Can Sleep Apnea Kill You?
Yes, and No
Can sleep apnea kill you? … … … … … … Yes
Do you have sleep apnea? … … … … … … Probably
Can you fix it and not die from it? … … … … … … Certainly
Sleep apnea is a series of micro-strangulations.
What is sleep apnea and how it kills you?
1. What is sleep apnea
Sleep apnea is a condition where your breathing stops and restarts many times while you sleep. (National Health Institute definition)
This is a bland, scientific definition. But think about it for a second. Your breathing stops while you sleep. It’s not a for a second or two. The average duration is 10 to 60 seconds.
Apnea is suffocation. It’s silent strangulation in the night.
Strangling kills. In movies, it kills in minutes. In reality, sleep apnea kills in years. But it still kills
2. How sleep apnea kills
Every cell in your body needs energy. They produce it with glucose and fat (from food) and oxygen (from breathing). When you breathe, your lungs move oxygen from the air into the blood. The heart pumps it throughout the body. Your cells extract oxygen from the blood and use it to live.
No oxygen = no energy = cell death = your death
We cannot survive without oxygen. After 1 minute without oxygen, brain cells begin to die. After 3 minutes, severe brain damage is likely. More than that and brain damage is certain.
When you stop breathing from sleep apnea, your cells lack oxygen. They suffer. Some die, some are crippled.
Your body recovers from one such event. But sleep apnea means it happens multiple times every night. The harm adds and adds, and leads to severe consequences:
And many, many more problems
Sleep apnea is deadly. The question is: do you have it?
3. Do you suffer from sleep apnea?
Diagnosed sleep apnea is rare. It’s likely you don’t have a diagnosis of sleep apnea.
But, most sleep apnea is not diagnosed. Research estimates 80% of cases are undiagnosed.
In reality sleep apnea is common. Estimations place it at 25% incidence.
There is a one in four chance you have sleep apnea.
How can you tell if you have sleep apnea?
If you have any of the following symptoms, then you might have sleep apnea (aka night-time strangling):
Snoring
Noticing that your breathing stops during the night
Wake up abruptly during the night, gasping for air or choking
Morning headache
Sleepiness during the day
Waking up without reason
Difficulty focusing during the day
Irritability or mood changes
Frequent Urination at Night
Dry mouth or thirst during the night or in the morning
Morning fatigue
Quite common, right? On top of that, being a man and overweight increases your risk.
My experience: I had sleep apnea for most of my life without knowing
Most of my life, I have had awful sleep.
After discovering circadian health, I changed my lifestyle to improve my sleep. It changed my life. I had more energy, clearer thinking and a greater mood. But something was still off.
Despite sleeping at the right time and the right duration, I was still tired when I woke up in the morning. I needed 30-60 minutes to muster the energy to wake up after actually waking up.
For a long time I was puzzled. I did not know why this happened. Turns out I had sleep apnea.
Solving it made my sleep a hundred percent better. Gone was the morning fatigue, the dry mouth, the excessive thirst, poor cognitive and physical performance, and the sleepiness.
You can also solve sleep apnea.
How do you beat sleep apnea?
Option 1: CPAP
The official treatment for sleep apnea is with a CPAP machine.A CPAP (Continuous Positive Airway Pressure) machine delivers a steady stream of pressurised air to keep the airways open during sleep. This prevents oxygen deprivation.
It works to prevent oxygen deprivation, and the subsequent harms.
However, it is uncomfortable physically and socially. It is also less effective at reducing the cause of sleep apnea, so you have to use it indefinitely.
Treating apnea with CPAP is like if your bed cuts you. But instead of making it less sharp, you keep bandaging the cuts.
Option 2: Solve the cause of sleep apnea
There are two types of apnea:
Central Sleep Apnea (CSA): the brain momentarily "forgets" to send the signals to the respiratory muscles, leading to brief pauses in breathing.
Other medical problems or opioids use can cause CSA. Sometimes these can be treated, sometimes not.
However, it is likely that if you have apnea, it is not Central Sleep Apnea, but Obstructive Sleep Apnea. CSA is rare, less than 1% of general population. It constitutes 5-10% of all sleep apnea cases. While the other type, Obstructive Sleep Apnea, afflicts around 1 billion people worldwide.
Obstructive Sleep Apnea (OSA): physical obstruction of the airways causes apnea
OSA occurs when the muscles at the back of the throat relax excessively during sleep, leading to a blockage of the airway. This obstruction results in a temporary pause in breathing or shallow breathing.
What causes this obstruction of the airways?
There are many factors, but the key cause is mouth breathing which makes the tongue block your breathing.
Breathing through the mouth often leads to a lower tongue and jaw position. When the jaw drops down, it causes the tongue to fall back towards the throat. This, in turn, narrows the space in the throat and increases the likelihood of the soft tissues in the throat collapsing or partially blocking the airway.
This is the main mechanism, but then there are several others ways in which mouth breathing leads to sleep apnea:
Airway Dynamics change. Nose breathing produces a slower and more laminar (smooth) airflow, which creates a stable pressure in the upper airway. This helps keep it open during sleep. In contrast, mouth breathing produces a turbulent and faster airflow, lacking the stabilizing effect.
Decreased Nasal Resistance: The nose is a natural filter and humidifier for incoming air. When you breathe through your nose, the nasal passages provide resistance to the airflow, maintaining optimal pressure in the airway. Mouth breathing bypasses this natural resistance, allowing the airway to collapse more easily.
Dry Mouth and Throat: Mouth breathing dries the mouth and throat. This dryness can lead to increased inflammation and swelling of the tissues in the throat, making them more susceptible to collapse during sleep.
Increased Negative Pressure: Mouth breathing can create more negative pressure in the upper airway during inhalation. This increased pressure differential between the airway and the outside can cause the airway to collapse more readily.
To stop Obstructive Sleep Apnea, you need to switch from mouth breathing to nose breathing. But how?
How to stop mouth breathing and apnea
The path to nose breathing during sleep can be easier or harder. It is easier if you breathe during the nose while awake. It is harder if you mouth-breathe while awake.
You can tell whether you are a mouth-breather with a simple test.
Take a piece of tape. Put it on your lips so that they keep your mouth shut. It is there to prevent you from breathing through the mouth. Keep it on and breathe through your nose for 10 minutes. Put on a timer for 10 minutes and see how difficult it is. You can continue reading while you do so.
If you can breathe only through the nose for 10 minutes without effort, then you can jump directly to Step 3: Nose-breathe during sleep.
If you feel discomfort during the 10 minutes of nose breathing, then start with Step 1
Step 1: Nose breathe during the day
If you cannot nose breathe for 10 minutes, then you will not be able to do so at night. First you have to train this ability. The most effective and basic way to do so, is to breathe through the nose during the day.
Put tape on your mouth to keep it shut for short intervals during the day. Start with a couple of minutes. Then gradually increase how long you can do it without feeling out of air.
Step 2: Increase tolerance for nose breathing
The reason nose breathing is difficult when you are a habitual mouth breather is your carbon dioxide tolerance is low. The following breathing exercise will help increase it. They are in ascending difficulty:
Box breathing: 4 seconds inhale, 4 seconds hold breath, 4 seconds exhale, 4 seconds hold breath. Do this for 5-10 minutes per session. When 4 seconds is easy, increase the intervals to 5 seconds and so on.
Longer exhales: 3 seconds inhale, 7 seconds exhale. Also 5-10 minute sessions.
Empty breath holds: 4 seconds inhale, 4 seconds exhale, 7-8 seconds breath hold (with empty lungs). Also 5-10 minute sessions
Empty breath holds while doing exercise. The same as above but done while walking. If you are a runner, then do it while running (easy pace).
Step 3: Nose-breathe during sleep
Tape your mouth at night.
It’s that simple. Most important changes are, but they depend on consistency to work.
Some tips to make mouth-taping easy and effective:
Put it on 10-20 minutes before sleep to make sure you are comfortable with it
It does not need to be super tight. You can leave a little slack so that you don’t feel constricted
Don’t be excessively strict. If your nose is stuffed from a cold or other cause, don’t tape your mouth on that day.
Sleep on your side. It’s the best for breathing during sleep.
If you have a moustache or beard, try not to tape it. Put the tape under the hair over the lip. I have a beard and manage not to epilate myself with mouth-tape.
Do you think it’s absurd to tape your mouth to cure apnea? This study used this method and found all participants experienced improvements in apnea from mouth taping.
Very very short version:
Likely you have sleep apnea.
Certainly it will kill you.
Probably you can cure it by nose breathing during sleep.