Common signs of obstructive sleep apnea include unexplained daytime sleepiness, restless sleep, and loud snoring (with periods of silence followed by gasps). Less common symptoms are morning headaches; insomnia; trouble concentrating; mood changes such as irritability, anxiety and depression; forgetfulness; increased heart rate and/or blood pressure; decreased sex drive; unexplained weight gain; increased urination and/or nocturia; frequent heartburn or Gastroesophageal reflux disease; and heavy night sweats.
Adults
In adults, the most typical individual with obstructive sleep apnea syndrome suffers from obesity, with particular heaviness at the face and neck. Obesity is not always present with OSA, in fact a significant number of adults with normal body mass indices (BMI) have decrease in muscle tone causing airway collapse and sleep apnea. The cause of the decreased tone is not presently understood. The hallmark symptom of obstructive sleep apnea syndrome in adults is excessive daytime sleepiness. Typically, an adult or adolescent with severe long-standing obstructive sleep apnea will fall asleep for very brief periods in the course of usual daytime activities if given any opportunity to sit or rest. This behavior may be quite dramatic, sometimes occurring during conversations with others at social gatherings.
The hypoxia (absence of oxygen supply) through OSA may cause changes in the neurons of the hippocampus and the right frontal cortex in the brain. Research through the use of neuro-imaging revealed evidence of hippocampal atrophy in people suffering from OSA. They found some OSA sufferers to have problems in mentally manipulating nonverbal information and executive function.
Children
Although this so called "hypersomnolence" (excessive sleepiness) may also occur in children, it is not at all typical of young children with sleep apnea. Toddlers and young children with severe obstructive sleep apnea instead ordinarily behave as if "over-tired" or "hyperactive." Adults and children with very severe obstructive sleep apnea also differ in typical body ''habitus''. Adults are generally heavy, with particularly short and heavy necks. Young children, on the other hand, are generally not only thin, but may have "failure to thrive," where growth is reduced. Poor growth occurs for two reasons: the work of breathing is high enough that calories are burned at high rates even at rest, and the nose and throat are so obstructed that eating is both tasteless and physically uncomfortable. Obstructive sleep apnea in children, unlike adults, is often caused by obstructive tonsils and adenoids and may sometimes be cured with tonsillectomy and adenoidectomy.
This problem can also be caused by excessive weight in children. In this case, the symptoms are more like the symptoms adults feel: restlessness, exhaustion, and more.
Children with OSA may experience learning and memory deficits. OSA has also been linked to lowered childhood IQ scores (Halbower, et al. 2006).
Old age is often accompanied by muscular & neurological loss of ability of the airways. Premature aging is temporarily caused by chemical depressants; alcoholic drinks being the most common. Permanent premature airway aging may be caused by traumatic brain injury, or poor adherence to chemical and or speech-therapy treatments.
Individuals with decreased muscle tone, increased soft tissue around the airway, and structural features that give rise to a narrowed airway are at high risk for obstructive sleep apnea. Men, whose anatomy is typified by increased body mass in the torso and neck, are more typical sleep apnea sufferers, especially through middle age and older. Adult women suffer typically less frequently and to a lesser degree than men do, owing partially to physiology, but possibly to emerging links to levels of progesterone. Prevalence in post-menopausal women approaches that of men in the same age range.
Further Reading
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