Younger people are increasingly diagnosed with obstructive sleep apnea
Despite getting eight hours of sleep at night, Maddy Dumas struggled to stay awake during the day. If she laid down for a nap, she was out cold. It wasn’t until her husband kept complaining about her loud snoring and a choking noise at night that Dumas contacted her doctor to see if she had a sleep disorder. Turns out she had obstructive sleep apnea.
“As a 30-year-old woman in good shape, I didn’t look like the stereotypical sleep apnea patient. I wasn’t old or overweight. My body was telling me something was wrong. I was always tired and starting my days with heavy headaches from not getting enough oxygen overnight. Getting the official diagnosis was a relief but it also reminded me how easy it is for younger people like me to not be diagnosed,” she said.
Increasingly, Meena Khan, MD, and other sleep medicine physicians at The Ohio State University Wexner Medical Center have been diagnosing younger people with sleep apnea, which affects nearly 30 million Americans of all ages. About 80% of sleep apnea cases are undiagnosed, according to the American Academy of Sleep Medicine. A recent Ohio State survey of 1,004 Americans found 43% think being sleepy during the day means they didn’t get enough sleep. It’s possible that a full night’s rest of seven or eight hours is being interrupted by sleep apnea, said Khan, associate clinical professor of Internal Medicine in Ohio State’s Department of Sleep Medicine.
“I think there’s more public awareness that snoring or gasping can be caused by sleep apnea. There’s also more awareness in the medical community to ask patients of all ages about their sleep habits and if they’re sleepy during the day to decide if they should be tested for sleep apnea,” she said.
What is obstructive sleep apnea?
Obstructive sleep apnea causes the airway to collapse or become blocked during sleep. Those with the disorder often snore loudly and may not be aware of the disturbances in their sleep, Khan said. Besides fatigue during the day, other signs are morning headaches, dry mouth or sore throat when waking up, trouble focusing and mood changes such as depression.
“With obstructive sleep apnea, oxygen drops whenever the airways closes or narrows, putting stress on your heart and brain. It’s often associated with high blood pressure, increased risk for heart attacks, strokes and memory problems down the road,” Khan said.
How is it diagnosed?
Sleep specialists diagnose sleep apnea with a sleep study. A sleep study in a lab monitors sleep stages (with sensors on the scalp), breathing, heart rate, leg movements and oxygen levels for seven to eight hours. Dumas was diagnosed after doing an at-home sleep study from a kit that she picked up at an Ohio State medical office. The at-home study monitors breathing, oxygen levels, heart rate and sleeping position.
“I couldn’t believe how easy it was to use. It took just a few minutes for them to show me how to put it on and they gave me an instruction sheet in case I forgot a step. The next morning I dropped it off in a box and a week later I had my diagnosis,” Dumas said.
Different treatments for obstructive sleep apnea
Treatments for obstructive sleep apnea vary, depending on a patient’s medical history and severity of the disorder. Losing weight can help overweight patients, and last year the FDA approved tirzepatide (commonly known as Zepbound) as a medication for obstructive sleep apnea via weight loss.
“For patients who have obstructive sleep apnea mainly while sleeping on their back, they can try positional therapy where they avoid sleeping on their back. Patients can do this by putting pillows behind them or sewing tennis balls in the back of their shirt to keep them off their back,” Khan said.
Continuous positive airway pressure (CPAP) is the most effective active treatment for patients, Khan said. It’s a medical device that blows pressurized air into the airway to keep it open during sleep. Unfortunately, only about 50% of patients can tolerate CPAP, citing discomfort with the mask, leaks or feeling claustrophobic. Patients can try using nasal masks or nasal pillows instead of full-face masks to be more comfortable.
Another option is an implantable device that uses mild stimulation of the hypoglossal nerve that controls the tongue to maintain an open airway. Because Dumas couldn’t tolerate CPAP, she visited a dentist who custom created a mouth guard to move her lower jaw forward to keep her airway open at night.
Dumas is optimistic that her new mouth guard will help her get a full night’s sleep.
“Don’t assume you’re too young, too healthy or the wrong body type. Sleep apnea doesn’t always look like the textbook case,” she said. “I had to push past that stigma and advocate for myself, and I’m glad I did because untreated apnea affects every part of your health and daily life.”