If it weren't for chronic exhaustion, Linda Taylor might not have realized that something was wrong. "I just couldn't stay awake at my job," says Taylor, calling her behavior peculiar since she was normally adept at navigating the daily stress of her then "high-pressure" occupation. When her work began to slide, a friend suggested that Taylor undergo a sleep study to see if her terrible snoring might be a sign of a possible explanation. She did. Diagnosis: obstructive sleep apnea. "It was a hidden problem I didn't know I had," says the 59-year-old from Decatur, Ga., who has recovered so successfully with the help of a nighttime breathing apparatus that she now dreads going to sleep when the power is out.
More than 12 million Americans have obstructive sleep apnea, the most common form of sleep-disordered breathing, and like Taylor, many are unaware, according to the National Heart Lung and Blood Institute (NHLBI). Throat muscles, which are usually tense while awake, relax during sleep, allowing the airway to collapse or become plugged by the tongue. As with a kinked hose, the flow stops, sometimes for 10 seconds or more. As the brain senses distress, people may bolt upright and gasp for air, or they may simply snort and go back to sleep, experts say. This can go on hundreds of times a night, without the person realizing it. And it can erode health, says Michael Twery, director of NHLBI's National Center on Sleep Disorders Research.
Untreated, sleep apnea has been linked to high blood pressure, heart disease, stroke, memory loss, obesity, parasomnias, and insulin resistance, a precursor to type 2 diabetes. And a recent study in the Public Library of Science reaffirmed a long-suspected link between severe sleep apnea, the repeated drops in blood oxygen levels, and premature death. What's more, the ensuing daytime sleepiness can also be a "public health hazard," says Alejandro Chediak, medical director of the Miami Sleep Disorders Center and past president of the American Academy of Sleep Medicine, "if you happen to be an airline pilot or a 16-wheel truck driver who is sleeping at the wheel."
Snore loudly? Feel exhausted despite a "good night's rest"? It might be time to discuss symptoms with a doctor, says Twery, adding: "The initial detection of this condition often stems from things that the patient can tell their physician—there's no blood test." Those deemed at risk may be referred to a sleep specialist for a sleep study, although home-based testing options have become available. (Read about the controversial rise of home-based sleep testing for sleep apnea.) Treatment options may include a continuous positive airway pressure (CPAP) machine such as Taylor uses, which creates a column of air that keeps the airway open, or an oral device or surgery, says Chediak.
Meantime, here's what sleep doctors say can exacerbate obstructive sleep apnea or put people at risk for the nighttime breathing disorder:
Weight gain. Excess pounds can bulk up tissues in and around the airway, says Chediak, making the airway more vulnerable to collapse as muscles relax during sleep. Likewise, heavier people tend to have thicker necks, which can also be a factor, says David Schulman, director of the Emory Sleep Lab in Atlanta. Although thin folks can develop apnea, more than 50 percent of people who have the condition are overweight, according to the NHLBI.
Frustratingly, sleep apnea may also contribute to weight gain. There is evidence to suggest that it may lead to an increase in appetite for unhealthful foods, according to a study last year in the Journal of Clinical Sleep Medicine, which found that people with severe forms of the disorder, especially women, were more likely to make poor food choices than those unaffected or with mild cases. Additionally, sleep deprivation, a hallmark of sleep apnea, seems to tinker with hormones that normally suppress appetite, says Chediak. While shedding pounds may alleviate or eliminate sleep apnea if weight is the root cause—weight loss surgery, for example, has been shown to ease it in the morbidly obese—there's "no compelling evidence" that treating sleep apnea will make people melt pounds, Chediak says.