What is Sleep Apnea?
Sleep apnea is a potentially serious sleep disorder where a person's breathing repeatedly stops and starts as they sleep. There are two main types of sleep apnea:
- Obstructive Sleep Apnea (OSA): The more common form. Occurs when the muscles in the back of the throat relax too much which blocks/obstructs airway during sleep.
- Central Sleep Apnea: Caused by a miscommunication between the brain and muscles that control breathing. The airway is not blocked but the brain fails to signal for chest muscles to inhale.
Causes and Risk Factors for Sleep Apnea
What leads someone to develop sleep apnea in the first place? Common causes and contributing risk factors include:
- Being overweight or obesity
- Large tonsils, tongue or small jaw bone
- Use of alcohol, sedatives or tranquilizers
- Smoking
- Nasal congestion or blockage
- Family history of sleep apnea
- Age - more common in middle age and elderly
Connection Between Snoring and Sleep Apnea
One of sleep apnea's most stereotypical and obvious symptoms is loud snoring. The snoring sound occurs due to the airway narrowing or collapsing as a person with sleep apnea tries to inhale while sleeping. The snoring noise often gets louder then quieter as the cycle of blockage and opening of the airway repeats itself over and over through the night.
It's estimated that about half of chronic loud snorers have obstructive sleep apnea. However, just because someone snores does NOT necessarily mean they have sleep apnea. There are also people who have sleep apnea but do not snore at all.
Other Distinctive Signs of Sleep Apnea
Along with frequent loud snoring, here are some other common sleep apnea symptoms to be aware of:
- Gasping or choking during sleep
- Waking up short of breath
- Feeling tired even after a full night's sleep
- Morning headaches
- Difficulty concentrating and memory problems
- Falling asleep unintentionally during the day
Is It Possible to Have Sleep Apnea Without Snoring?
Yes, it's entirely possible for someone to have sleep apnea even if they don't snore. According to research estimates, around 20% of all people living with sleep apnea do NOT snore. The absence of snoring should not rule out sleep apnea as a potential cause of sleep disruption.
Reasons for Sleep Apnea Without Snoring
Why might someone have sleep apnea without any snoring?
- Women are less likely to snore - Female hormones offer some protective effects on the airway.
- Children can have sleep apnea but don't develop snoring until later ages.
- The tongue may fall back and block airflow without collapsing the throat tissues that generate snoring vibrations.
- Central sleep apnea causes include no actual obstructions, so no snoring.
Other Subtle Signs of Silent Sleep Apnea
Even without the obvious loud snoring, there may be other subtle clues that indicate someone has sleep apnea regardless of snoring pattern (or lack thereof!). These include:
- Waking up out of breath even just once
- Very restless sleep with frequent position shifts
- Waking up frequently to use bathroom as body tries to clear carbon dioxide
- Dry mouth or sore throat in morning
- Insomnia and struggling to stay asleep
Diagnosing Sleep Apnea Properly
Because sleep apnea symptoms can be very subtle, misleading or mimic other conditions like insomnia, the only way to accurately diagnose sleep apnea is to have a sleep study test done.
Home Sleep Apnea Tests
If snoring is not an obvious indicator, your doctor may recommend you undergo at-home sleep apnea screening first. A home sleep test involves wearing breathing monitors and oxygen saturation devices overnight as you sleep in your own bed to measure respiratory events, oxygen drops and airflow limitations.
Full Sleep Study
If your at-home sleep test results are inconclusive or concerning, your doctor will likely order an overnight stay at a medical sleep center/lab for a full polysomnography. This thorough test precisely measures your breathing, heart rate, oxygen levels, snoring noises, brain activity and sleeping positions throughout the night as trained technicians monitor you.
Sleep Apnea Severity Levels
Based on the results of your sleep study, your doctor can diagnose if you have sleep apnea and determine its level of severity. This helps guide treatment recommendations. The three sleep apnea severity levels are:
- Mild: 5-14 breathing events per sleep hour
- Moderate: 15-29 events per hour
- Severe: 30 or more events per hour
Even a low number of just 5 respiratory events per hour can start causing chronic fatigue, cognitive dysfunction and other symptoms that disrupt quality of life.
Seeking Treatment for Non-Snoring Sleep Apnea
Whether your sleep apnea includes loud snoring or is much quieter in nature, receiving an accurate diagnosis and promptly seeking treatment is critically important. Untreated sleep apnea raises risks of:
- High blood pressure
- Heart disease
- Type 2 diabetes
- Liver problems
- Headaches
- Depression
- Cognitive decline
CPAP Machines
The most common and effective sleep apnea treatment is CPAP therapy. This uses a small mask-like device worn over the nose/mouth while sleeping. The CPAP machine gently blows pressurized air into the throat to keep airways open. This prevents pauses in breathing and normalizes oxygen saturation levels during sleep no matter if snoring is present or not.
Other Sleep Apnea Treatments
Beyond CPAP therapy, other ways to manage sleep apnea may include:
- Oral appliances worn at night to adjust jaw/tongue position
- Upper airway stimulation surgery if CPAP fails
- Losing weight if overweight/obese
- Avoiding alcohol for better airway muscle tone
Following doctor recommended treatment is the best way to minimize health risks and resolve symptoms so people with sleep apnea can feel rested and energetic during the day - whether they snore or not!
Key Takeaways
- Yes, it's possible to have sleep apnea without snoring.
- An at-home or lab sleep study is required to confirm apnea diagnosis.
- All types and severities of sleep apnea need proper medical treatment.
FAQs
What percentage of people with sleep apnea don't snore?
Research estimates about 20% of people with clinically diagnosed sleep apnea do not snore at night. So lack of snoring does not rule out sleep apnea.
How is silent sleep apnea detected?
Since obvious snoring is absent, a sleep study test - either at home or in a lab facility with monitoring equipment - is needed to accurately detect and diagnose breathing events during sleep even without snoring.
Can I test myself for sleep apnea without snoring at home?
Without snoring which is an obvious symptom, it can be difficult to diagnose sleep apnea on your own at home. If you suspect you have symptoms even without snoring, you need to discuss taking an at-home or lab sleep study test with your doctor.
How serious is sleep apnea without snoring?
Even if you don't snore but are experiencing daytime fatigue, insomnia, or other signs of sleep disturbance that could indicate silent sleep apnea, it is still a serious medical condition that needs diagnosis and treatment. Untreated apnea can lead to heart disease, strokes, and other major health problems.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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