Sleep Apnea Self Assessment

Sleep Apnea Self Assessment

Sleep Apnea Self Assessment

 

It is estimated that over 1 billion people in the world suffer from Obstructive Sleep Apnea, also known as OSA (1), and most are unaware that they have it. OSA is a sleep disorder that involves cessation or significant decrease in airflow in the presence of breathing effort.(2) OSA can have major repercussions on a person’s overall health if not addressed accordingly and contribute to a deceased quality of life. So how do you know if you are at a high risk of having OSA? Well, there’s a few things you can look for by doing a basic self screening.    

 

Basic Self Screening for OSA

This basic self screening includes the most common signs and symptoms associated with OSA.  If you answer yes to any of the following questions, it is advised that you get a further evaluation by your medical doctor or a certified sleep medicine doctor in order to rule out OSA.

  • Do you snore and wake up gasping for air? 

Snoring is one of the primary signs of OSA, especially if accompanied by gasping of air; making it 70-95% common amongst those who suffer from OSA (3).  But it is not to say that everyone who snores has OSA.  The prevalence of snoring in the general population varies widely (from 15% to 54%), mainly because most studies rely on subjective reports.(3) Snoring alone can also occur when a person is completely exhausted or has a stuffy nose, but when it is accompanied by gasping for air, it increases your chances of having OSA.

  • Do you have enlarged tonsils and adenoids?

Enlarged tonsils and adenoids are a predictive marker for airway obstruction, as they contribute to narrowing of the upper airways.  According to sleepfoundation.org, surgical removal of enlarged tonsils and adenoids alone, has demonstrated improvement in the severity of OSA in children.  “Children who had these surgeries have experienced improvements in behavior, quality of life, and other symptoms. This is compared to children without these surgeries.”(4) Now, why is this not the first line of treatment for all of those suffering from OSA? Well, the answer is that not all persons suffering from OSA have enlarged tonsils and adenoids.

  • Are you a mouth breather? 

Mouth breathing has many repercussions associated with it, and can further contribute to OSA or make your apnea worse by further increasing airway collapsibility and nasal resistance. The more a person breathes through their mouth, the more congested they’ll become, and the more difficult it can be to treat their apnea.  A mouth breathing individual will also tend to carry their tongue low and forward on the floor of the mouth and this abnormal tongue position can further contribute to airway impingement, as it prevents the muscles located in the back of the throat from being properly toned. Hence further contributing to airway collapsibility.

  • Do you have a tongue tie?

A tongue tie or tethered oral tissue, is when the lingual frenum (the string located on the underside of your tongue) is restricted and impedes proper movement and function of the tongue.  This restriction is associated with a myriad of cascading overall health effects and has been linked to OSA.  These restrictions can have a tremendous impact on the orofacial development; hence impacting the proper development of the airway.  A study conducted on “A frequent phenotype for paediatric sleep apnoea: short lingual frenulum”, stated that “A short lingual frenulum left untreated at birth is associated with Obstructive Sleep Apnea Syndrome at later age, and a systematic screening for the syndrome should be conducted when this anatomical abnormality is recognised.”(5) to learn more about these restrictions check out my YouTube video “How A Restricted Frenum Can Impact Your Health” or our blog post “5 Ways Having A Restricted Frenum Can Impact Your Life“.

  • Do you have excessive daytime sleepiness? 

This is often a sign that you did not get a restful night sleep; and can also be a sign of OSA, as sleep is continuously being interrupted throughout the night due to arousals from snoring or gasping for air. Sleep is reparative for your body and if we don’t get enough quality sleep in our system, all sorts of problems can arise.  Sleep deprivation has been associated with various medical conditions such as diabetes and heart disease. Therefore, it is essential to make sure that we are getting a good quality of sleep.

  • Do you suffer from high blood pressure?

High blood pressure is often associated with OSA, as during an apnea episode there are sudden drops in the blood oxygen level.  During this sudden drop in oxygen, the brain sends a message to the blood vessels to increase the available oxygen to the heart and brain so that the body can continue functioning.  This increase in blood flow puts added pressure onto the blood vessels’ walls, resulting in even higher than normal blood pressure readings, and places extra strain on the cardiovascular system.(6) A Study of 3,000 adults determined that those who slept fewer than six hours a night had double the risk of stroke or heart attack as others who slept up to eight hours, possibly because too little sleep exacerbates other health conditions, including high blood pressure. (6)

  • Have you been diagnosed with diabetes?

According to  a study on sleep apnea and type II diabetes; Obstructive sleep apnea (OSA) alters glucose metabolism, promotes insulin resistance, and is associated with development of type 2 diabetes. (7) Therefore, having type II diabetes can be a potential sign of OSA.

  • Are you overweight? Or have a large neck size?

Being overweight and or having a large neck size can also increase your chances of having OSA.  Extra body weight contributes to an increase in pressure on the upper airways making it more difficult for the person to breathe. Thus resulting in airway collapsibility and decreased neuromuscular control due to the fatty deposits.

  • Do you have a recessed jaw?

Having a recessed jaw can place you at a higher risk of having OSA.  A study conducted on “Orthodontic View In The Diagnosis Of Obstructive Sleep Apnea”, found that having a retruded mandible or a recessed jaw puts a person at a higher risk for having OSA because a recessed jaw is a consequence of a backward position of the tongue, disturbing the cervical region (region of the neck). This further leads to impeded respiratory function in the region of the larynx. (8)

  • Are you experiencing mood changes?

Irritability, depression, anxiety, and lack of concentration are among some of the psychological changes that can be experienced due to lack of sleep and OSA.  A study conducted on “Prevalence of Obstructive Sleep Apnea in Suicidal Patients with major depressive disorder” found that approximately 14% of the participants suffering from major depressive disorder had OSA, and 52 out of the 125 participants had treatment resistant depression.(9,10)

 

Obstructive sleep apnea has many detrimental overall health effects, and it is essential to address it at its early onset.  This self assessment helps you with the identification of the most common signs and symptoms of OSA.  If you or someone you know are experiencing some of these symptoms a thorough evaluation from a certified sleep medicine doctor is advisable.  Click Here for our free downloadable checklist.  Download, print and take the self-assessment to discuss your sleep apnea risks with your medical provider.

 

References

  1. “B67. RISK AND PREVALENCE OF SLEEP DISORDERED BREATHING.” American Thoracic Society International Conference Meetings Abstracts, www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2018.197.1_MeetingAbstracts.A3962. 
  2. Himanshu Wickramasinghe, MD. “Obstructive Sleep Apnea (OSA).” Practice Essentials, Background, Pathophysiology, Medscape, 26 Mar. 2020, emedicine.medscape.com/article/295807-overview. 
  3. Letto
  4. “Surgery on Adenoid Tonsils Improves Outcomes in Children with Obstructive Sleep Apnea.” Sleep Foundation, 2 Sept. 2020, www.sleepfoundation.org/articles/surgery-adenoid-tonsils-improves-outcomes-children-obstructive-sleep-apnea. 
  5. Guilleminault, Christian, et al. “A Frequent Phenotype for Paediatric Sleep Apnoea: Short Lingual Frenulum.” ERJ Open Research, vol. 2, no. 3, 2016, pp. 00043–2016., doi:10.1183/23120541.00043-2016.
  6. “Sleep Apnea and Blood Pressure.” Sleep Foundation, 28 July 2020, www.sleepfoundation.org/articles/how-sleep-apnea-affects-blood-pressure. 
  7. Doumit, Jimmy, and Bharati Prasad. “Sleep Apnea in Type 2 Diabetes.” Diabetes Spectrum, American Diabetes Association, 1 Feb. 2016, doi.org/10.2337/diaspect.29.1.14. 
  8. Banabilh, Saeedm. “Orthodontic View in the Diagnosis of Obstructive Sleep Apnea.” Journal of Orthodontic Science, vol. 6, no. 3, 2017, p. 81., doi:10.4103/jos.jos_135_16. 
  9. McCall, William V., et al. “Prevalence of Obstructive Sleep Apnea in Suicidal Patients with Major Depressive Disorder.” Journal of Psychiatric Research, Pergamon, 19 June 2019, www.sciencedirect.com/science/article/abs/pii/S0022395619302018?via=ihub. 
  10. Mcfarlane, Samy I. “Depression, Obstructive Sleep Apnea and Psychosocial Health.” Sleep Medicine and Disorders: International Journal, vol. 1, no. 3, 2017, doi:10.15406/smdij.2017.01.00012. 

 

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