Sleep apnoea, which is commonly dismissed as merely loud snoring or poor sleeping quality, has a much more serious and systemic impact on the body. In obstructive sleep apnoea, there are frequent episodes
of breathing cessation during sleep that result in intermittent oxygen level drops. The body takes this as a signal to activate the stress response, and in addition, the inflammatory pathways are turned on, and the affected organs undergo sustained strain, especially the heart, since it is vital.
Dr Vivek Anand Padegal, Director, Pulmonology, Fortis Hospital, Bannerghatta Road, Bengaluru, says, “When we look at it from the cardiovascular point of view, sleep apnoea that has not been treated might be a major factor in the development of high blood pressure, coronary artery disease, irregular heartbeats such as atrial fibrillation, heart failure and even stroke.” The main reason is that during each episode of oxygen deprivation, blood pressure and heart rate are increased. Night after night, month after month, this stress slowly but surely causes the blood vessels to deteriorate and the normal heart function to be disrupted, thereby making sleep apnoea one of the risk factors for heart disease.
The effects of sleep apnoea are not confined only to the heart. Indeed, it also has far-reaching consequences on mental health. Among the complaints that patients often mention are mood changes, irritability, decreased desire to do anything, anxiety, and symptoms that can be mistaken for depression. Sleep apnoea interferes with the natural sleep cycle and keeps a person lying awake and restless when the brain can process emotions, store memories, and perform cognitive tasks. Thus, after a while, one might suffer from mental fatigue, distractedness, and reduced efficiency at the workplace.
Metabolic health is another major victim of sleep apnoea. The condition has been found to be significantly associated with overweight, insulin resistance, and type 2 diabetes. Sleep loss disturbs hormones that control hunger and glucose metabolism. A person may feel hungrier and have stronger cravings due to the disrupted levels of leptin and ghrelin, whereas at the same time, insulin resistance is increasing, leading to higher blood sugar levels. This creates a violent cycle in which obesity is the root cause of sleep apnoea, and apnea, in turn, is responsible for metabolic disorders.
One of the biggest challenges with sleep apnea is delayed diagnosis. Symptoms like having too much fatigue during the day, suffering from headaches in the mornings, not sleeping well at night, snoring loudly, and being unable to concentrate, usually come on slowly and are accepted as normal. Daytime sleepiness that will not go away must be taken seriously, particularly if it is interfering with normal living or safety, e.g., while working, driving, travel, etc.
Certain groups are at higher risk, including individuals who are obese, with a wide neck, smokers, drinkers, and people with diabetes, high blood pressure, or thyroid problems. Men and post-menopausal women, and those with a family history of sleep apnea are also at an increased risk.
Early diagnosis followed by proper treatment can go a long way in cutting down the long-term complications significantly. A sleep study remains the gold standard for diagnosis. Treatment options include continuous positive airway pressure (CPAP) therapy, oral appliances, weight reduction, altering positions while sleeping, and in select cases, surgical interventions.
Lifestyle changes are the main factors in preventing the problem. Maintaining a healthy weight, engaging in regular physical activity, avoiding alcohol and sedatives before bedtime, quitting smoking, and following good sleep hygiene can improve symptoms. Early treatment of sleep apnea not only leads to better quality of sleep but also protects heart health, mood stabilisation, and metabolic outcomes. It is a condition that needs much more visibility and active management.
