7 Signs You Might Have Sleep Apnea

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What are the seven signs you might have sleep apnea? Over 800,000 Canadian men and women suffer from obstructive sleep apnea. Are you one of them?

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Undiagnosed OSA in Women

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Symptoms that point to OSA can be less pronounced in women than men, but studies suggest the consequences are just as damaging for women, if not worse. And it may be more common in women than we think.

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Is snoring suffocating your marriage?

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We talk about a lot of issues in these blogs, and you hear a lot about the negative health impacts of leaving Obstructive Sleep Apnea untreated, but have you thought about how it affects your relationship with your partner?

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Dealing with the growing problem of insomnia in Canada

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Tossing and turning in her bed for the third time that week, Sylvie sat up and glanced at her alarm clock in frustration.

3:37 AM, it read – which meant she had been awake for more than two hours. Again.

Although she’d gone to bed at a decent hour and fallen asleep right away, here she was wide awake, knowing that in a few short hours she’d have to get up, make her way to work, and somehow find the energy to get through that big presentation to the new client that her boss was counting on her to bring in.

Sylvie flopped down on the bed. She was so tired – so why couldn’t she fall asleep?

Sylvie’s experience is not uncommon.

Here in Canada, insomnia is on the rise.  A new study conducted by Dr. Charles M. Morin at Université Laval revealed that 40% of Canadians had experienced one or more symptoms of insomnia at least three times a week in the preceding month and only 13% said they had consulted their doctor about it.

“Many people who suffer from insomnia try to treat the problem themselves rather than consulting a healthcare professional,” said Dr. Morin. His survey revealed that Canadians use prescription medicine (10%), natural products (9%), over-the-counter drugs (7%), or alcohol (5%) to treat their sleep problems. “This is not a good idea because we don’t know the risks and benefits of products that have not been approved by government health agencies,” he explained.

pie chart showing a tired man in 40% and a sleeping one in the remaining 60%

What is Insomnia?

Insomnia is a sleep disorder whereby you can’t fall asleep, even though you want to, or you can’t stay asleep long enough. It is generally defined as taking more than 15 minutes to fall asleep, being awake and unable to fall back asleep from periods of 30 minutes or more during the night, and/or sleeping less than five hours per night. Acute insomnia can afflict you for just a few days, or it can become a chronic condition, depriving you of rest for months or even years.

It can also make a person exhausted, moody, irritable, accident-prone, anxious, and less able to think straight or remember things. Over the long term, insomnia is also linked to conditions like obesity, high blood pressure, diabetes, and heart disease.

woman staring at her alarm clock in the middle of the night

Insomnia Rates in Canada

Insomnia affects all segments of the population, including children and the elderly. According to a recent survey1, half of Canadian adults have trouble going to sleep or staying asleep. One in five adults do not find their sleep refreshing, and one in 3 have difficulty staying awake during waking hours. Younger adults are more likely to report problems falling asleep, whereas middle-aged and older adults find it harder to stay asleep throughout the night.

Insomnia is more prevalent among women, middle-aged and older adults, and individuals who say they are in poor physical or mental health. It’s also more common among lower-income Canadians. And insomnia is on the rise – the report notes an increase of 42% in insufficient sleep among Canadians from 2007 to 2015.

tired woman rubbing temples

Insomnia Costs Us All

A recent study2 estimated the total annual cost of insomnia in the province of Quebec alone to be $6.6 billion. This total includes direct costs associated with healthcare consultations and products used to promote sleep (including medications and self-administered aids such as alcohol), as well as indirect costs arising from lost resources (absenteeism and reduced productivity) associated with insomnia.

The study also found that insomnia costs those who suffer from it in particular, both directly and indirectly. The average cost to someone suffering from insomnia is $5,010 annually, which includes indirect costs such as reduced productivity and lost revenue as well as direct costs like medications.

a pile of money

What causes insomnia?

Stress and Worry

Stress and worry are two of the most common disruptors to the sleep cycle – more than half of insomnia cases are caused by a troubled mind. If you are dreading an upcoming event, it can be difficult to put it out of your mind at bedtime. Our dependence on devices such as smartphones may lead us to check work emails right before bed, causing job-related stress that contributes to worry as you try to fall asleep.

Ongoing stress, such as worry about work, school, money or a relationship, can intrude on your sleep on a regular basis. And major life events, such as a job loss, divorce, or the death of a loved one often cause insomnia. People with depression, anxiety, dementia, or mental disorders are far more likely to have sleep problems, including insomnia.

In Sylvie’s case, a recent round of layoffs at work and a new, abrasive boss had her worrying about her job security and financial stability. She was working later hours to demonstrate her worth – and skipping regular exercise, which could have helped her manage the stress better.

stressed out man, rubbing temples

Substances and Medications

Sylvie had started having an extra cup or two of coffee in the morning, to shake off the brain fog she got out of bed with most days. To relax after a hard day at the office, she regularly had a few glasses of wine in the evenings as well. Both caffeine and alcohol, however, can affect the ability to fall asleep, stay asleep, and enjoy a restful night.

Caffeine is well-known as a stimulant, but its effects can last for several hours, so the chances of it affecting sleep are significant. Caffeine not only makes it hard to fall asleep, but can also cause you to wake up during the night. Alcohol may have a sedative effect for a few hours, but as it is metabolized by the body it can rouse you from sleep and affect sleep quality as well.

Many medications, such as decongestants or asthma inhalers, are also stimulants and can disrupt sleep. Other drugs that might cause insomnia include allergy medications and those for heart disease, hypertension, thyroid problems, and depression.

a pile of pills spilling out of a container

Irregular Schedule

On nights when she worked late, Sylvie ordered pizza and ate it in front of the TV before falling into bed. Eating a late dinner or snacking before bed can activate the digestive system and keep you up, and fatty foods can contribute to acid reflux problems or heartburn, especially when you’re lying down in bed. Even drinking water or herbal tea just before bed can require you to wake up and visit the bathroom during the night, disturbing your sleep.

An irregular sleep schedule also contributes to insomnia, as your body becomes accustomed to sleeping and waking at regular intervals. Sylvie would tell herself that she would “catch up” by sleeping in on weekends, and while she did get some much-needed rest, inconsistent sleep patterns made it hard to fall asleep once she was back on her weekday schedule.

broken clock

Menopause

To make matters worse, Sylvie was suffering from the shifting balance of hormones caused by menopause. Occasionally, hot flashes — surges of adrenaline that raise body temperature – would make her so uncomfortable that she would wake up drenched in sweat, sometimes several times a night.

Menopause is another contributor to insomnia, which may help explain why insomnia affects middle-aged women more than any other age group.

confused woman trying to remember something

Breathing Problems

Sylvie had noticed that she woke up more when she was on her back – a position in which she had been told she sometimes snored in her sleep. Snoring is associated with sleep apnea, a condition where the normal breathing cycle is interrupted, waking you up several times every night.

You may not realize it’s happening, but you feel tired the next day. Fortunately, sleep apnea can be diagnosed with a simple test. Sufferers of sleep apnea report great improvement in sleep after treatment.

snoring woman sleeping on her back

What Can I Do to Beat Insomnia?

At Apnea Health, we can help.

After yet another sleepless night, Sylvie came to see us for a sleep test. It turned out that she stopped breathing 18 times per hour. One of our respirologists (sleep doctors) met with her to explain that she suffered from moderate sleep apnea and the treatment options available to her.

Sylvie did a trial of CPAP for 3 months where our team was able to eliminate her sleep apnea so that she no longer stopped breathing 18 times per hour. However, after 3 months she was still waking up at night or too early in the morning unrefreshed.  After consultations with our therapists and our sleep doctor, we determined that Sylvie also suffered from insomnia. She joined a 4-week cognitive behaviour workshop for insomnia.

Today, Sylvie wakes up refreshed and with more energy. And on weekend mornings, when she used to sleep late, she now spends time exercising or outdoors with her family.

If you are one of the 40% of Canadians suffering from insomnia, contact one of our sleep specialists today to set up a sleep test.

Apnée Santé Team

  1. Chaput JP, Yau ,J, Rau DP and Morin CM, Prevalence of insomnia for Canadians aged 6 to 79, Statistics Canada, December 19, 2018.
  2. Daley M, Morin CM, LeBlanc M, Grégoire JP, Savard J. The economic burden of insomnia: Direct and indirect costs for individuals with insomnia syndrome, insomnia symptoms, and good sleepers. Sleep. 2009;32(1):55-64.
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Sleep apnea may be a surprising symptom of menopause

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October is Menopause Awareness Month.

Menopause is a time of major hormonal, physical and psychological change for women, although menopausal symptoms vary from one woman to another.
Women enter menopause around the age of 50, and during the transition they can encounter a multitude of different symptoms such as hot flashes, headaches, fatigue, and mood swings and surprisingly, even sleep apnea.

Menopause can cause sleepless nights

During the perimenopause, or transition phase, a woman’s ovaries gradually (over several years) decrease production of estrogen and progesterone. One year after menstrual periods have stopped, a woman is considered to have reached menopause – and from peri-menopause to post-menopause, women report an increased rate of symptoms that interfere with sleep. Most notably, these include hot flashes, which are unexpected feelings of heat all over the body accompanied by sweating. They usually begin near the face and spread to the chest, affecting 75-85% of women around menopause.

Hot flashes can interrupt sleep and last on average three minutes, leading to less sleep efficiency. Most women experience these for a year, but about 25% have hot flashes for five years. While total sleep time may not suffer, sleep quality does. Interrupted sleep and frequent awakenings cause next-day fatigue.

Other symptoms of menopause include mood disorders, insomnia, and sleep-disordered breathing; sleep problems are often accompanied by depression and anxiety. Generally, post-menopausal women are less satisfied with their sleep and as many as 61% report insomnia symptoms. Snoring has also been found to be more common and severe in post-menopausal women. Snoring, along with pauses or gasps in breathing are signs of a more serious sleep disorder, obstructive sleep apnea (OSA).

woman staring at her alarm clock in the middle of the night

What’s OSA?

  • In obstructive sleep apnea the airway becomes blocked (obstructed) during sleep, which causes a pause in breathing.
  • When we stop breathing our oxygen levels drop, which triggers the brain to tell us to wake up and breathe.
  • However, we don’t wake up completely (these sleep interruptions are called “micro-arousals”).
  • It’s these micro-arousals that disrupt our sleep architecture and cause us to wake up in the morning feeling as if we haven’t slept a wink.

Woman sleeping with mouth open

Sleep apnea and menopause: What’s the connection?

According to The National Sleep Foundation, “During menopause, levels of the hormones estrogen and progesterone decrease in women’s bodies. These hormones act as stimulants and play a role in keeping airways open by maintaining muscle tone in the throat. As they decrease, the chances of obstructed breathing rise. What’s more, hormonal changes can lead to weight gain and a redistribution of body fat, sending more fat to the throat area, which can cause disrupted breathing.”

This weight gain can also cause snoring.  According to statistics, snoring affects 3% of women before menopause and 11% after menopause1. An American study examined 2,852 post menopausal women to asses whether sleep apnea was more common in women who were not treated with Menopausal Hormonal Therapy (MHT) than those who did. In this study, MHT is associated with a significant decrease in the frequency of sleep apnea.  Researchers found that patients receiving replacement therapy were able to reduce the severity of their apnea; however, it did not eliminate it.2

Sleep apnea is a risk factor in cardiovascular disease.  In women, its frequency increases at the time of menopause.  A study published in France in 2017 studied obstructive sleep apnea (OSA) in postmenopausal women with a high risk of cardiovascular disease.  The 2 year study included 91 menopausal patients hospitalized at Lille University Hospital for cardiovascular disease.  All these patients had a screening test for OSA and 73% of them had sleep apnea.3

Tired woman driving car

So what should you do if you’re past menopause, you snore, and you suspect sleep apnea?

The first step is to get tested for sleep apnea. If you have OSA symptoms and feel that your sleep is not restful, it’s important to talk to your doctor about it. Apnea Health offers simple, fast and effective home testing. You can also contact us for a free evaluation to see if sleep testing is right for you.

If the test shows you have sleep apnea, you’ll most likely be prescribed a continuous positive air pressure (CPAP) device. CPAP is the most effective treatment for OSA. Thousands of Canadians use it every time they sleep. CPAP consists of a gentle stream of air that is directed through the airway during sleep, allowing the airway to remain open, and therefore preventing apnea.

Treating your sleep apnea can reduce other health risks, too, from impaired memory to weight gain.

Respiratory therapist with smiling patient

Additional tips for restful sleep

  • Eat healthy. Avoid large meals, especially before bedtime. Maintain a regular, normal weight. Some foods that are spicy or acidic may trigger hot flashes. Try foods rich in soy as they might minimize hot flashes.
  • Avoid nicotine, caffeine and alcohol, especially before bedtime.
  • Dress in lightweight clothes to improve sleep efficiency. Avoid heavy, insulating blankets and consider using a fan or air conditioning to cool the air and increase circulation.
  • Reduce stress and worry as much as possible. Try relaxation techniques, massage and exercise. Talk to a behavioral health professional if you are depressed, anxious or having problems.
  • Create a schedule and avoid naps. Establishing a schedule will make it easier to fall asleep the same time every night, and napping could make it harder to get to sleep.
  • Create a controlled sleeping environment. Your bedroom should be cool and dark to promote the bed sleep possible, invest in a fan or sleep mask if necessary.
  • Don’t exercise before bed. It is important to maintain a healthy lifestyle through exercise, but try to fit your workout in earlier in the day.

Woman stretching to get ready to exercise

Better sleep, better life

Women are underdiagnosed for sleep apnea across the country and around the world.  To improve your sleep and your life, call Apnea Health today!  Proper diagnosis and treatment can make you more successful at home, at work or wherever your life’s focus is.

woman sleeping peacefully

Sources:

  1. Menopausal status and sleep-disordered breathing in the Wisconsin Sleep Cohort Study. American journal of respiratory and critical care medicine. Young. 2003. 1;167(9):1181-5  S,
  2. Hormone replacement therapy and sleep-disordered breathing. Shahar. American journal of respiratory and critical care medicine. Mai 2003. 1;167(9):1186-92
  3. Souad Sedir,Claire Mounier Vehier Christelle CharleyMonaca: Science direct, Médecine du sommeil, Volume 14, Issue, Mars 2017, page 21, https://www.sciencedirect.com/science/article/pii/S1769449317300109
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How to lose weight and sleep better at the same time

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Have you ever noticed that when you are tired you eat more?

You may even feel ravenous and spend your day grazing the office freebies in the kitchenette. Your portions may be getting larger and the number of times you eat during the day may be increasing in an attempt to get more energy and combat fatigue.

Rest assured this is not your fault! It is not a lack of willpower. The answer may lie in your sleep and sleep apnea may be the culprit responsible for your weight gain.

Why do we pack on the pounds when we are sleep deprived?

When we’re sleep deprived, the hormones that control hunger and appetite start sending out faulty messages.

There are four hormones that control hunger and appetite:

  • Ghrelin tells the body to eat
  • Leptin tells it to stop eating
  • Cortisol makes us crave sugary foods when we’re stressed
  • Insulin stores calories

When we’re short on sleep, we produce more ghrelin (making us want to eat) and less leptin (the hormone that tells us to stop). On top of that, we produce more cortisol due to the stress caused by lack of sleep, so we crave sugary foods. And we produce extra insulin, which leads the body to store glucose in fat cells . . . so we gain weight.

It’s no wonder that as much as we might try, if we’re lacking sleep, we will invariably turn to food. We simply cannot combat the signals our bodies are sending us. Moreover, with an increasing amount of cortisol, we’re likely to give in to junk food cravings.

tired woman eating pizza on couch

Sleep apnea and weight gain: a vicious cycle

Here’s what happens:

  • In obstructive sleep apnea the airway becomes blocked (obstructed) during sleep, which causes a pause in breathing.
  • When we stop breathing our oxygen levels drop, which triggers the brain to tell us to wake up and breathe.
  • However, we don’t wake up completely (these sleep interruptions are called “micro-arousals”).
  • It’s these micro-arousals that disrupt our sleep architecture and cause us to wake up in the morning feeling as if we haven’t slept a wink.

Gaining weight can cause us to sleep less and sleeping less can make us eat more! This vicious cycle can turn into a nightmare.

But there is hope: The cycle can be broken, starting with a proper night’s sleep. And the good news is Apnea Health can help you achieve a good night’s rest.

A continual cycle that shows that sleep apnea leads to poor sleep which leads to increased hunger hormones which weight gain. After that, the process repeats.

How to break the cycle

The first step is to get tested for sleep apnea.

If you have OSA symptoms and feel that your sleep is not restful, it’s important to talk to your doctor about it.

Apnea Health offers simple, fast and effective home testing. You can also contact us for a free evaluation to see if sleep testing is right for you.

Here’s a checklist to review with your doctor for signs of sleep apnea.

  • Loud snoring
  • Occasionally waking up during the night feeling that you’re choking or gasping
  • Restless sleep
  • Having a sore or dry throat in the morning
  • Having a headache in the morning
  • Sleepiness, low energy or fatigue during the day
  • Feeling sleepy behind the wheel
  • Weight gain
  • Erectile dysfunction
  • Forgetfulness, mood changes, and a decreased interest in sex

a checklist

Will CPAP treatment help with weight loss?

Yes! A three-month study of CPAP users published in the New England Journal of Medicine showed a marked reduction in body mass index, as well as a mild to moderate decrease in blood pressure and cholesterol levels 1.

That’s three good reasons for people with sleep apnea to use their CPAP device every night!

 

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Is it okay to stop CPAP treatment after losing weight?

Treating sleep apnea and restoring sleep will obviously have an impact on your health and weight. You’ll stop feeling drowsy and fatigued. You’ll want to be more active, and with your new energy you might take up exercise, which will support your weight loss. And, of course, your hunger hormones will work normally.

Still, even if you snore less and feel you no longer suffer from sleep apnea, you should never stop CPAP without checking with a sleep medicine specialist first. That’s because there is no 100% guarantee that your sleep apnea will be completely eliminated.

Although being overweight is a cause of sleep apnea, sometimes other factors are present too – such as ear, nose and throat abnormalities (including nasal obstruction, tonsillar hypertrophy, large tongue base, elongated uvula or palate), or facial abnormalities. If these factors are present, sleep apnea will not necessarily disappear with weight loss.

man holding cpap e1610479937791

 

So you’ve lost that extra weight. What next?

After you’ve lost weight, it’s a good idea to visit your sleep clinic. It’s possible that the pressure setting on your CPAP machine will need adjustment because your airway has become less restricted.

After that, start thinking about other healthy lifestyle changes! With cravings under control, you can take the time to make nutritious meals. The extra energy you get from being well-rested can help you get a good workout, either outdoors or in the gym. You’ll find that with the help of Apnea Health, a whole new outlook begins with a good night’s sleep!

weight loss

 

1 Rishi, Muhammad Adeel MD et al. Effect of Positive Airway Pressure Therapy on Body Mass Index in Obese Patients With Obstructive Sleep Apnea Syndrome: A Prospective Study. American Journal of Therapeutics: March/April 2016 – Volume 23 – Issue 2 – p 422–428

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