Living with Sleep Apnea

Written by Petar Petrov

Sleep apnea is a sleep disorder characterized by repeated pauses in breathing, which interrupt sleep and render it less effective and restorative.

Sleep apnea can be tricky because these pauses in breathing can be subtle enough to be forgotten almost instantly, yet pronounced enough to break up your sleep cycles and snap you out of the crucial deep sleep phase. It is particularly true for people who sleep alone, with nobody to hear them snoring, snorting, or gasping for air, which is this condition’s most conspicuous trademarks. They wake up already tired, unable to shake off the cobwebs throughout the day, brushing it off as chronic fatigue.

And in more severe cases, sleep apnea can mean consciously and repeatedly waking up throughout the night, bordering with insomnia.

Types of Sleep Apnea

Sleep apnea falls in one of three sub-categories: obstructive, central, or mixed.

Obstructive Sleep Apnea (OSA)

OSA is the most common type of sleep apnea because it’s a more straightforward condition that’s generally marked by simple mechanics. It occurs when the airway in the back of the throat becomes obstructed physically, partially blocked.

Simply put, this happens because the muscles in the back of the throat, which support the soft palate, relax to the point of collapsing and blocking the passage of air. But that’s the immediate cause rather than the predisposing factors.

Causes and Predisposing Factors

Anatomical features like a thick neck, which can come with a narrower airway

  • Obesity: The excess fat stored around the airway can become an obstruction. A 10% increase in body weight can translate into a “6-fold increase in the odds of developing moderate-to-severe sleep-disordered breathing.” [1]
  • Smoking: Smoking increases the chances of OSA proportionately to the severity of the habit. [2]
  • Being older and male
  • Alcohol and sedatives: These deepen the relaxation of the muscles in the back of the throat. It is why the stereotypical drunker slumber in movies is always accompanied by heavy snoring.
  • Nasal congestion: This is practically like sleep apnea in itself, an obstruction of the airway.
  • Sleeping on back: This increases the chances of the supporting muscles in the throat collapse

Central Sleep Apnea (CSA)

CSA is more complex and, respectively, less common. It stems from a problem in the brain’s sending signals to the muscles involved in breathing.  As such, it’s generally tied to a more profound medical condition, such as heart disorders and a stroke. Being older and male and heavy alcohol and sedative use are risk factors as they are for OSA.

Central Sleep Apnea (CSA)

CSA is more complex and respectively less common. It stems from a problem in the brain’s mechanisms of sending signals to the muscles, involved in breathing.  As such, it’s generally tied to a deeper medical condition, such as heart disorders and/or a stroke. Being older and male, as well as alcohol and sedative use, are risk factors as they are for OSA.

Mixed Sleep Apnea

It is a combination of both OSA and CSA.


Besides the loud snoring, in all its variations (which don’t have to be caused by sleep apnea), the most common sleep apnea symptoms are pretty much the same as the ones of sleep deprivation, which can make this condition fly under the radar. One almost dead giveaway is chronic fatigue despite having enough sleep hours, as this means the quality of the actual sleep is compromised.

More severe symptoms can include heart problems and high blood pressure, metabolic syndrome [3], type 2 diabetes [4], and more.

It’s essential to monitor both your sleep and your waking hours, as they’re tightly entwined, and consult an expert over any concerns of sleep apnea you might have.


  1. Peppard et al, Longitudinal study of moderate weight change and sleep-disordered breathing, JAMA, 2000 Dec 20;284(23):3015-21, Impact Factor = 45.540;Times Cited = 1984
  2. Wetter et al, Smoking as a risk factor for sleep-disordered breathing, Arch Intern Med 1994 Oct 10;154(19):2219-24, Impact Factor = 18.652; Times Cited = 623
  3. Castenada et al, Correlation between metabolic syndrome and sleep apnea, World J Diabetes.2018 Apr 15; 9(4): 66–71, Impact Factor = 2.00, Times Cited = 28
  4. Muraki et al, Sleep apnea and type 2 diabetes, J Diabetes Investig.2018 Sep; 9(5): 991–997, Impact Factor – 3.902; Times Cited = 31

Image Credits: Wikimedia Commons

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Petar Petrov

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