Difficulty breathing or even suffocation during sleep is generally hard for individuals to notice, especially sincesleep apneapatients may not have obvious symptoms, yet many potential risks exist. For instance, airway obstruction during sleep can hinder breathing, not only affecting sleep quality and leading to fatigue and poor concentration but also potentially damaging cardiovascular health, triggering serious conditions like heart disease and stroke. Which 5 types of people are at high risk? What warning signs should one look out for? Doctors advise seeking medical attention early if any of the following situations occur: frequent fatigue, ability to fall asleep anytime during the day, constantly tossing and turning during sleep, or recently diagnosed with diabetes and high blood pressure. It is recommended to consider undergoing a sleep test to determine if the problem stems from sleep apnea, allowing for appropriate treatment plans.
Are you at high risk for sleep apnea? 5 types of people need to pay attention
．Elderly individuals
．Obese individuals
．Abnormal jaw structure
．Men and post-menopausal women
．Individuals with nasal allergies, especially children
Sleep apnea patients experience worsening sleep quality
Sleep apnea is one of the common diseases in Hong Kong, affecting as many as 8% of adult men and women. The older one gets, the higher the proportion of people suffering from this condition, with one in four individuals over the age of 65 experiencing sleep apnea.
Dr. Lam Bing, Director of the Respiratory System Centre at Union Hospital, stated that obese individuals and the elderly, among others, have poorer muscle tone, making them more prone to sleep apnea. Abnormal jaw structure can also easily lead to airway obstruction. In addition to congenital factors, some children with nasal allergies who habitually breathe through their mouths for extended periods may experience impaired growth of their upper and lower jaws, leading to narrowed upper airways and making them susceptible to sleep apnea in adulthood.
Dr. Lam pointed out that when a person enters sleep, all muscles, including those in the upper airway, relax, causing the airway to narrow. However, this usually does not impede breathing. For sleep apnea patients, the airway narrowing is severe, or even completely blocked, leading to difficulty breathing and a drop in blood oxygen. The brain then experiences oxygen deprivation, causing a brief awakening. Muscle tone is restored, reopening the airway and allowing normal breathing to resume. However, the body quickly falls back asleep, only to wake up again when oxygen-deprived. This cycle of sleeping and waking repeats throughout the night, naturally leading to poor sleep quality.
Long-term impact on cardiovascular system; increased risk of flatulence and acid reflux
Sleep apnea can lead to other symptoms, such as easy fatigue, daytime sleepiness, memory impairment, and decreased concentration. However, only about half of sleep apnea patients exhibit obvious symptoms; the rest may appear normal. The most concerning aspect is the long-term damage this disease can inflict on patients' blood vessels, potentially increasing the threat of cardiovascular diseases.
Dr. Lam explained that when blood oxygen levels drop, the body reduces consumption, causing heart rate to slow down and blood pressure to decrease. But when the brain, due to oxygen deprivation, commands the body to wake up, heart rate and blood pressure immediately surge. "Fluctuating blood pressure accelerates arterial hardening, and heart rate can become irregular, or even stop suddenly."
On the other hand, to cope with blood pressure changes, the heart speeds up fluid drainage, causing patients to frequently wake up in the middle of the night to urinate. Additionally, the body's forceful inhalation to breathe increases negative intrathoracic pressure, affecting the esophageal sphincter and leading to an increased risk of flatulence and acid reflux.
Severe snoring does not necessarily mean sleep apnea; a sleep test is recommended
Dr. Lam emphasized that patients often find it difficult to notice if they have experienced suffocation during sleep; it is often discovered by their bed partner or family members. Some individuals only discover their condition is related to sleep apnea when seeking medical attention for poorly controlled diabetes or high blood pressure, glaucoma, irregular heartbeats, or other diseases.
Diagnosing sleep apnea cannot rely solely on symptoms, as even severe snoring does not necessarily mean sleep apnea. Patients need to undergo a sleep test to confirm the presence of the condition and its severity. According to the guidelines of the American Academy of Sleep Medicine, 5 to 15 apneic events per hour are considered mild; 15 to 30 times are moderate; and over 30 times are severe.
Patients with diabetes and high blood pressure with mild apnea should be actively treated
Dr. Lam stated that the severity of sleep apnea is not directly related to the symptoms. Some people may have fifty or sixty episodes of apnea per hour without feeling anything, while others with only seven to eight episodes already exhibit obvious symptoms. Clinically, moderate to severe sleep apnea requires treatment. If there are vascular risks such as diabetes and high blood pressure, even mild conditions should be actively managed.
Treatment for sleep apnea depends on its cause. If the problem is due to obesity, active weight loss is necessary. If it stems from an abnormal jaw structure, corrective surgery can be considered, although jaw surgery would mean not being able to eat solid food for a month. The United States approved the use of implanted pacemakers two years ago to stimulate airway muscles and maintain airway patency, but this technology has not yet been introduced to Hong Kong.
CPAP machine helps keep airways open; weight and lifestyle adjustments aid prevention
Dr. Lam stated that the standard treatment for sleep apnea is the use of a Continuous Positive Airway Pressure (CPAP) machine, which keeps the airway open to prevent suffocation. However, about 20% of patients cannot use a CPAP machine and need to consider other methods, such as using an oral appliance to advance the lower jaw, or positional therapy (side sleeping), which can help improve sleep conditions for patients.
What methods can prevent sleep apnea? Dr. Lam said that gender and aging degradation are unavoidable, but one can adjust lifestyle habits, including maintaining an ideal weight and avoiding smoking and alcohol. Some people whose breathing only stops when sleeping on their back can try to maintain a side-sleeping position to help smooth breathing, and getting enough sleep also helps maintain normal muscle tone.
If you suspect or experience 4 symptoms of sleep apnea, seek medical attention early
He reminded that especially for those at high risk of sleep apnea, if you experience or suspect any of the following 4 symptoms, such as: constantly tossing and turning all night, breathing with sounds but no regular pattern, experiencing breathing pauses, or even being woken up by your own snoring, you should be vigilant and seek medical attention as soon as possible. Early treatment can prevent health deterioration.
Dr. Lam suggested that recently diagnosed diabetes or high blood pressure patients should consider undergoing a sleep test to assess early if there's a link to sleep apnea. If sleep apnea is confirmed, proper control of the condition can also help manage blood sugar and blood pressure.
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