a full night of rest, people who are sleep deprived are more likely to view a neutral face as negative or aggressive. Participants who lack good quality sleep also consistently rate neutral voices and sentences as threatening. This unwarranted negative mindset may feed into worry, anxiety and even panic attacks.

It’s clear from all of these medical consequences that sleep apnea is a dangerous condition if left untreated. If you think you or someone you know is suffering from the condition, please contact your doctor immediately to ensure early diagnosis and treatment. If you require more information, read our previous articles which explain the major signs and symptoms, causes and treatments for sleep apnea.