Snored to death: The symptoms and dangers of untreated sleep apnea

Paul G. Mathew, MD, FAAN, FAHS

Sleep is a critically important component of human existence. On average, humans spend about 25%-35% of their lives sleeping. Sleep allows both the body and brain to rest and recover from the stress of daily life. As such, trouble sleeping can cause a range of health problems, and if left untreated dire consequences.

Longing for more sleep

There is a common misconception that there is an exact amount of sleep that the body requires. The necessary hours of sleep can vary, as some people can require as little as five hours or as much as nine hours to function optimally. In addition, too little or too much sleep can cause problems. The classic example is someone who sleeps in on the weekends. Although one may think getting more sleep than usual would leave a person feeling well rested, sleeping an extra 2-3 hours can actually cause the person to feel groggy and less rested.  For my migraine patients, both under and over sleeping can serve as triggers for more migraines. Naps can also be detrimental to sleep hygiene, as they often lead to poor sleep that evening.

Quality, not just quantity

Even if sleep duration is good, sleep quality can be quite poor. Sleep interruptions can fragment sleep. When a person goes back to sleep after an  interruption, it can take one hour to reach the restful part of the sleep cycle. Another interruption before reaching deep sleep will cause yet another delay in the cycle. People who wake up many times during the night can have some nights with zero hours of deep, restful sleep. Poor sleep quantity and/or quality can cause excessive daytime drowsiness (falling asleep while reading, or even driving), chronic fatigue, headaches, mood issues, irritability, poor memory, and cognitive dysfunction.

Urine trouble

When discussing sleep interruptions, many patients will claim that they have to get up to use the bathroom, which is common, particularly for elderly patients. In reality, the bladder is rarely waking up a majority of these patients, and they instead are experiencing a spontaneous arousal. After they wake up, they realize, “Ohh, there is some urine in my bladder…that must be the reason I woke up.” When there is disbelief, I suggest that the patient reduce fluid intake, and yet they still wake up with the same number of interruptions.

Raining cats and dogs

I fondly recall one patient who came to see me due to worsening headaches. She told me about how miserable she was from not only her daily headaches, but also from her constant fatigue and worsening memory. While we were talking, I could not help but notice the fur all over her black fleece and black pants. After making this observation, I asked, “Do you have a dog?” and she said, “Yes, I have two dogs and three cats.” I then asked, “Where do your pets sleep?”  She replied, “On my bed with me and my husband.” Given the PETential for sleep interruptions, I recommended that she stop sharing the bed with her pets, and keep them two closed doors away from the bedroom. Keeping them just outside the bedroom door would surely lead to clawing on the door and other noises that would interrupt her sleep. After following just this simple advice, she experienced a significant improvement of her headaches, fatigue, and memory. I, on the other hand, experienced a significant improvement of the amount of animal fur on the furniture and floor of my office.

Snore in trouble

Sleep apnea is literally when a person stops breathing during sleep. As a result, the brain undergoes repeated moments of suffocating. In popular culture, snoring is viewed as funny, and people often laugh when a snoring person lets out a sudden explosive snort. The reality is this loud snort is often the person gasping for air as the brain is not getting enough oxygen. Sleep apnea interrupts sleep for both the person and their bed partner. In the case of a female patient whose husband refuses to get evaluated despite showing signs of sleep apnea, I often urge the patient to bring their husband with them to their next appointment with me. Whether it’s the patient or the spouse, I often hear the line “I have always slept this way.” When that happens, I explain that poor sleep is like alcohol. In our 20s drinking a six pack of beer would lead to a rough morning after, but the same six pack of beer in our 50s can require a week to fully recover. Likewise, recovering after an all nighter without sleep in our 20s tends to be much easier than trying to pull an all nighter in our 50s. That being said, younger brains tend to be more resilient with toxic situations, like alcohol consumption and sleep dysfunction, than the same brains later in life.

If improvement of headaches, mood, energy, wakefulness, memory, and cognition are not motivation enough, I also advise that untreated sleep apnea leads to an increased risk of stroke, heart attack, and dementia (brain damage). That usually gets people’s attention, and reduces the need for me to perform unnecessary surgeries like a husbandectomy to allow the wife with insomnia to get a good night’s sleep, and subsequently less headaches.

Comments:

  1. Carl Kolenda

    Last November, 2016, after two sleep studies, I was diagnosed with severe “brain central” OSA-Sleep Apnea. I am 75. Since December 15, I have been using a cpap mask with a ResMed AirCurve V10 auto (BiPap) machine.
    I average nightly 8 hours of sleep. I started out with 47.5/hour AHI (apneas and hypopneas incidents per hour). After several increases in my pressure from 12/25 -almost no help, to 18/25, for past 2-months, my AHI is at my goal of 2-5 AHI per hour. The good news is that my blood oxygen levels went from as low as 84% to a normal 95% and above.
    I am personally disappointed. After 3-months, I am still just as tired when I get up as before and I still have to take afternoon naps ( over an hour each day). I know technically the cpap machine is helping me. However, I do feel any better than before I started on the machine December 15th! I never miss using the machine daily

  2. Glynis McFarlane

    I was diagnosed with obstructive sleep apnea in 2014 & have real problems sleeping & physically exhausted due to only sleeping 30 to 60 minutes at a time xx. This has got worse since doctor reduced my sedative mess for ptsd & flashbacks . I also have tumours in my thyroid which may cause obstruction ?? Not happy not having my sedative meds that helped . Would an oral appliance help me ? What is an oral appliance & how does it work with cpap ?? I get up t toilet every 30 to 60 minutes too xx. Have lots of mucous that blocks my airways & is really painful to cough up to clear airways & with cpap I panic to get mask off choking with mucous .. is there anything that helps this or makes more barable .. ? My consultant thinks I have a condition called Bronchiectasis linked to having whooping cough & pneumonia & passive smoking from my dads pub from age of 7 which we lived above & was so smoky we had to gasp for air when smoke was extremely bad when busy . Would a bi pap be better suited to me

  3. Ronald T. Plotka, DDS, PC

    If you snore you may have sleep apnea. Most people have never heard of sleep apnea. Well it’s a real entity. It’s when a person frequently stops breathing during sleep. This can lead to heart attacks, strokes, and a multitude of other health issues. If you’re tired all day, doze at the wheel of your car, feel like you can’t get enough sleep, then tell your physician or dentist. A sleep study can be ordered to see if you have obstructive sleep apnea.
    Don’t risk your life , ask your spouse or significant other if they hear you snore or see you struggling to breath while sleeping.

  4. Briggs Agnes

    This article is very useful and educative.
    Thank you to the editor. Great job.

  5. Tarin Sultana

    I shared this article with my Parents. They have difficulty in releasing oxygen to their brains during sleep.

  6. Joanne Bedard

    I suffer from Sleep apnea and have suffered for many man years without knowing it.. finally had the test done and it was pretty serious results.. now I’m on the CPAP machine and can’t live without it.. life changer for sure..

  7. Lakshmi pillai

    Its very nice to read such articles which is very helpful.
    But remedy is also necessary.
    Regarding snoring,can u pls give remedy for the same for females aged after 45 yrs
    Thank u

    • Paul G. Mathew, MD, FAAN, FAHS

      If you suspect you have a sleep breathing disorder, you should consult a physician with expertise in sleep medicine.

  8. Martha Otis

    I want to know if taking Sleeping pill or valium or other pills is a bad idea – because you don’t get the right kind of sleep…?

    • Paul G. Mathew, MD, FAAN, FAHS

      Sleep medications can be helpful, but can also mask an underlying diagnosis. If sleep apnea is suspected, a sleep study should be performed prior to initiating sleep medications.

  9. Mary A Foley

    I fail to see the relationship between sleep apnea and letting pets sleep on one’s bed. Was this paragraph one that escaped from another article?

  10. sola Talabi -neurologist, Abeokuta, nigeria

    sleep apnea is actually own played in sub saharan west africa. i am very convinced its clearly unidentified ,undiagnosed and untreated in most cases

    given the attendant risks i believe medical personnel may need to probe into any one with excessive day time sleepiness

    i must however say that even when pockets of clinicians make the diagnosis, treatment options are not available

  11. Paula

    Hello, thank you for the alarming info.. now, how do I treat night apneas on my 10 yr old whose dustmite allergy keeps his turbinates chronically swollen and the only alleviating treatment has been living by the sea? We do not live by the sea anymore and I have been advised to do daily multi nose cleanses with hypertonic sea water spray, and that’s what I have been doing for the past 9 yrs…together with other natural and less natural sprays, and homeopathic remedies. But there must be a better cure!! Doctor can you help us?
    Thanks!

  12. S in Arizona

    I was diagnosed with moderate sleep apnea in 2014. Have been using a cpap ever since. I am still incompliance, but it’s very frustrating because still get up at night. Tried sleeping without the cpap once and found I couldn’t nod off. Is is possible to get addicted to cpap? lol As for pets, I find if I don’t let my cat sleep with me she gets quite upset. So she sleeps at the foot of the bed. So far no problems.

  13. Pete Skinner

    An excellent article. I’ve had periods of sleep problems, and periods of generally good sleep. I seem to have benefited from using melatonin. 5 mg.

  14. Barbara

    I awaken 2 times per night to urinate. I can’t go back to sleep unless I go to the bathroom. I often can’t return to sleep for an hour after this. I restrict my fluids all evening. I also awaken a few other times, but can go back to sleep. Isn’t this disruptive sleep due to having to urinate? I may have a small bladder. I started Detrol, but it doesn’t work to eliminate nighttime urination. What can I do?

  15. Aruodo Uche

    I’ve been using a bipap for a year.

  16. brian Clarke

    I have both kinds of sleep apnea stopping breathing 40 to 50 times per hour have not had a refreshed sleep since my teenage years (67 now)
    I have a CPAP machine now that aids in my breathing occurances are down to 2 to 15 per hour each night is different
    This could save your life

  17. Dana Blankschtein Tilkin

    At least I got this one covered! Ruled out sleep apnea with a sleep study a few years ago. Super important, and my mom is having an in-home one next week. I will share this article with her. Thank you so much!

    • Bruce Boyle

      I have APNEA (diagnosed in a sleep study). I have slept using a CPAP for nearly 20 years. Lately (I am 67) I have noticed that when I do wake up at night (and I do in the last couple of years) I cannot get back to sleep while using the CPAP. I have taken to leaving it off after that first get up (usually 4-6 hours). Of course I don’t need as much sleep as I did when I was young but still find 7.5 to be best. I know that I snored terribly before I used the machine. Not now (when I have it on). No one there to tell if I snore after I leave it off. One thing however is that the condition of the uvula improves when using the machine so it should be less for those few hours.

      • Louise Love-Keough

        If you have been diagnosed with OSA-obstructive sleep apnea, you can have an Oral appliance fitted. It puts patient into a protrusive position ( pushes patient jaw forward) which opens airway. This type of appliance has changed the life of patients.