According to sleep specialist Rafael Pelayo of the Stanford Sleep Medicine Center, sleep apnea can start at any age, but does occur more often as we age. “But it’s not normal at any age”, Pelayo states. “When we’re awake, we don’t snore. All snoring is abnormal and is caused by some degree of obstruction in your breathing.”
Body and chemistry changes
Sleep disorders and troubles increase with age, and more than 50% of adults 65 and up have some form of chronic sleep related complaints including difficulty falling asleep, trouble maintaining sleep, and total amount of nightly sleep. The reasons for higher prevalence of sleep apnea in older people is believed to be caused by increased fatty deposits in the parapharyngeal area (areas in the head and neck), lengthening of the soft palate, and changes in body structures surrounding the pharynx. “As we get older, we put on weight. The pattern of weight gain changes and we often gain weight around the neck, so the throat space becomes narrower,” Pelayo says. “Muscle tone also decreases, that’s why we snore more.” For women in particular, after menopause, hormonal changes- including decreased progesterone- may also cause weight gain. Post-menopausal women not on hormone replacement therapy also run a higher risk, as the onset of post-menopausal sleep apnea is believed to be related to weight gain and fluctuating hormonal changes.
This applies mainly to women, but hormonal changes can affect men too. Loss of estrogen and progesterone can diminish their protective effects on the upper airway. In particular, progesterone is an upper airway muscle stimulant/dilator. As it begins to diminish in the early 40s, the tongue begins to relax more and more over the years, leading to less efficient sleep and the consequent symptoms, which include night sweats, weight gain, mood swings, and irritability.
Studies show that as a person ages, the prevalence of sleep apnea increases. A study published by the American Thoracic Society (ATS) showed the prevalence of sleep apnea in adult men of various ages:
3.2% prevalence in men 20-44 years old; 11.3% prevalence in men 45-64 years old; and 18.1% prevalence in men 61-100 years old. However, a separate study published by the ATS indicates that although prevalence of sleep apnea increases with age, the severity of sleep apnea decreases with age.
Age-related changes in the control of breathing at sleep onset could also increase the prevalence of sleep apnea in older people. However, studies of sleep-related changes indicate that aging per se does not promote central sleep apnea. Another factor that may predispose older people to sleep apnea is the age-related increase in arousal from sleep that may lead both to hyperventilation and to relative hypocapnia, which can cause respiratory instability and compromised breathing throughout the sleep cycles.
Sleep apnea symptoms that affect people in all age groups include, but aren’t limited to:
excessive daytime sleepiness; waking unrefreshed after sleep; problems with memory and concentration;
experiencing personality changes and depression; morning or night headaches; frequent night-time urination.