Shaq’s Apnea

Shaq O’Neal, like many athletic big men, has sleep apnea.

Posted May 22, 2011

You may have seen the articles on Shaq O'Neal's discovery that he has sleep apnea. His situation is instructive because it says something about the nature of sleep apnea and the warning signs that indicate you or a loved one may be suffering with it.

The usual picture that we have of someone with apnea is that of an overweight, middle-aged male. There is some truth to this image but being slim, young or athletic does not mean you are safe from apnea. Apnea is caused by blockage of the upper airway that occurs when muscles relax as we fall asleep. It is often worse when sleeping on the back and during REM sleep. Using fairly stringent criteria it is usually estimated that 2% of women and 4% of men have sleep apnea with rates for women rising toward the male level after menopause.

So what are some risk factors for sleep apnea?  The usual risk factors are obesity, age over 65, male gender and a positive family history of sleep apnea. Some anatomic factors include a large neck size, high and narrow hard palate, an elongated soft palate, small chin and an upper air way crowed by large tonsils and adenoids. Mouth breathing can lead to enlargement of the tonsils and is often seen in children with sleep apnea. The presence of elevated blood pressure, depressed mood, heart failure, and atrial fibrillation add to the suspicion that someone may be suffering from sleep apnea, as sleep disordered breathing can increase risk for these disorders. Alcohol, sedative drugs, sleep deprivation, tobacco smoke and sleeping on one's back tend to aggravate sleep disordered breathing.  The most common symptoms are snoring, witnessed apneas, gasping awakenings, excessive daytime sleepiness, frequent nocturnal urination, memory or learning problems, impotence, weight gain, morning headache, and dry mouth or throat in the morning.  Anyone, young or old, slim or obese, male or female can have sleep apnea.

The tip- off that Shaq was suffering from sleep apnea was his girlfriend's observation that he snored and had breathing pauses. Any time a bed partner detects this combination of symptoms there is a very high probability that sleep apnea is present. Shaq did what anyone with these symptoms should do - he had a sleep evaluation and sleep study. In this way sleep apnea can be ruled out or found and treated. Shaq's apnea was discovered and treated. Like Shaq, all apnea sufferers can know improved alertness and improved relationships when their sleep apnea is properly treated. 

Shaq is a great athlete and he has done a real service by going public about his sleep apnea. Hopefully this will further raise public and professional awareness of this serious but treatable condition. Thanks, Shaq.