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If you’re snoring at home, you may have obstructive sleep apnea, or OSA — a potentially serious condition in which people stop breathing for 10 seconds or more at a time.
This condition has been linked to smaller brain size, damage to the brain’s white matter communication pathway, and even a three-fold increased risk of death from any cause. If left untreated, obstructive sleep apnea puts you at greater risk for high blood pressure, heart disease, type 2 diabetes, depression and even early death, according to the American Academy of Sleep Medicine.
However, even if you’re a snoring rock star, you may not know you have obstructive sleep apnea unless someone tells you about your nighttime snoring. That’s why it’s important for partners and friends to talk up and encourage people who snore to get professional help.
But what if you have a strange or quirky symptom along with snoring? You and your loved ones may have no idea you are at risk, and the condition may remain undiagnosed for years.
“More than 30 million people have sleep apnea in the United States, yet it is often underdiagnosed or misdiagnosed,” said Dr. Raj Dasgupta, a sleep specialist and pulmonologist. Professor of Clinical Medicine at the Keck School of Medicine of the University of Southern California.
“Snoring has been misdiagnosed among women and men, because women may not experience the classic heroic snoring that men often exhibit,” he said.
Here are five strange signs of obstructive sleep apnea to watch for, according to Dasgupta.
There are many reasons why people may sweat at night. It can be very hot, especially with the continued heatwaves of the past few years due to the climate crisis. Some medications can cause night sweats, as can cancer, thyroid problems, flu and bacterial infections, and menopausal symptoms, according to the Mayo Clinic.
But research has shown that about 30% of people with obstructive sleep apnea report night sweats, Dasgupta said.
“Because your body isn’t getting enough oxygen, you fall into sympathetic fight-or-flight mode, which leads to night sweats,” he said. “The research showed that people with sleep apnea who had night sweats were also more likely to have low oxygen levels as well as obstructive sleep apnea.”
Many people wake up at night to empty their bladder, and this may be caused by alcohol consumption Overeating, diabetes, edema, high blood pressure, certain medications, pregnancy, prostate problems, and even drinking too much fluid before bed, according to the Cleveland Clinic.
But waking up at least twice a night to urinate — called nocturia — can also be a sign of obstructive sleep apnea, Dasgupta said.
“One study found that about 50% of patients with sleep apnea experienced nocturia, and indicated that treating the sleep disorder resulted in reduced awakenings,” he said.
However, frequent nocturia is not commonly asked on sleep apnea screening questionnaires in primary providers’ offices, Dasgupta said.
Grinding or clenching your teeth during sleep is called bruxism, and it may also be a sign of obstructive sleep apnea, Dasgupta said.
“Anxiety and other factors can certainly cause teeth grinding, but the common cause is obstructive sleep apnea,” he said. “There is a theory as to why, the airway becomes blocked, so the muscles of the mouth and jaw move to try to free the blocked airway. This has not been proven, but it is an interesting hypothesis.”
Most people who grind or clench their teeth use a mouthguard suggested by a dentist for protection, but it won’t protect the jaw, Dasgupta said.
“So, a person may also develop temporomandibular joint dysfunction, which is pain in the temporomandibular joint, and that may also lead to other problems, such as headaches,” he said.
Dasgupta said studies have found a link between having obstructive sleep apnea and waking up with a headache.
“It usually occurs daily or most days of the week and may last for several hours after waking up in the morning,” he said. “The cause of headaches is not well defined and may be multifactorial.”
Headaches caused by obstructive sleep apnea do not appear to lead to nausea or increased sensitivity to light and sound. Instead, it appears to be a sensation of pressure on either side of the forehead that lasts about 30 minutes, according to a June 2015 study.
Depression, fatigue and insomnia
Some symptoms of obstructive sleep apnea can masquerade as mental health issues, brain fog, or other sleep problems, Dasgupta said.
“Sleep affects our ability to think, interact, remember and solve problems,” he said. “Women in particular tend not to report atypical symptoms such as insomnia, fatigue, and depression.”
If obstructive sleep apnea wakes you up, it may be difficult to get back to sleep. A person may suspect insomnia, without realizing that there is a different problem that may be causing them to wake up.
Symptoms of daytime fatigue include a lack of motivation to complete daily tasks, lack of productivity at work, memory problems, and decreased interest in staying social, Dasgupta said. These are also signs of depression, so if sleep problems are not brought up at the health visit, the underlying cause may be missed.