You may be thin though still experience symptoms similar to those diagnosed with sleep apnea. Although you may not fit the typical profile cast many years ago of apnea patients, you find yourself asking “If I am thin, how can I have apnea?” But the truth is, you can be a healthy weight and still have apnea.
Sleep apnea, a serious sleep disorder, remains a condition in which the majority of apnea sufferers remain undiagnosed. Left untreated, sleep apnea can lead to a higher risk of having high blood pressure, cardiac arrhythmias, stroke and erectile dysfunction.
There are several types of sleep apnea: obstructive, central and mixed, (also called complex apnea), that includes a combination of both obstructive and central sleep apnea.
Obstructive sleep apnea (OSA) is far more common than central apnea and is often associated with individuals that are overweight.
Here’s a list of often correct but not fully inclusive characteristics of many sleep apnea patients:
- middle aged
- thick- necked
- a snorer
You may not fit this typical profile of an apnea patient. Instead you may have a normal BMI (Body Mass Index), considered thin or of average weight, a woman, and have a thin neck. You may be of average weight and extremely fit and active; you still may experience signs that often accompany sleep apnea such as:
- morning headaches
- unrefreshing sleep
- poor sleep quality
- daytime fatigue and sleepiness
The majority of apnea patients have not been diagnosed. Another disturbing fact is that individuals that don’t fit the typical ‘apnea profile’ are completely overlooked for a sleep evaluation, and often treated or evaluated for many other medical conditions such as depression, anxiety, hormones issues, and more; these treatments may even be needless.
To understand why thin people can have apnea, let’s explore how a sleep apnea event is created during sleep:
In obstructive sleep apnea (OSA), the muscles in the throat and the jaw relax during sleep. As this happens, the tongue also falls back creating a ‘bottleneck’ effect and blocking the airway either fully or partially causing decreased airflow. As this happens, oxygen levels in the blood are lowered and carbon dioxide blood levels increase. Ultimately, the oxygen-starved brain signals the body to awaken so that the airway can get wider and unobstructed. The person can breathe again for a moment: until the next episode. These cycles of breathing , stopping, and awakening can can occur hundreds of times during sleep.
Aging and increased weight are increasing risk factors for obstructive sleep apnea.
Related to weight gain as a contributing risk factor for apnea is the increase in tongue size and overall tissue around the neck narrowing the airway. During aging process, airway throat muscles are less stiff increasing the likelihood that the airway will narrow or collapse as described above.
Although aging and weight are increased risk factors for apnea, thin, younger and even highly fit individuals can have obstructive sleep apnea. Why?
Airway architecture, and here’s how…
- Family predisposition of certain anatomical features that put you at risk for apnea. These include a narrower airway, enlarged adenoids or tonsils, and micrognathia (retruded jaw).
- Ethnic features can put you at risk for sleep apnea. Sleep apnea is more common in African-Americans, Hispanics, and Pacific Islanders than in whites. Again, architectural features that are often accompany these ethnicities, make for an airway environment that during sleep is susceptible to obstructions.
- Features of highly fit individuals can make one more susceptible for apnea. Some highly fit athletes have thicker and more muscular necks. The muscles and fat pads can compress and narrow the airway again making the person more susceptible for an obstruction.
- Medical conditions can also be contributing factors to increasing risk of sleep apnea in overweight or thin individuals. These may include hypothyroidism, acromegaly (growth hormone irregularities), allergies, and other medical conditions that cause congestion in the upper airways such as deviated septums.
If you don’t fit the profile of a typical apnea patient, but exhibit one or more of the typical symptoms such as: morning headaches, unrefreshing sleep, snoring, poor sleep quality or daytime fatigue and sleepiness, it’s best to seek a medical evaluation. If your medical provider doesn’t take you seriously because you don’t fit the typical ‘apnea profile’, consider seeking a second opinion.
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