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Sleep apnea is a condition that causes periods of total breathlessness when you sleep. You simply stop breathing until your body's suffocation reflexes cause you to snore or snort to open your trachea so you can breathe again. Sleep apnea is made worse by a failure of the throat muscles to support the throat and keep it open. The problem can be degeneration of the muscles, but it is more likely to be the weight of fat pads on the throat that tend to close it when you lie on your back. The same people who have a problem with fat pads on the throat also tend to have thyroid issues, so it isn't that thyroid problems cause sleep apnea but rather than the same processes are involved in both conditions.

There are several basic ways you can tell that you have sleep apnea without having a sleep study:

  • Your sleeping partner complains that you snore, or people in adjacent rooms tell you that you snore. Or, in my case, people next door tell you that you snore.
  • Your pets wake you up in the middle of the night by putting a paw over your mouth.
  • You wake up with a dry mouth from breathing through your mouth, even though your nose doesn't feel stopped up.
  • You have a sore throat in the morning that goes away after you have your morning water, coffee, or juice.
  • You get eight or more hours of sleep but still need to want to take naps during the day.
  • You feel tired all the time.
  • You have high blood pressure or diabetes that just doesn't seem to respond to your best efforts at control.

And the most important sign is, you wake up in the middle of the night unable to breathe until you change position to let pressure off of your throat. 

Your heart may be pounding, because you haven't been able to get enough air and it is struggling to get oxygen to your brain. You may feel a need to urinate, even if you don't have any physical condition that causes nighttime urination. That's because your pounding heartbeat sends more blood to be filtered by your kidneys. You may even feel like someone has been sitting on your chest or someone is strangling you, only to wake up to find no one was there. (The corrective paw of my cat, who did not approve of my snoring, felt a lot lighter than the feeling of strangulation I got from sleep apnea.) You may feel like you are about to die.

Fortunately, you probably aren't, although severe sleep apnea uncorrected over a period of years can result in damage to both your brain and your heart.

It's best to get medical intervention for apnea. If you can't because your insurance won't cover sleep studies and CPAP machines, there are some stopgap measures that may also help.

  • Don't sleep on your back. If you can't sleep on your stomach because of GERD, then sleep on your right side. Sleeping on your left side may introduce another problem, the sound of your heartbeat.
  • Lose weight if you can. Don't beat yourself up if you can't lose weight, but losing weight almost always helps in obstructive sleep apnea.
  • Consider the various therapies other than CPAP ("sleep machines") that may help a little or a lot, such as Breathe-Rite nose strips, snore-relief mouthpieces and other oral appliance therapies, the Winx system that creates negative air pressure in the mouth to keep airways open, the pillar procedure to stiffen the palate (requiring minor surgery at the dentist's office), and somnoplasty, laser surgery to remove tissue in the back of the throat. It's impossible to know whether these methods will work in advance, and insurance often doesn't pay for them, but if you don't want to use CPAP, they may be your best bet.

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