26/09/2025
🌙 Understanding Sleep Apnea — Full Explanation for Patients
What is sleep apnea?
Sleep apnea means that while you are sleeping, the muscles in your throat relax too much. The soft palate and tongue fall backwards and your airway closes off. When this happens, air stops flowing and you actually stop breathing for a few seconds.
What happens during these episodes?
Because no air is moving, your oxygen levels drop.
Your brain immediately notices this lack of oxygen and sends a signal to “wake up” just enough to make you gasp and breathe again.
You may not remember waking up, but this cycle of stop breathing → oxygen drop → mini-wake-up can repeat dozens or even hundreds of times every night.
🧠 What does it do to your body?
Every time your oxygen drops and your sleep is interrupted, your body suffers:
Your sleep is broken → you wake up feeling unrefreshed, tired during the day, struggling with memory, focus, and mood.
Your blood pressure spikes each time → over time this causes high blood pressure that is hard to control.
Your lungs squeeze harder to push blood through when oxygen is low → this causes high pressure in the lungs (pulmonary hypertension).
Your right heart works overtime against this pressure → eventually it can stretch, weaken, and cause heart failure (with swollen legs, shortness of breath).
Your blood pressure no longer dips at night (it normally should dip around 2 a.m.) → this causes resistant hypertension that stays high during the day.
Your heart rhythm becomes unstable → people with untreated sleep apnea are much more likely to develop atrial fibrillation and other dangerous arrhythmias, which also increase the risk of stroke.
Your metabolism suffers → low oxygen and broken sleep make it very hard to lose weight and can worsen insulin resistance and diabetes.
Your daytime life changes → you may feel constantly exhausted, depressed, unable to concentrate, and you are more likely to have car accidents or even fainting spells from the sleepiness.
⚖️ Who is at risk?
The two strongest risk factors are:
Obesity (being overweight) — fat around the neck and throat makes the airway collapse more easily.
Large neck circumference:
Men: greater than 43 cm
Women: greater than 40 cm
Other risk factors: being male, middle-aged or older, family history, small jaw or crowded airway, alcohol or sedatives at night, or blocked nose from allergies/deviation.
💡 If you are overweight, have a thick neck, and feel sleepy in the day → the chance of sleep apnea is very high.
📊 How do we diagnose it?
The test is a sleep study (polysomnography) or sometimes a home sleep apnea test.
We count the number of times per hour that you stop or reduce breathing (the “Apnea–Hypopnea Index” or AHI).
Mild sleep apnea: 5–14 times per hour (with symptoms like sleepiness or high blood pressure).
Moderate: 15–29 times per hour.
Severe: 30 or more times per hour.
Rule of thumb: ≥5/hour with symptoms, or ≥15/hour without symptoms = sleep apnea.
💊 How do we treat it?
1. Lifestyle
Weight loss: even 5–10% of body weight makes a big difference.
Avoid alcohol and sleeping tablets at night.
Don’t sleep flat on your back if possible (sleep apnea is worse in that position).
2. CPAP — the gold standard
CPAP = Continuous Positive Airway Pressure.
It’s a small machine with a mask that gently blows air to keep your airway open.
You must use CPAP every time you sleep — at night and even for daytime naps.
Benefits of CPAP:
Keeps oxygen levels stable.
Restores deep, refreshing sleep.
Protects your heart and brain from damage.
Improves mood, memory, and concentration.
Greatly reduces the risk of car accidents and fainting.
Helps with weight loss — many people lose around 5% of body weight in the first year because their metabolism works better once they sleep properly.
In some patients, if enough weight is lost, the sleep apnea can even disappear completely.
3. Other treatments (for selected cases)
BiPAP (a machine that gives higher pressure in and lower pressure out).
Dental devices that bring the lower jaw forward (helpful in mild/moderate cases).
Surgery (on the throat, nerves, or weight-loss surgery in severe obesity).
🌟 Take-home message for you
Sleep apnea is not just snoring. It’s a progressive condition that damages your body every single night if untreated.
It can lead to high blood pressure, heart failure, stroke, and reduced lifespan.
The good news: CPAP is simple and effective. It can give you back your energy, protect your health, help you lose weight, and even add years to your life. Above mentioned complications can be avoided by early recognition and appropriate constant treatment of sleep apnea.
💡 Whenever you sleep, use CPAP — it’s the single best thing you can do for your long-term health.
