Most people think that snoring is synonymous with sleep apnea and vice versa. Let’s clear this misconception first. Snoring is the sound you make while sleeping. It can be a barely noticeable sound or a bang in your ears train whistle type of sound. Snoring has various causes that range from simple tiredness to medical conditions like obstructive sleep apnea.
What This Article Is All About?
Now let’s come to sleep apnea. It is a medical condition that causes difficulty in breathing while you sleep. Sleep apnea may or may not be accompanied by snoring. But it is in no case a compulsion that if you have sleep apnea, you will snore.
The intensity of sleep apnea can vary from a mild case to a severe case. In the mild version of sleep apnea, you may not even realize that you have sleep apnea. But as the severity of sleep apnea increases, you will start to notice the signs. You will have difficulty breathing normally while in a supine position or sleeping.
Nancy Foldvary-Schafer (DO, MS) is Director of the Sleep Disorders Center at the Cleveland Clinic Lerner College of Medicine.
She says that “Sleep apnea is grossly under-recognized.” According to the data collected by Cleveland Clinic, Nancy states, “We estimate that 85 to 90 percent of people with sleep apnea in the USA don’t know they have it.”
A study showed that sleep apnea is more common in men than in females. The results showed that:
- About 10 percent of men aged 30 to 49 snore and the percentage goes higher to 17 percent in men aged 50 to 70.
- Approximately 3 percent of women aged 30 to 49 snore, and 9 percent of women aged 50 to 70.
According to research, these numbers have considerably increased since the 1990s. Research associates the rise in sleep apnea cases with the worsening of the obesity epidemic.
What is Sleep Apnea?
What is sleep apnea? There are various misconceptions related to the term sleep apnea. Let’s try to break down sleep apnea in simple terms so that you can have a clear understanding.
First of all, you need to know that sleep apnea is an involuntary pause in breathing while you sleep. The duration and type of pauses in breathing are dependent on severity. It’s interesting to note that “apnea” is a Greek word that means without breath.
There are three main types of sleep apnea. Obstructive sleep apnea (OSA) is the most common type of sleep apnea. It occurs due to the physical narrowing of the air passageway. It is the type most commonly associated with snoring.
The second type of sleep apnea is central sleep apnea (CSA). It is a less common and more severe type of sleep apnea. In this type, the air passageway may be normal, but while you sleep, your brain doesn’t tell your muscles to take in the air. In this type of sleep apnea, there is no physical blockage of the airways. This type of sleep apnea does not commonly cause snoring.
The third type is known as mixed type sleep apnea. In mixed-type sleep apnea, the person suffers from both obstructive and central sleep apnea.
In this article, we are going to focus more on central sleep apnea because our topic of discussion is whether you can have sleep apnea without snoring or not?
So if you want to read more about obstructive sleep apnea, just browse our website.
Causes of Sleep Apnea
There are various reasons behind sleep apnea. The causes vary for each type of sleep apnea. In this section, we are going to focus more on the causes of central sleep apnea. Following are some of the causes and reasons behind central sleep apnea:
- About half of the people suffering from central sleep apnea have Cheyne-Stokes breathing. In this type of breathing, your breathing speeds up, slows down, stops, and then starts again. Each cycle can last from 30 seconds to 2 minutes. Cheyne-Stokes breathing more commonly occurs in people who are suffering from heart failure or stroke.
- Narcotic-induced central sleep apnea. Opioids (morphine, oxycodone, and codeine) are medications that can affect your breathing pattern. It is so because these medications suppress the central nervous system.
- High altitude periodic breathing. Many people have trouble breathing at high altitudes (800 feet or above). It is due to lower oxygen saturation in the atmosphere at high elevations.
- Treatment-emergent central sleep apnea. Some people may develop central sleep apnea after positive airway pressure treatment for obstructive sleep apnea. It may lead to mixed type sleep apnea.
- Medical condition induced sleep apnea. Different health problems can lead to central sleep apnea. Some of these health problems may include heart failure, Parkinson’s disease, stroke, or kidney failure. These conditions either affect the breathing regulating center of the brain or the oxygen concentration in the blood.
- Idiopathic sleep apnea is also known as primary central sleep apnea. It means that there is no clear reason behind the person’s sleep apnea.
Symptoms of Sleep Apnea
One of the main features of obstructive sleep apnea is snoring, which is most likely not found in central sleep apnea. Following are some of the main features of central sleep apnea:
- Pauses in breathing while sleeping
- Daytime tiredness
- Waking up often throughout the night
- Having headaches early in the morning
- Having trouble concentrating
- Lack of sleep may also contribute to memory and mood problems
The Relation Between Snoring and Central Sleep Apnea
Most people think that snoring and sleep apnea are the same thing or at least are strongly interlinked. It is a misconception. To clear this misconception, let’s first have a look at why we snore?
Snoring is the sound that we make while sleeping. It can be a barely noticeable sound or a truck horn blaring in your ear kind of sound. Snoring occurs due to the narrowing of the air passageway. The narrowing can occur due to inflammation from a cold or a sore throat. The narrowing of the airway can also be due to its anatomy or any disorder like obstructive sleep apnea. The narrowing of the airway causes the muscles and tissues to vibrate as air passages through it. The vibration of these muscles and tissues, in turn, produces the sound known as snoring.
Snoring is the key symptom of obstructive sleep apnea. However, it does not mean that if you don’t snore, then you don’t have sleep apnea.
Central sleep apnea is a silent type of sleep apnea. In the central type of sleep apnea, your brain is the region affected and there is no physical narrowing of the airway. If your airway is patent and the air flows in and out without vibrating structures in the airway, then there will be no snoring sound. In central sleep apnea, the brain is unable to regulate the muscles in your airway. It causes pauses in your breathing.
Most people think that you cannot have sleep apnea without snoring. It is defiantly not correct. As mentioned above, sleep apnea has types and not all types are associated with snoring. The fact is that when people talk about sleep apnea, they are talking about obstructive sleep apnea because it is the more common and known type.
Most people don’t even know about central sleep apnea. Thus the misconception that snoring and sleep apnea are sleeping patterns.
Risk Factors for Central Sleep Apnea
Central sleep apnea is more common in the elderly, typically older than 65 years of age. Obstructive and central sleep apnea are more common in men compared to women. In this section, we will have a look at health conditions that can occur or worsen due to central sleep apnea. These conditions include:
- Congestive heart failure
- Kidney dysfunction
- Stroke or brainstem injury
- Neurological disorders like Parkinson’s disease, ALS, and Alzheimer’s disease
Diagnosis of Central Sleep Apnea
Most people think that the first sign or symptom of sleep apnea is snoring. While this may be true for the obstructive type of sleep apnea, it is not correct for central sleep apnea.
Most people who suffer from central sleep apnea don’t snore. Snoring occurs due to the vibration of the muscles and tissues in your airway due to its narrowing. This physical narrowing of the airway does not occur in central sleep apnea.
You may not notice the pauses in your breathing while you sleep and thus go undiagnosed. Most people with central sleep apnea cannot connect their sleep disturbance with sleep apnea. It is because they may not even notice the pauses in their breathing while sleeping.
Most of the time, a family member or a bed pattern may be the one to notice the lapses in breathing.
For a proper diagnosis, your doctor will do a physical exam, take a detailed medical history and suggest a sleep study (polysomnogram). During the sleep study, a specialist will monitor and record information regarding your sleep like:
- Eye movement
- Electrical activity in your brain.
- Breathing pattern
- Heart rate
- Blood oxygen levels
- Muscular activity
Solutions for Central Sleep Apnea
The solution to your sleep apnea problem depends on its cause. For some people, simple lifestyle modifications can help manage central sleep apnea. Other forms of sleep apnea may need medical intervention. Some of the commonly recommended treatment options for central sleep apnea are:
- To develop healthy sleep habits
- To keep a healthy weight
- Avoid opioids and alcohol
- Sleep on your side instead of on your back
- Use nasal spray
- Use of CPAP (continuous positive airway pressure).
- Try medications like acetazolamide (Diamox) and theophylline.
- Remede System. It is a small machine that is implanted under the skin on your chest. It sends impulses to your diaphragm to move and monitor breathing patterns while you sleep.
Dr. Muhammad Usman is a Doctor, Nutritionist, Wellness Coach and a Researcher with a deep insight into all aspects of writing related to health and science.