What causes sleep apnea in young adults (18-30 years)?

When you think of sleep apnea, you might associate it with older men who snore loudly.

However, this is not always the case. Granted, a huge proportion of older men do suffer from sleep apnea, but in reality, it can actually affect anyone, at any age. This includes young, lean and fit men, women and children too, especially those with pre-existing chronic pain conditions.

A quick review of sleep apnea

Obstructive Sleep Apnea (OSA) is caused by the muscles in your throat relaxing at night and blocking your airway. This impairment to breathing causes the levels of oxygen in your blood to reduce. When you stop breathing, your brain is triggered to wake you from sleep, and the breathing and oxygen levels are restored through snorting, snoring, choking, or gasping to encourage better airflow. Sleep apnea can also occur without any obstruction in airflow, which is referred to as central sleep apnea.

What causes sleep apnea in young adults (18-30 years)?

Studies have found that young adults with high blood pressure or “hypertension’ have a high prevalence of obstructive sleep apnea. This can be due to several factors, including a sedentary lifestyle. A lot of young adults spend hours each day sitting at their desk or computer and as a result many have an increased BMI or gain weight as a result. Increased day to day stress at work or home, pressure to ‘burn the candle at both ends’ or a struggle to balance hectic schedules have also been shown to cause increased stress and hypertension. For these reasons, more exercise and an improved diet can help to reduce or prevent high blood pressure in young adults.

Interestingly, however, young, lean men are also at risk. The presence of OSA is sometimes associated with insulin resistance and a rise in insulin secretion to maintain normal glucose levels. One study showed that OSA may increase the risk of type 2 diabetes independently of traditional risk factors such as obesity and OSA may adversely affect glucose metabolism at a very young age. 

Other research has shown that young adults with OSA are more likely to suffer from moderate to severe pain. Because of the high prevalence of chronic pain in younger adults, this study highlights the need to understand the impact of OSA diagnosis and treatment on pain intensity and how this might improve their quality of life.

Are You At Risk of Developing Sleep Apnea? 

Certain conditions put you at an increased risk of developing sleep apnea. They are:

1. Obesity: Overweight individuals tend to develop sleep apnea due to excessive fat deposition in the upper airway that narrows the air pipe. However, obesity plays a role in sleep apnea only 60% of the time. You don’t have to be overweight to have sleep apnea.
2. Genetics: If your family member has sleep apnea, then there is a chance (4X the risk) that you might develop it too.
3. Respiratory illness: People with respiratory disorders such as asthma and COPD (Chronic Obstructive Lung Disease) are at higher risk of developing sleep apnea.
4. Blocked nose: Nasal obstruction due to a deviated nasal septum or nasal polyps causes mouth breathing. According to some studies, mouth breathers have a higher chance of developing sleep apnea.
5. Gender: Research indicates that men are more prone to obstructive sleep apnea, but many women have sleep apnea as well.
6. Habits: Smokers and alcoholics have shown to develop sleep apnea at a younger age than their counterparts.

Earlier the Diagnosis, Better the Prognosis! 

Snoring is the first and most common sign of sleep apnea. The person who has sleep apnea might not be aware of their condition. And hence, their partner might be able to give a clearer indication of the duration and intensity of snoring which can be beneficial to diagnosis. The sooner you communicate with your physician about your issues, the better your treatment outcome will be.

A sleep apnea diagnosis is reached when a sleep medicine doctor assesses the signs and symptoms of the individual. Most patients complain of disturbed sleep, feeling drowsy throughout the day, headaches, lack of concentration, and sometimes dry mouth and sore throat. The physician will then make their diagnosis based on further investigations into the patient’s history and prior complaints.

Management of Sleep Apnea

The primary goal of treatment for sleep apnea is to improve the quality of sleep and to avoid any potentially serious health disorders that can result from the sleep disorder. The most important step in the management of sleep apnea is eliminating the cause.

Elimination of causes and associated disorders such as obesity, diabetes, smoking, stress, etc. can be effectively done through lifestyle modification strategies. These involve:

•     Weight reduction
•     Quitting habits such as smoking, alcohol consumption and substance abuse
•     Controlling blood pressure
•     Exercise
•     Yoga and meditation
•     Treating diabetes
•     Positional therapy (e.g. sleeping on the side)

Lifestyle changes can significantly improve symptoms of sleep apnea. However, some patients, especially those with more significant cases, find simple lifestyle changes ineffective for their sleep apnea, and therefore, require additional therapy.

Oral appliances are also effective in managing sleep apnea such as those that prevent the tongue muscles from falling back, thus maintaining a patent airway.