We can only think of two reasons you wake up sweaty and breathless at night – you just had a nightmare, or you may have a disorder called sleep-disordered breathing. It is probably the latter if you are not feeling too good.
To be on the safer side, ask your partner if you were breathing shallow, moaning or groaning while sleeping, or pausing breathing altogether. If you get a yes, for either of these options, consult a healthcare practitioner.
Meanwhile, this article will help you understand what’s happening to you and how you can sleep properly.
What is Sleep-Disordered Breathing?
Chances are you can’t sleep because you have what the experts call sleep-disordered breathing or SDB. It is a syndrome (a group of psychopathological conditions) characterized by a dysfunctional upper airway during sleep. It is characterized by snoring and increased effort to breathe. In other words, not everyone who snores has SDB, but everyone with SDB snores.
Some types of SDB are – upper airway resistance, hypopnea (shallow breathing), apnea (pausing for 10 seconds or more while breathing), catathrenia (moaning while sleeping), and heavy snoring.
It is an umbrella term that encompasses various sleep-related issues. In simpler words, however, it involves conditions in which you can’t sleep because you can’t breathe. Some of the broad spectra of sleep-related breathing disorders that it encompasses are as follows – sleep apnea and its types, sleep-related hypoventilation, hypoxemia.
SDB is the most common form of sleep-disordered breathing—and at the same time—highly underdiagnosed. In fact, studies have suggested that the actual cases of SDB exceed the estimates.
Some of the reasons why you get all breathless and wake up sweaty in the middle of the night could be:
- Narrowing airways
- Enlarged tonsils or adenoids
- Fat deposits around the neck and throat
- Abnormalities in the lower jaw or tongue
Is it the Same as Sleep Apnea?
Sleep Apnea is often mentioned when discussing SBD, but that does not mean the two are the same. However, SDB is related to sleep apnea.
SDB includes many chronic health conditions like the various types of sleep apnea—central sleep apnea, obstructive sleep apnea, and mixed sleep apnea. Sleep apnea, however, is defined as the cessation of airflow for over ten seconds.
How to Be Sure it is Sleep-Disordered Breathing?
To be sure, see if you are experiencing one or more of these symptoms:
| Daytime symptoms | Nighttime symptoms |
| Excessive sleepiness | Snoring and groaning loudly – could be accompanied by gasping and snorting noises |
| Depressed mood | Bedwetting (for children) |
| Memory or concentration problems | Your partner says you sometimes stop breathing |
| Irritability | Waking up with dry mouth, sore throat, headache |
| Lower sex drive or decreased interest in sex |
Diagnosis of Sleep-Disordered Breathing
However, before pronouncing that you have SDB, we would recommend you see a healthcare practitioner. They would ask for sleep history and use screening instruments to diagnose you.
They would consider various factors, and depending on the combination of your symptoms and their patterns; they would diagnose you. They could ask for a medical history, sleep studies, or physical exam. They might suggest you take some tests to rule out other potential disorders that could cause these symptoms.
Differential Diagnosis
Some possible disorders that could be causing these symptoms are as follows:
- Central sleep apnea syndromes
- Asthma
- Depression
- Gastroesophageal reflux
Are You at Risk of Developing Sleep-Disordered Breathing?
You are at risk of developing SDB if you have the following risk factors:
- Family history of SDB or snoring
- Obesity
- Large tonsils
- Drinking before bed
Besides this, you have more chances of developing SDB if you are a male or post-menopausal woman.
How Can You Breathe Easy and Sleep Well?
Taking these symptoms or risk factors lightly is not a good idea because the syndrome can cause major physiologic changes and likely impact brain health (largely unproven).
Don’t worry; depending on your diagnosis, overall health, and risk factors, you can easily win over the issue. There are several treatment options for you, beginning from focusing on lifestyle to surgeries.
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Lifestyle changes: Many times, your doctors might just ask you to make some sweeping changes to your lifestyle:
- Quit smoking
- Lose weight
- Don’t drink before bed
- Restrict caffeine post-lunch
- Maintain quiet bedroom
- Maintain proper ventilation
- Keep the bedroom dark
- Make the bed comfortable
- Restrict drinks like tea, chocolate, or coke
- Positional Therapy: They might also suggest positional therapy – changing the sleep position – if the symptoms return. Whether or not your doctor will suggest positional therapy also depends on your sleep study report. It is generated by observing your breath disturbances and sleeping positions – supine (on the back), lateral (on the right/left side), and prone (on your stomach).
It consists of two indexes calculated based on your sleep position:
- One is the respiratory–disturbance index (RDI), and
- the other is an apnea-hypopnea index (AHI)
If your RDI or AHI is normal when you stay off your back with fewer than five sleeping disturbances, the doctor may recommend you to do positional therapy.
- Machines: You may also be recommended bilevel positive airway pressure (BiPAP) or continuous positive airway pressure (CPAP). You would be required to sleep with a mask on, and the mask would be connected to a machine that would keep your airways open. While these machines are the gold standard of treatment, most people avoid them.
- Oral Appliances: If you would rather not have a machine, you could go for mandibular advancement devices (MADs) or mandibular repositioning appliances (MRAs). These appliances change the position of your tongue and jaw as you sleep so the air can flow freely.
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Surgery: In serious cases, your consultant might recommend surgery; here, you have several options:
- Tongue Reduction Surgery: It is the least invasive surgical option – extra tissue from the base of your tongue is removed, so air can flow freely.
- Thyrohyoid Opexy: If you have SBD due to an obstruction behind the tongue, this surgery can help. Your tongue and epiglottis are pulled down and forward during the surgery.
- Trans Oral Robotic Surgery (TORS): Your surgeon gets an enhanced view or three-dimensional image of your tongue, which allows them to remove tissue behind your tongue that could be obstructing your throat. Sometimes, the epiglottis is also trimmed.
Take a Deep Breath!
Your future is not as bleak as it looks. Don’t look at the severity of the situation or the number of accidents this syndrome has caused.
Plus, you are not alone. You’ll be surprised that the percentage of healthy sleepers is meager. In fact, a study to establish the proportion of healthy sleepers could not recruit enough people – even though they were looking for ‘healthy sleepers’ and not ‘healthy subjects.’ Moreover, among 286 volunteers who showed up, only 47 finished the study. The researchers had to ask nearly 40% of people who showed up to leave – because they were not healthy sleepers, even though they considered themselves as such.
So, take a deep breath and consult your doctor – sit with them and develop a health plan. There are many medical and non-medical solutions available depending on the severity of the situation.
