24 Jun Interrupted breathing during sleep: how dangerous are they really?

A particularly common and distressing symptom of nocturnal breathing pauses is pronounced tiredness during the day. Although those affected have supposedly slept long enough, they feel exhausted, listless and unrested in the morning - as if they have hardly slept at all. This is because sleep is repeatedly interrupted by repeated micro-awakenings and the body never gets enough of the deep sleep phases that are so important for regeneration.

This chronic fatigue not only affects general well-being, but can also have a significant impact on performance. Those affected often find it difficult to concentrate for long periods of time, react more slowly and feel mentally "foggy".

In particularly severe cases, it can even lead to involuntary microsleeps - short, sudden phases of falling asleep that occur without warning. This is not only unpleasant, but can also be dangerous in certain situations, such as when driving a car or operating machinery.

Interrupted breathing at night not only impairs sleep, but also has a noticeable effect on mental and physical performance during the day. Disturbed sleep means that the brain lacks the necessary recovery time to optimally prepare for the demands of the next day.

The result is reduced mental alertness: thinking becomes more difficult and concentration wanes more quickly. Even simple tasks require significantly more energy and attention.

In addition, the ability to react decreases, which is just as noticeable in everyday situations as in stressful phases at work. Many sufferers report increasing forgetfulness, inner restlessness and reduced resilience - both mentally and physically.

The ability to grasp complex relationships or react flexibly to new situations can also be significantly limited. These losses have an impact on professional life, social contacts and overall quality of life.

In the long term, this can develop into a feeling of chronic overload - with negative consequences for mental health.

Those who are deprived of restful deep sleep phases night after night due to breathing interruptions are often emotionally unbalanced the next day. After just a few nights of disturbed sleep, irritability often increases noticeably: small things trigger exaggerated reactions, patience and tolerance decrease. Added to this are inner restlessness, nervousness and the feeling of being under constant tension.

In the long term, this condition can have a negative effect on your mental state. The chronic lack of sleep drains energy, weakens emotional resilience and promotes depressive moods. Many sufferers report a lack of motivation, loss of interest or social withdrawal. Feelings of anxiety or a persistent feeling of being overwhelmed can also occur.

The psychological consequences of untreated apnoea are often underestimated - although they can have a significant impact on quality of life and interpersonal relationships.

Breathing pauses during sleep also pose a significant risk to the cardiovascular system. Each pause in breathing reduces the oxygen content in the blood - the body reacts with stress. The nervous system is activated and blood pressure rises briefly. As a result, the heart has to work harder to ensure the oxygen supply. These repeated nocturnal alarm reactions lead to the body remaining permanently in a state of increased tension.

In the long term, this mechanism can have serious consequences. The constantly changing blood pressure and increased heart rate during the night favour the development of high blood pressure (arterial hypertension) - one of the most common and most dangerous secondary diseases of obstructive sleep apnoea. Cardiac arrhythmias, such as atrial fibrillation, also occur much more frequently in those affected.

Studies also show an increased risk of heart attack and stroke, especially if sleep apnoea remains untreated:

Meta-analysis in "Neurological Sciences"

for people with obstructive sleep apnoea (OSA):

• a 71 % higher risk of cardiovascular disease,
• an increased risk of stroke by 86 %,
• an increase in mortality of 77 %,
• a 48 % higher risk of coronary heart disease (heart attack)

Source: "The effect of obstructive sleep apnea on the increased risk of cardiovascular disease: a systematic review and meta analysis" - based on 24 cohort studies

Triple the risk of heart attack and stroke

An analysis showed that people with untreated severe obstructive sleep apnoea have almost three times the risk of heart attack or stroke over a ten-year period.

Source: "Obstructive sleep apnea and risk ...: meta-analysis of prospective cohort studies"

As you can see: The nocturnal breathing interruptions not only put acute strain on the heart, but also damage it in the long term. It is therefore important to take warning signs such as constant snoring, unexplained daytime tiredness or high blood pressure in the morning seriously and have them checked out by a doctor.

In addition to the effects on the heart and circulation, untreated sleep apnoea can also significantly affect the metabolism. The sugar metabolism in particular reacts sensitively to continuous nocturnal breathing interruptions. Due to the lack of oxygen and the repeated stress reactions, the body releases increased amounts of stress hormones such as cortisol and adrenaline. These hormones have a negative effect on the glucose balance and promote the development of insulin resistance - i.e. a reduced effect of the body's own insulin. Insulin resistance is considered to be one of the main precursors of type 2 diabetes.

Studies confirm that patients with obstructive sleep apnoea have a significantly increased risk of developing this form of diabetes:

Meta-analysis in "Chest"

for people with obstructive sleep apnoea:

• an increased risk of developing type 2 diabetes by 35 % (regardless of body mass index or other concomitant factors)
• a clear correlation between the severity of OSA and diabetes risk

Source: "Obstructive sleep apnea and type 2 diabetes: a bidirectional relationship?"

Prospective cohort study

revealed the following results in three large US cohort studies with 146,519 participants:

• People with OSA had a 37 % increased risk of a type 2 diabetes diagnosis
• Effect was independent of BMI and waist circumference
• Significantly higher incidence of diabetes in OSA with excessive daytime sleepiness

Source: "A Population-Based Study of the Bidirectional Association Between Obstructive Sleep Apnea and Type 2 Diabetes in Three Prospective U.S. Cohorts"

Furthermore, if you already have diabetes, sleep apnoea can make it more difficult to control your blood sugar levels and therefore increase the risk of secondary damage.

Other metabolic processes are also impaired: The fat metabolism becomes unbalanced, which can lead to an increase in cholesterol and triglycerides. In combination with obesity - which is often present with sleep apnoea - this creates a vicious circle that endangers health in many ways. Early diagnosis and treatment of sleep apnoea can help to prevent or control these metabolic disorders.

Non-restorative sleep due to breathing interruptions at night has a direct impact on alertness and responsiveness during the day - with sometimes serious consequences for safety in everyday life. People with untreated sleep apnoea often suffer from severe daytime sleepiness and microsleep. This poses a particularly high risk in road traffic.

Reduced concentration can also be dangerous in the working environment - for example when working with machines, at heights or in safety-relevant professions such as transport, construction or care. The risk of accidents increases not only due to reduced reaction speed, but also due to limited decision-making ability and resilience.

The link between untreated sleep apnoea and an increased risk of accidents is so clear that it also has legal and insurance relevance - for example in terms of fitness to drive. Anyone who suffers from severe daytime sleepiness should definitely have a medical assessment carried out, not least to avoid putting themselves and others in unnecessary danger.

The effects of untreated sleep apnoea can also have a significant impact on sexuality. Those affected often report a loss of libido or a general decline in sexual performance. These problems do not occur in isolation, but are closely linked to the physical and hormonal changes caused by disturbed sleep.

The nocturnal breathing interruptions constantly disrupt sleep, which disrupts the production and release of important hormones - including testosterone, which plays a central role in sexual desire and erectile function. Men with obstructive sleep apnoea often have significantly lower testosterone levels. At the same time, the constant drops in oxygen levels and the activation of the stress system (sympathetic nervous system) have a negative impact on blood circulation - another factor that can lead to potency problems.

Psychological aspects also play a role: chronic fatigue, irritability and weakened self-esteem have an additional negative impact on sex life.

In women, sleep disorders can also lead to reduced sexual desire, vaginal dryness and arousal difficulties.