causes and treatments for sleep apnea

Sleep Apnea in Seniors: Types, Causes and Treatment Options

Do you wake up feeling tired even though you should have had a good night’s sleep? You may be suffering from sleep apnea, a disorder that causes you to stop breathing multiple times throughout the night.

These lapses in breath can last anywhere from a few seconds to a few minutes, according to the National Institutes of Health.

Sleep apnea in seniors is more common than you think, but thankfully there are treatment options available. This disorder affects more than just seniors: About 20 million Americans suffer from sleep apnea.

Types of Sleep Apnea

There are three main types of sleep apnea: Obstructive, Central and Mixed.

1. Obstructive

Obstructive sleep apnea (OSA) is the most common form of this disorder. It affects about 4% of men and 2% of women.

Experts believe only 10% of people with this form of sleep apnea seek treatment, so many people have this disorder and don’t know it – or don’t get treatment for it.

Obstructive sleep apnea occurs when there’s a complete or partial blockage of the airways during sleep. When you fall into a deep sleep, the muscles in your throat relax. This relaxation of the muscles allows the fatty tissue in your throat and/or your tongue to fall back into your airways.

When air is blocked, it reduces blood flow to the brain, which sends a signal to the body that it’s time to wake up and move. That’s when you’ll hear the characteristic snorting, gasping or choking sound just before waking up and turning over.

Once that breath is taken, the brain goes back into sleep mode and the vicious cycle starts again.

Some people with obstructive sleep apnea only wake up a few times a night, while others will wake hundreds of times in just one evening.

  • Mild: 5-14 episodes of OSA
  • Moderate: 15-30 episodes of OSA
  • Severe: 30 or more episodes of OSA

There are many possible cases for OSA, including:

  • Age: OSA is common in seniors because muscles begin to lose their tone as people age. That loss of muscle tone also affects the throat muscles. When the throat muscles lose their definition, they are more likely to collapse into a person’s airways during sleep.
  • Weight: Weight is a major contributing factor to the development of OSA. People who are obese or overweight are far more likely to develop OSA than those who maintain a healthy weight. When excess fatty tissues build up in the throat, it can restrict airflow during sleep.
  • Narrow Throat: Genetics can make you predisposed to developing OSA. People with naturally narrow throats or enlarged tongues are more likely to develop OSA.
  • Tonsils: Enlarged tonsils are the most common cause of OSA in children, but seniors who have never had their tonsils removed can also develop this form of sleep apnea.
  • Smoking and Alcohol: Smoking irritates the respiratory system, which can cause inflammation and fluid retention that restricts airflow. Alcohol also relaxes the body – including the throat muscles.

2. Central

Central sleep apnea (CSA) is a form of sleep apnea that occurs when the brain fails to send a signal to the muscles that control your breathing.

In this case, the issue is more of a communication problem than a physical problem.

CSA is less common than OSA. While exact figures are unknown, it is estimated that only 20% of sleep apnea cases are CSA.

Central sleep apnea can be caused by:

  • Obesity
  • Parkinson’s disease
  • Heart failure
  • Certain medications
  • Medical conditions that affect the brain (i.e. stroke, brain infection)

CSA is more common in men and among seniors. People with congestive heart failure and atrial fibriliation are at a greater risk of developing this form of sleep apnea.

Other risk factors include:

  • Stroke
  • People sleeping at higher altitudes
  • People who take opioid medications
  • People using PAP devices to treat OSA

3. Mixed

Mixed sleep apnea, also known as complex sleep apnea, is exactly what it sounds like – a combination of OSA and CSA.

Some people who are treated for OSA with PAP machines develop CSA and continue to have difficulty sleeping despite their airways being splinted open.

Common Symptoms of Sleep Apnea

While symptoms vary from person to person, most seniors will experience the following:

  • Restless Sleep: Those with sleep apnea are awakened several times throughout the evening, which interrupts the REM and non-REM cycles. People with sleep apnea often feel like they do not get a restful night of sleep.
  • Snoring: Frequent and loud snoring is the most common symptom of sleep OSA.
  • Excessive Fatigue: Frequent interruptions throughout the night can leave you feeling excessively tried during the day.
  • Frequent Lapses in Breathing: OSA can cause frequent lapses in breathing, which can cause snorting, gasping and choking sounds as the respiratory system fights the airway restriction.
  • Emotional Issues: Lack of quality sleep can cause irritability and depression.
  • Morning Headaches: Lack of oxygen in the bloodstream can cause headaches in the morning.

Health Risks of Sleep Apnea

Sleep apnea can lead to serious health issues down the road.

Daytime Fatigue

One of the most common complications is daytime fatigue. In cases of severe sleep apnea, lapses in breath can occur 20 times or more in an hour. That can mean you’re only getting four hours of sleep versus the recommended six to seven hours.

Sleep apnea can lead to difficulty concentrating and extreme fatigue. You may fall asleep during the day, while watching television or while driving.

The fatigue can sometimes lead to irritability and depression.

Diabetes

People who have diabetes are more likely to develop insulin resistance, which can lead to type 2 diabetes.

Heart and Blood Pressure Problems

Frequent lapses in oxygen flow can put excessive strain on the heart and increase blood pressure. OSA can also increase the risk of having a stroke.

Those with heart issues and sleep apnea are more likely to die suddenly from an irregular heartbeat.

Complications with Surgery and Medications

People who have sleep apnea are more likely to develop complications after surgery. There’s also increased concern with general anesthesia and medications.

Liver Problems

Those with sleep apnea are more likely to see abnormal results on a liver test, and are more likely to show signs of scarring, also known as non-alcoholic fatty liver disease.

Treatment of Sleep Apnea

The treatment for this disorder largely depends on the type of sleep apnea.

Treating OSA

The most common treatment for obstructive sleep apnea is PAP therapy, which can be in the form of:

  • CPAP (Continuous Positive Airway Pressure)
  • BiPAP (Bilevel Positive Airway Pressure)
  • APAP (Automatic Positive Airway Pressure)

Other treatment options include:

Treating CSA

When treating CSA, doctors typically focus on addressing the underlying cause of the disorder.

In the meantime, many treatments used for OSA are also used for CSA, including:

  • CPAP and BPAP machines

An ASV (adaptive-servo ventilation) device may also be used, which monitors and adjusts airflow through the mask to the person’s natural breathing patterns when awake.

Medications may also be used to treat CSA, depending on the cause of the disorder. Common medications include theophylline and acetazolamide.

Treating Mixed Sleep Apnea

Treating mixed sleep apnea can be a challenge. CPAP and BiPAP machines are currently the most commonly prescribed treatment options.

If you’re experiencing any of the symptoms of sleep apnea, talk to your doctor right away. Sleep apnea is considered a serious medical condition and should be treated as soon as possible.