Signs and Symptoms of Obstructive Sleep Apnea (OSA)
The signs and symptoms of OSA result from disruption of the normal sleep architecture. Frequent arousals from sleep and the inability to achieve or maintain the deeper stages of sleep can lead to
- excessive daytime sleepiness
- nonrestorative sleep
- automobile accidents
- personality changes
- decreased memory
- erectile dysfunction (ED, impotence)
Patients rarely complain about frequent awakenings due to OSA, but awakenings do occur. Excessive daytime sleepiness may be mild or severe, depending on the severity of the obstruction. In some cases, patients continue to experience excessive daytime sleepiness while they are being treated for obstructive sleep apnea.
Some patients suffering from OSA fall asleep in a nonstimulating environment, such as while reading in a quiet room. Others may fall asleep in a stimulating environment, such as during business meetings, eating, and even while having sex.
Patients with OSA often complain of waking up feeling like they had never slept at all. They often feel worse after taking a nap than they did before napping.
The so-called drowsy driver syndrome, which a growing number of law enforcement authorities believe to be responsible for many automobile accidents, may result from OSA, which causes some drivers to fall asleep at the wheel or to suffer from lack of alertness because of sleep deprivation.
Decreased alertness places a person at risk in a variety of potentially hazardous situations. It is recommended that persons with excessive daytime sleepiness not drive or operate dangerous equipment until their condition is effectively treated. Other symptoms of OSA, such as morning headaches and frequent urination during the night, may be caused by apneic events themselves.
The physical signs that suggest OSA include loud snoring, witnessed apneic episodes, and obesity. Patients with OSA often say that their only problem is that their bed partner complains about their snoring. A large number of snorers are believed to have OSA. Many times, a sleep partner will witness an apneic event.
Hypertension (high blood pressure) is prevalent in patients with OSA, although the exact relationship is unclear. It has been shown, however, that treating OSA can modestly lower blood pressure.
Not everyone who snores has sleep apnea, but if two or more of the above symptoms are present the person should consider consulting a sleep specialist. A high score on the Epworth Sleepiness Scale is also a strong indicator of possible sleep apnea.