This is usually not noticed by the apneic patient during the night but is felt the next day through a feeling of not being refreshed in the morning and finding oneself not fully alert during the day. This lack of alertness is not usually experienced if one can keep physically active but is frequently noted if you have to sit quietly for any length of time. One quickly becomes drowsy in passive situations. As apnea worsens the daytime sleepiness becomes stronger and stronger.
People who have sleep apnea often think that there is nothing wrong with their sleep because they can easily get to sleep when they want to do so. Sometimes they think they are good sleepers because they can go to sleep anywhere, anytime, and it takes them no time at all to drop off to sleep. This is not normal. Most people who have slept well, cannot just lie down and go to sleep and certainly not at any time of the day. It takes most healthy people 10-15 minutes to get to sleep and they can only do this once they have been up and about for 16 hours.
There is a natural tendency for healthy people to be a bit sleepy in the afternoon. This can make work after lunch difficult and the drive home more challenging. For patients with sleep apnea this natural tendency can be more acute.
People with sleep apnea often develop forgetfulness once the apnea has been present for some time. They also have problems with attention and concentration. This can make their work difficult.
Typically, the poor sleep causes an increase in irritability – one can become very cranky. It also causes a low mood even leading to depression. One can also become quite anxious and start worrying about things that one usually would not worry about.
Much higher chance of developing it or, if you already have it, of making it worse. If you already have high blood pressure, you can usually expect improvement in your blood pressure once you treat your sleep apnea. Some people have even been able to have their doctors take them off blood pressure medication entirely. Controlling your high blood pressure will reduce your risks from the bad consequences of hypertension such as heart failure, heart attacks, kidney damage and others.
CAD seen more commonly in patients with sleep apnea and can lead to heart attacks. Repeated episodes of low oxygen occur when your breath is obstructed by the apneic events. This is the probable cause of damage to the arteries to your heart. Stopping these events by treating the apnea reduces your likelihood of having a heart attack. There is a shortened lifespan in people who have untreated sleep apnea. This is usually due to heart disease.
This occurs when your heart muscle becomes too weak to adequately pump blood around your body. Your lungs tend to fill with fluid and your body becomes depleted of oxygen. You become very fatigued and short of breath, especially when lying flat. Apnea makes heart failure more likely. If you have heart failure and sleep apnea, treating the apnea can significantly improve the strength of your heart muscle. It is about as effective as the best heart medication we have today. Treating the apnea also lengthens your lifespan if you have heart failure.
Apnea can cause or make heart irregularities worse and again lead to serious complications.
The damage done to the arteries to the heart can also be done to the arteries to your brain. This can lead to strokes. There is a higher incidence of strokes in patients with sleep apnea.
Sleep apnea causes your cells to become less responsive to insulin. This can lead to higher blood sugar levels and to the development of diabetes.
If you have to go to hospital for an operation and you are to have a general anesthetic, you must inform the anesthetist that you have sleep apnea. The drugs we doctors use to put patients to sleep can have a very bad effect on you. Your neck muscle can collapse and make it difficult to get the breathing tube in place for the operation. There may also be problems at the end of the operation when they take the tube out. Your throat may keep on collapsing.
You need to be treated in a step-down unit after the surgery, and not just put in the recovery room as is usual after surgery.
Accidents in the home and in the workplace, are much more common in patients with untreated sleep apnea. Untreated sleep apnea patients have more time off work for injury than the general workers and treated sleep apneics.
Motor vehicle crashes are more common in patients with untreated sleep apnea. Treating the apnea reduces this risk. Of course, this risk is not just carried by you, but is also borne by other road users. It is estimated that 20% of all crashes are caused by sleepiness. But apnea does not just cause problems because of sleepiness. Sleep apneics also have delayed reaction times. At 120 km/hr on the 401, a delay in your response of one or two seconds can be a matter of life or death for someone. Most apneic patients never have an accident in their lifetime. Most apneic patients who do have accidents, have not had prior accidents. So, thinking that you will not have a problem with this on the basis that you never feel drowsy when you drive and that you have an unblemished driving record, would not stand up in court if you do have an accident. It is a matter of risk. The scientific evidence is clear, depending on the degree of your apnea, you have a 3 to 13- old increased chance of hurting or killing someone on the road. In Ontario, our government has decided that, as this is an eminently treatable disease, it is not fair for a patient with sleep apnea not to treat it and still to drive. They are putting other people at an unfair risk. So, if you drive, to maintain your license in Ontario, you need to treat your sleep apnea.