You might be reading this because you’ve been told you stop breathing at times while you sleep, or your partner is choking or gasping after a period of not breathing during the night.
Perhaps you’ve been diagnosed with sleep apnea and are shocked to find out this means your breathing is stopping and want to understand what’s happening to you.
Either way, we understand your concern and are here to help. Please read on to find out more.
What is an apnea?
The word ‘apnea’ is derived from the Greek word apnos, which means ‘without breathing’.
- A- means ‘not’ or ‘the absence of’
- -pnea comes from the word that means ‘to breathe’.
So, literally, an apnea is when you stop breathing. The word can be used in any instance when breathing stops but, most usually today, it’s put together with the word ‘sleep’ to become sleep apnea.
Sleep apnea is therefore when you stop breathing while sleeping.
How can I stop breathing and still be alive?
Our bodies are very sophisticated and clever. When you stop breathing, carbon dioxide builds up in the blood and sends alert messages to the brain, causing it to take drastic action to override whatever has prevented breathing if at all possible.
In sleep apnea, when you stop breathing in sleep, it’s short-term before your brain activates you to wake up just enough to draw a deep breath. A breath stoppage might last from a few seconds to 15-20 seconds. That’s not long enough to cause brain damage or put you at risk of death.
But, sleep apnea can be scary – for the person who stops breathing during sleep and anyone sharing a bed with them.
Sleep apnea is a serious condition that can negatively affect your health and safety.
What it’s like to experience an apnea during sleep
When you’re asleep, your awareness of what’s happening to you is limited. This is so much so that the majority of people diagnosed with sleep apnea have no idea they stop breathing while asleep.
Some people become aware of a problem when they are awakened by suddenly taking in a huge breath. This can be accompanied by a sensation of choking or gasping and might be loud enough to wake you up more fully.
This experience can be confusing and annoying. If it’s happening many times a night, which is often the case with sleep apnea, it can also get frightening.
For others though, the brain wakes the body up enough to get the breathing started again but not so much that the person realises they are awake. Your brain waking you up without you becoming fully conscious is known as a ‘micro arousal’.
(No, not that sort of arousal! We know that ‘arousal’ is a word usually used for bedroom activities of a sexual nature but, in this case, it’s about arousal from sleep).
Stopping breathing during sleep is often more scary for the one sharing a bed or room with a person with sleep apnea. Realising a loved one is not breathing is a scary experience.
Then, the choking or gasping that happens as the body’s reflexes kick in can be extremely concerning, especially if you don’t understand what’s happening. Or, this can be very annoying as the sound and movement can wake up a person’s bed partner more fully than they wake up themselves.
Observing a stoppage of breath in someone diagnosed with sleep apnea is known as a ‘witnessed apnea’.
Why do I stop breathing when I sleep?
In obstructive sleep apnea, breathing stops because the muscles in the back of the throat relax so much that they block the airway. No air can get through, so the breathing stops.
Everyone has the potential to experience apneas and sleep apnea can happen in people of all ages and genders. However, the likelihood of stopping breathing during sleep is higher in those who:
- Are overweight around the middle (as lung volume is decreased)
- Are overweight around the neck (fatty tissue means the airway is narrower – males with a neck circumference of more than 17 inches and females with more than 16 inches are at increased risk).
- Have a naturally narrow airway, even if not overweight.
- Drink alcohol, especially soon before bed (alcohol is a muscle relaxant).
- Have an ‘overbite’ (as the lower jaw being set back makes it harder for the muscles to keep the airway open)
- Have a nasal obstruction, perhaps because of a deviated septum or polyps.
- Experience nasal congestion (either because of illness or allergies)
- Are pregnant or post-menopause (as hormonal changes can affect muscles)
- Are smokers (as smoking can cause inflammation and fluid retention in the airway)
- Sleep on their back (as gravity makes it harder for the muscles to keep the airway open).
There is another type of sleep apnea, called central sleep apnea. Instead of the breathing stopping because of an obstruction, central sleep apnea is caused by other factors, including:
- Some medications, especially those used for pain relief, such as opioids
- Some medical conditions, such as heart failure or stroke
- Conditions that cause weakness of the breathing muscles, like polio.
Where obstructive sleep apnea (shortened to OSA) is about the throat closing over, central sleep apnea (CSA) is more about the signals to the brain about levels of oxygen and carbon dioxide in the blood not working as well.
Central sleep apnea is very uncommon. Most people with sleep apnea have the obstructive type.
Some people with sleep apnea stop breathing per hour up to dozens of times. More than five breathing pauses (or periods of greatly reduced breathing) is enough for a diagnosis of sleep apnea.
I’m worried! How can I stop sleep apnea?
If any of this information rings true for you or someone you know, you’re right to be concerned. However, there is no need for panic. It’s estimated that around 1 person in every 20 has sleep apnea so it’s not uncommon. And, sleep apnea is a highly treatable condition.
Depending on what stage you’re up to in your sleep apnea journey, choose one of the following two options for where to go next:
Already diagnosed with sleep apnea?
If you’ve already had a sleep test and have been diagnosed with sleep apnea, please aim to make lifestyle changes, such as losing weight, reducing alcohol and sleeping on your side, and seek treatment, such as Continuous Positive Airway Pressure, or CPAP.
And, if you are based in or near Adelaide, Ballarat, Chermisde, Gladstone, Gold Coast, Gosford, Ipswich, Maroochydore, Mascot, Morayfield, Sandstone Point, Mt Gravatt or Toowoomba, you can seek sleep apnea CPAP treatment via our partners, CPAP Direct.
Haven’t had a sleeping test yet?
If you haven’t been diagnosed with sleep apnea and you’re concerned about stopping breathing while sleeping, your next step is to have a sleeping test.
This can involve an overnight stay in a laboratory or can be as simple, quick and convenient as wearing a watch-like device around your wrist overnight in your own home.
See our overview of at-home sleep test options in our article here.
We applaud you taking your sleep seriously and strongly encourage you to take the next step towards a satisfying and health-giving night’s rest.
Sleep Health Foundation Fact Sheet: https://www.sleephealthfoundation.org.au/central-sleep-apnea.html