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What causes sleep apnea?

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causes of sleep apnea

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  • Sleep apnea can develop for many reasons. For starters, poor nutrition in early childhood can result in improperly shaped mouths, incorrect positioning of the tongue and, ultimately, adverse brain changes that can affect behavior and cognition
  • Keep reading to learn about and understand the many causes of sleep apnea, and whether you’re at risk for it

Not all cases of sleep apnea may be the same, since there are many factors responsible for this disease. Keep reading to learn about and understand the many causes of sleep apnea, and whether you’re at risk for it.

The different types of sleep apnea and their potential triggers

The different types of sleep apnea are caused by or linked to particular conditions:

Upper airway resistance syndrome (UARS) — UARS can develop because of a naturally narrowed air passage, loose fatty tissues of the throat collapsing back into the airway or tongue position (falling back) during sleep.1

Obstructive sleep apnea (OSA) — This arises because of a mechanical problem, wherein the muscles at the back of the throat relax too much to facilitate normal breathing. OSA develops during sleep, when the patient’s tongue falls back against the soft palate, and the soft palate and the uvula fall back against the back of the throat. This closes or narrows the airway, resulting in inadequate breathing for 10 to 20 seconds.2

Central sleep apnea (CSA) — This occurs because of the inability of the brain to send proper signals to muscles responsible for controlling breathing.3 In other cases, CSA can develop because of conditions affecting the ability of the brainstem to control breathing.4 The brainstem connects the brain to the spinal cord and controls your heart and breathing.5

According to the Mayo Clinic, there are different types of CSA, depending on what causes this condition in the first place:

Cheyne-Stokes breathing — This is most commonly associated with congestive heart failure or stroke. Cheyne-Stokes breathing is characterized by a gradual increase and decrease in breathing effort and airflow. A total lack of airflow can occur during the weakest breathing effort.

Drug-induced apnea — Medications like opioids can trigger irregular breathing, increases and decreases of breathing in a regular pattern or complete stoppage of breathing, although temporary.

High-altitude periodic breathing — Exposure to high altitudes can cause a patient to develop a Cheyne-Stokes breathing pattern. Changes in oxygen at this altitude are often responsible for alternating rapid breathing (hyperventilation) and underbreathing.

Medical condition-induced CSA — There are medical conditions that can cause central sleep apnea of the non-Cheyne-Stokes variety.

Idiopathic (primary) central sleep apnea — Its nature as an idiopathic condition means that the cause is unknown.

Other possible causes of sleep apnea

Sleep apnea can develop for other reasons. For starters, poor nutrition in early childhood can result in improperly shaped mouths, incorrect positioning of the tongue and, ultimately, adverse brain changes that can affect behavior and cognition.

More specifically, lack of breastfeeding6 and excessive intake of processed foods7 are possible causes why children are being diagnosed with sleep apnea. Dr. Arthur Strauss, a dental physician and diplomat of the American Board of Dental Sleep Medicine, explains that mouths have progressively gotten smaller throughout generations because of lack of breastfeeding and poor overall nutrition.8

Breastfeeding helps expand the size of the child’s palate and assists in moving the jaw further forward. Essentially, these factors help prevent sleep apnea by creating more room for breathing.

Tongue placement is also said to play an important role in lowering sleep apnea risk. Results from a 2015 International Journal of Pediatric Research study emphasized that an abnormally short lingual frenulum can lead to impaired orofacial growth in early childhood, decreasing the width of the upper airway. This upper airway is very pliable, so this increases the risk of it collapsing during sleep and potentially causing sleep disorders like sleep apnea.9

Furthermore, low vitamin D levels have been linked to sleep apnea. A February 2016 study published in the journal Sleep notes a significant inverse relationship between vitamin D levels and severity of OSA. Vitamin D levels were significantly lower among OSA patients, and people with lower vitamin D levels had more severe disease.10 As such, if you have OSA, have your vitamin D levels checked and optimized.

The Mayo Clinic also notes certain risk factors that make people more susceptible to different types of sleep apnea, namely OSA and CSA.11

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Risk factors for obstructive sleep apnea

Excess weight or obesity If you’re obese, you are twice as likely to have sleep apnea compared to normal weight individuals,12 because fat deposits around the upper airway can obstruct breathing. However, not everyone with sleep apnea is overweight.

Neck circumference — People with thicker necks have a higher risk of OSA. According to researchers of a 2013 study:13

“[Neck circumference] NC and BMI measurements were higher in severe OSAS patients compared to non-severe patients. Increased NC may be a greater risk factor for severe OSAS than are MS parameters.”

Narrow airway — This may occur if you were born with a naturally narrow throat. Your throat may also become narrow because of enlarged tonsils or adenoids that block the airway.

Gender — Men are more likely to have sleep apnea than women. However, one study notes that OSA may be underreported and underdiagnosed in women.14

Age — Sleep apnea occurs more often among older adults.

Family history — Genetics related to physical factors like body fat distribution and facial structure may be linked to sleep apnea.15

Alcohol, sedative or tranquilizer use — These are known to relax muscles in the throat.

Smoking — The risk of sleep apnea is 2.5 times higher among smokers compared to non-smokers,16 since smoking can increase the amount of inflammation and fluid retention in the upper airway.

Nasal congestion — People are more likely to develop OSA if they have difficulty breathing through the nose.

Risk factors for central sleep apnea

  • Age — Middle-aged and older adults are known to have a higher CSA risk.17
  • Heart disorders — People with congestive heart failure are more at risk of CSA.18
  • Use of narcotic pain medicines or opioids — Taking these medicines can increase CSA risk.19
  • Stroke — People who’ve had a stroke are more likely to have CSA or treatment-emergent CSA.20

Now that you’re aware of what potentially causes sleep apnea, you can determine possible ways to prevent it from affecting you and your loved ones. You can also identify strategies to help manage this disease so you can enjoy restful nights.


Sleep Apnea: An Introduction

What Is Sleep Apnea?

Sleep Apnea Symptoms

Sleep Apnea Causes

Types of Sleep Apnea

Sleep Apnea Treatment

Sleep Apnea Testing

Sleep Apnea Surgery

Sleep Apnea Prevention

Sleep Apnea FAQ

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