5 Warning Signs of Sleep Apnea

Jennifer Romans, BSN, RN

Sleep Apnea Defined

Sleep apnea is a sleeping disorder defined by 10 seconds or longer of apnea. The American Heart Association estimates that 1 in 5 adults suffer from this disorder.

Why is it Dangerous?

Sleep apnea leads to heart disease, stroke, hypertension, increased risk of diabetes, and premature death.

During sleep, the body releases growth hormones which generate new cells to heal and repair the body. Sudden drops in oxygenation during sleep affect heart health and can contribute to arrhythmias.

Many patients are undiagnosed with this condition, so how do you know if your patient is at risk?

Warning Signs

1- Loud Snoring

Does your patient snore loud enough to hear them in the hallway? Does a bed partner complain about the decibel of snoring?

2- Gasping for air during sleep

Is there a long pause in breathing with a gasp for air?

3- Morning headache

Does your patient complain of frequently having a headache upon waking?

4- Insomnia or the inability to fall into a deep sleep

Does your patient toss and turn and have difficulty falling asleep or complain of waking multiple times per night?

5- Excessive daytime fatigue

Does your patient fall asleep during conversations or activities or frequently nap?

Other Indicators

Other indicators that my patient may be at risk for sleep apnea:

Increased Body Mass Index (BMI)

Increased body fat also means increased fat around the airway.

Gender

Males are more likely to be affected than females.

Age

As bodies age, tissue becomes more lax, including the tissue supporting airway structures.

Thicker neck

Individuals with a thicker neck anatomy may have a narrower airway, contributing to sleep apnea.

Enlarged tonsils

Having large tonsils can contribute to a narrower airway and more difficulty passing air, and increased snoring.

Smokers

Smoking can contribute to irritation and swelling in the upper airway, which can increase the narrowing of the airway and airway collapse.

Alcohol use

Drinking alcohol can further relax the muscles in the airway, worsening sleep apnea. Alcohol also disrupts the body's natural sleep cycle.

Report findings of observed sleep apnea to the provider for further investigation in undiagnosed patients.

Monitor at-risk patients by your facility's protocol. In urgent situations, supplemental oxygen and airway management, such as a chin lift, may be required.

How to Confirm a Sleep Apnea Diagnosis?

Testing such as a sleep study needs to be completed and evaluated by a practitioner for an official diagnosis.

What to Do After an Official Diagnosis of Sleep Apnea?

There are treatment options depending on the patient and the severity of sleep apnea.

Lifestyle changes such as exercise and nutrition to decrease body mass.
Alcohol and smoking cessation education.
Use Continuous Positive Airway Pressure Machine (CPAP) as prescribed.
- The CPAP machine prevents the airway from collapsing during sleep and improves sleep quality.
- If your patient has sleep apnea and has a CPAP machine, encourage them to use their machine while in the hospital and when they are discharged home. If the patient did not bring their machine, consult with respiratory therapy to see if they qualify for a CPAP provided by the hospital.
Uvulopalatopharyngoplasty (UPPP)
- Surgery that improves sleep apnea by removing excess tissue from the throat.
Educate the patient and family on the importance of compliance to promote rest and healing.
Provide an ideal sleep environment by offering a few simple items:
- Ear plugs to block noise
- Eye mask to block light
- Lowering the lights
- Have a comfortable temperature conducive to sleep.

Sleep is essential to health and well-being. Identifying sleep apnea in patients will improve outcomes, increase healing and save lives.

References/Resources

What you need to know about how sleep apnea affects your heart: American Heart Association (AHA)