If you have been to the doctor recently, you may have been asked if you snore. Screening questions like this help health care providers see if you are at risk for sleep apnea. Sleep apnea affects people of all ages, but it becomes more common as you age. CPAP therapy is often prescribed to treat sleep apnea. Not everyone with sleep apnea will need a CPAP machine, but there are symptoms and tests that can help you and your provider know when a CPAP machine may be needed. Knowing the warning signs of sleep apnea and how to proceed can help you or someone you know get back to a restful night’s sleep. Here are some details about sleep apnea and signs you might need a CPAP machine.
What is sleep apnea?
Sleep apnea occurs when you stop breathing in your sleep. When your body detects a lack of oxygen, it uses a survival mechanism to wake you up so that you take a breath. With sleep apnea, these episodes of not breathing (apnea) can occur frequently and disrupt your sleep cycle. You may wake up feeling tired or fatigued despite being in bed all night. There are two main types of sleep apnea:
- Obstructive sleep apnea (OSA) occurs from a physical blockage when the muscles in your throat relax and air cannot pass through.
- Central sleep apnea (CSA) occurs when your brain stops or pauses in sending messages to your body to keep you breathing during sleep.
Some people have both types of sleep apnea, which can be called mixed or complex sleep apnea.
Signs you might need a CPAP machine to treat sleep apnea
Symptoms commonly associated with sleep apnea can include:
- Frequently waking up at night.
- Pauses in your breathing, which are usually noticed by someone sleeping in the same room as you.
- Snoring.
- Waking up gasping or feeling short of breath.
- Feeling tired during the day or upon waking.
There are many other less common symptoms that older adults may experience. If you have concerns about anything related to sleep or a partner, or if family members express concerns about your breathing at night, you should discuss it with your health care provider.
How does sleep apnea affect seniors differently?
Like any aspect of aging, your body begins to work differently, and sleep is no exception. Sleep generally changes as you age, but there are noticeable differences, such as an increase in the amount of time spent in lighter stages and a decrease in deep sleep. This typically causes older adults to sleep for less time and wake up more frequently. Other chronic conditions that are more prevalent as you age can also disrupt sleep for older adults, such as insomnia, cardiovascular disease, restless leg syndrome, and different forms of pain (neuropathy, arthritis, and acute or chronic injuries).
There are also additional physiological changes to your body as you age that can cause increased airway resistance and, therefore, sleep apnea during sleep. Some of them are:
- Reduced size of the pharynx (area in the throat behind your nasal passage) due to fat build-up that accumulates over your lifetime.
- Changes in how the muscles in your throat work.
- Loss of teeth, which can change the structure of your mouth.
When you are diagnosed with sleep apnea, on top of the physiological changes related to age and sleep, you can find yourself getting even less restorative sleep at night.
How is sleep apnea diagnosed?
A diagnosis of sleep apnea in older people starts with your health care provider reviewing your health history and any symptoms reported by you and your sleep partner or someone who lives with you. You may be referred to a sleep specialist who can perform further tests and determine if you have sleep apnea or a different sleep disorder.
It is common to have an overnight sleep study where your breathing and other vital signs are continuously monitored. This can occur at home with a wearable device or at a sleep center or hospital. You may be diagnosed with sleep apnea if you receive abnormal results from these tests.
When is a CPAP machine recommended?
Not everyone who has sleep apnea will need a CPAP machine. After diagnosis, you will work with your provider or sleep specialist to determine the recommended treatment. CPAP machines are the treatment of choice for older adults who have moderate to severe obstructive sleep apnea. The severity of your sleep apnea is graded based on the number of times you stop breathing or do not get enough air during your sleep study. In the moderate stages of sleep apnea, you may have 15 to 30 episodes of apnea or hypopnea per hour, and with severe apnea, it can be 30 or more episodes per hour.
There are different types of PAP machines, and getting used to wearing one will take time. You may work with a respiratory therapist or other specialist to determine which type of mask or breathing device works for you.
While wearing a CPAP machine may feel cumbersome at first, it is important to try to find a routine that works for you. Consistency with wearing your CPAP machine every time you sleep is key to ensuring restful sleep.
Special considerations for seniors
Diagnosing and treating sleep apnea in seniors requires some additional special considerations. Older adults can be less likely to report some of the clinical symptoms that would lead to diagnosis, such as daytime sleepiness and disrupted sleep. These symptoms are often attributed to age and not believed to be treatable.
Older adults may also have difficulty wearing and operating their CPAP machines and may be resistant to using them. Factors such as limited dexterity and living alone without help have been shown to decrease treatment compliance. Older adults prescribed CPAP treatment will need to work with their health care provider to develop a plan to ensure continued use.
Contact your health care provider if you recognize these signs that you might need a CPAP machine
Sleep apnea is a serious condition that can have dangerous repercussions. If you recognize these signs that you might need a CPAP machine, contact your health care provider so you can get the care you need to stay healthy and rested.
