Causes of sleep apnea

Sleep apnea is a sleep disorder in which breathing repeatedly stops and starts during sleep. Each pause can last 10 seconds or more and may happen dozens of times an hour. The brain briefly wakes the body to restart breathing, which fragments sleep, often without the person remembering it.

Obstructive sleep apnea (the most common cause) The muscles at the back of the throat relax too much during sleep, and the airway narrows or closes. Factors that make this more likely:

• Excess weight, especially fat around the neck and throat.
• A thick neck (above about 43 cm in men or 41 cm in women).
• Narrow airway, large tonsils or adenoids, a small lower jaw or a large tongue.
• Nasal blockage from allergy, a deviated septum or polyps.
• Being male, older age, and for women, after menopause.
• Family history.
• Alcohol, sleeping pills and sedatives, which relax throat muscles.
• Smoking, which causes airway inflammation.
• Sleeping on the back.

Central sleep apnea The brain does not send the proper signals to the breathing muscles. It is linked with heart failure, stroke, some medicines such as opioids and living at high altitude.

Mixed or complex sleep apnea A combination of obstructive and central types.

Other contributing conditions Hypothyroidism, polycystic ovary syndrome, acromegaly, high blood pressure, type 2 diabetes and neuromuscular disease.

Ayurvedic view (interpretive) Ayurveda links heavy snoring and breathing disturbance in sleep with aggravated Kapha, excess body weight (sthaulya) and obstruction of the channels of breath. This is a traditional framework and not a medical explanation.

When to see a doctor See a doctor if you snore loudly, if someone has seen you stop breathing in sleep, or if you feel very sleepy in the daytime.

Remember Sleep apnea is common, often undiagnosed and treatable. Weight, alcohol and sleep position are the main factors you can change.