Obstructive sleep apnea is an important medical breathing disorder in which one’s upper airway collapses episodically during sleep. The lack of oxygen and the buildup of carbon dioxide in the bloodstream resulting from airway closure then provoke frequent brief arousals from sleep throughout the night, causing substantial fatigue and sleepiness during the day.
The cardinal symptoms and signs of sleep apnea are well-known: excessive daytime sleepiness, nocturnal sleep disruption, loud snoring, witnessed breathing pauses, gasping sensations out of sleep. However, what is not well known to the public is that there are many additional symptoms–some subtle, some not so subtle–that can be caused by or attributable to untreated sleep apnea. If you are experiencing one or more of the following in the setting of some of the above-mentioned sleep apnea symptoms, you may want to consider seeing a doc like me.
1. Headaches. Many people with untreated sleep apnea have headaches, which are typically worse in the early morning or upon awakening as compared to later in the day. Sometimes the headaches can actually cause awakenings in the middle of the night or in the morning.
2. Nocturnal palpitations. Because of sympathetic overactivity (hyperstimulation of the adrenalin system), untreated sleep apnea can cause people to awaken abruptly feeling like their hearts are “racing,” “pounding,” and/or beating irregularly.
3. Night sweats. Some people “run hot” while they’re sleeping, but sleep apnea can often cause people to sweat profusely and frequently in bed, sometimes to the point of being drenched, due to the effects of frequent brief arousals from sleep.
4. Frequent urination at night. This is a big one. I can’t tell you how many patients of mine have previously undergone comprehensive urology evaluations because of multiple awakenings due to a full bladder. This is a huge problem, one that men and woman alike often try to learn to live with for years before seeking medical attention. Untreated sleep apnea tends to increase one’s urine production at night, and treating it often makes this problem improve or go away.
5. Sexual dysfunction. The association between untreated sleep apnea and erectile dysfunction and reduced libido is clearly documented in the medical literature, and sleep apnea treatment–such as with positive airway pressure (CPAP)–has been demonstrated to be helpful in improving or resolving these problems for many.
6. Leg swelling. Ever notice that sock line around your ankles when you take off your socks at the end of the day? Sometimes this soft tissue swelling of the legs can be severe and painful. Peripheral edema can be related to a number of different medical issues, sleep apnea being one.
7. Memory problems and depression. Think about it. If you’re constantly awakening briefly from sleep all night every night for years, this problem can easily take a toll on your mood and your ability to concentrate and remember things. On numerous occasions patients have visited me after having had extensive workups for dementia or depression, with treatment of their sleep apnea subsequently improving or even resolving their memory and mood problems.
8. Difficulties losing weight. If you’re tired and fatigued all day, you may not have the energy to exercise and burn off calories. But in addition to this, untreated sleep apnea can impair your metabolism as well, affecting certain weight-mediating hormones such as growth hormone and leptin. Treating the sleep apnea doesn’t necessarily make you lose weight automatically–you still have to work at it, with diet and exercise–but it may make it substantially easier to lose weight with a proper weight reduction program.
Bottom line: sleep apnea can be associated with a surprising number of problems that initially may not appear to be related directly to your sleep. Don’t ignore your symptoms. The primary sleep apnea symptoms of daytime fatigue, loud snoring, and witnessed breathing pauses during sleep shouldn’t be ignored anyway, but additional problems like morning headaches or urinating a lot at night should increase your level of concern still further.
Have a great day, y’all!