Sleep apnea is a condition where breathing repeatedly stops and starts during sleep. It often causes loud snoring, gasping or choking during sleep, and persistent daytime fatigue. However, these symptoms are not exclusive to sleep apnea. Many other conditions can produce similar signs, making accurate diagnosis important for effective management.
Other Sleep Disorders
Chronic insomnia
Chronic insomnia involves difficulty falling asleep, staying asleep, or waking too early. This fragmented and insufficient sleep leads to significant daytime fatigue, irritability, and difficulty concentrating. Such sleep deprivation can severely impact daily functioning.
Restless Legs Syndrome (RLS) and Periodic Limb Movement Disorder (PLMD)
Restless Legs Syndrome (RLS) and Periodic Limb Movement Disorder (PLMD) involve uncomfortable leg sensations and involuntary leg movements, respectively. These symptoms typically occur or worsen at night, disrupting sleep. This disturbance results in fragmented sleep and subsequent daytime fatigue.
Narcolepsy
Narcolepsy is a neurological disorder causing overwhelming daytime sleepiness and sudden, uncontrollable sleep attacks. Individuals with narcolepsy experience extreme fatigue, which can be misattributed to poor sleep quality. Sudden sleep onset is also a distinguishing feature.
Upper Airway Resistance Syndrome (UARS)
Upper Airway Resistance Syndrome (UARS) is a milder form of sleep-disordered breathing. It involves slight throat narrowing during sleep, requiring increased breathing effort. This effort leads to micro-arousals and fragmented sleep, causing daytime fatigue, unrefreshing sleep, and difficulty concentrating, even without significant oxygen drops.
Underlying Medical Conditions
Chronic Obstructive Pulmonary Disease (COPD) and asthma
Chronic Obstructive Pulmonary Disease (COPD) and asthma are respiratory conditions causing nocturnal breathing difficulties, coughing, and wheezing. These symptoms disturb sleep, leading to daytime fatigue. Asthma symptoms often worsen at night due to increased inflammation and airway narrowing.
Congestive heart failure (CHF)
Congestive heart failure (CHF) can produce symptoms overlapping with sleep apnea. Fluid retention and breathing difficulties, especially when lying down (orthopnea) or at night (paroxysmal nocturnal dyspnea), lead to nocturnal awakenings and perceived breathing problems. These issues resemble sleep apnea’s disturbed sleep patterns.
Hypothyroidism
Hypothyroidism, an underactive thyroid, causes generalized fatigue, weight gain, and various sleep disturbances. The resulting sluggishness and poor sleep quality can be mistaken for sleep apnea. Proper thyroid function is important for maintaining regular sleep patterns.
Chronic nasal congestion
Chronic nasal congestion from allergies or sinusitis significantly impacts sleep quality. Blocked nasal passages often force mouth breathing, leading to snoring and disturbed sleep. Allergies can increase snoring and sleep apnea risk due to inflamed airways.
Gastroesophageal Reflux Disease (GERD)
Gastroesophageal Reflux Disease (GERD) can contribute to sleep disturbances, especially with nighttime acid reflux. The reflux can cause coughing and choking sensations. These events interrupt sleep, leading to daytime tiredness similar to sleep apnea.
Lifestyle and Other Factors
Certain medications
Certain medications can induce side effects that mimic sleep apnea symptoms. Sedatives, muscle relaxants, and some pain medications may cause drowsiness, fatigue, or worsen snoring by relaxing throat muscles. These effects can contribute to sleep-disordered breathing symptoms, making diagnosis more complex.
Alcohol and sedative use
Alcohol and sedative use significantly impair sleep and breathing. These substances relax throat muscles, leading to increased snoring and temporary breathing pauses. Alcohol consumption increases sleep apnea risk by approximately 25%.
Obesity Hypoventilation Syndrome (OHS)
Obesity Hypoventilation Syndrome (OHS) is a distinct condition where severe obesity leads to insufficient breathing, resulting in high carbon dioxide levels and daytime sleepiness. While obesity is a risk factor for sleep apnea, OHS can occur even without significant airway collapse during sleep.
Anxiety and depression
Anxiety and depression profoundly affect sleep quality, leading to insomnia, restless sleep, and persistent daytime fatigue. A bidirectional relationship exists where sleep problems can exacerbate mental health conditions, and mental health issues can disrupt sleep. This creates a cycle of poor sleep and fatigue.
Poor sleep hygiene
Poor sleep hygiene, including irregular sleep schedules, excessive screen time before bed, or an uncomfortable sleep environment, contributes to chronic fatigue and disturbed sleep. Disruptions to the body’s circadian rhythm lead to sleep loss and fatigue. These habits can independently cause symptoms resembling sleep apnea.