Health

Can’t Breathe When Asleep? What You Need To Know about Sleep Apnea

Published

5 years ago

January 22, 2021

Restlessness during sleep or waking up multiple times at night could be a sign of an underlying serious sleep disorder. If you find yourself tired even after a full night’s sleep or if your partner complains about your loud snoring while you are asleep, then this could be due to sleep apnea.

Sleep apnea is a potentially life-threatening health condition where a person suddenly stops breathing for a few seconds during sleep. It is important to have yourself evaluated by a sleep apnea specialist if you suffer such symptoms and this is more often noticed by your sleep partner. Obstructive sleep apnea (OSA) increases the risk of high blood pressure while also putting you at risk of heart attacks, arrhythmias (irregular heartbeats), stroke and other cardiovascular diseases.

What is sleep apnea?

Sleep apnea is a disorder caused by collapse or closure of your airway where breathing is repeatedly interrupted during sleep. This interruption can occur from anywhere between 5 to over 100 times in an hour! The pauses in breathing can last between 10 to 20 seconds, and sometimes as long as more than a minute. During sleep apnea, when you stop breathing, no oxygen enters the lungs, causing a drop in the level of oxygen in the blood. This leads to reduced blood oxygen supply to your brain, heart and other vital organs.

Sleep becomes disturbed in patients with sleep apnea which means that they do not get the deep restorative sleep which is needed for mental alertness and clear memory for a productive next day. Abnormal sleep patterns arise, consisting of frequent long pauses in breathing where the patient suddenly goes silent for a while, followed by a sudden loud gasping, choking or snorting episode when they start to breathe again. This becomes a vicious cycle night after night for prolonged periods, sometimes many years before the patient finally decides to seek medical help for his sleep problems. Sleep apnea needs medical intervention as it leads to many health problems and could even be fatal, leading to sudden death during one’s sleep. A person with the condition may not be aware, but anyone sleeping beside him or her can easily recognise the worrying symptoms of sleep apnea. If your partner suspects you are a victim of sleep apnea, then you should consult an ENT specialist without delay.

What are the types of sleep apnea?

The most common is obstructive sleep apnea (OSA). During this condition, the inflow and outflow of air from the nose is blocked due to throat muscles relaxing and collapsing inwards while sleeping. This will result in loud snoring with recurrent pauses in breathing, night-time waking and gasping or snorting episodes. Another condition is central sleep apnea where the central nervous system is involved. In central sleep apnea, the brain temporarily stops signalling the muscles responsible for breathing to continue. Some patients may suffer from mixed sleep apnea which is a rare combination of both central and obstructive sleep apnea.

What are the causes of sleep apnea?

There could be many reasons for obstructive sleep apnea. Individuals who are overweight tend to have excess fatty tissue deposited just outside the throat. This causes the pressure on the inside of the throat to increase, especially when lying flat during sleep, causing the airway to collapse and close off. In addition, throat muscles can relax even further due to alcohol or medication use prior to sleep, worsening the airway obstruction. Presence of nasal obstruction from nasal allergies or deviated nasal septum, or enlarged tonsils or jaw deformities may also obstruct the airway. Asthma patients and smokers have a higher chance of sleep apnea. This condition is more common in males than women and it increases with age, although this condition may occur at any age.

What are the symptoms of obstructive sleep apnea?

The initial signs are complaints by your partner of loud snoring. Other signs to look out for include:

Headaches in the morning
Fatigue and tiredness throughout the day
Memory loss
Difficulty focusing or concentrating on the task at hand
Sore throat
Dry mouth
Mood and behavioural changes like irritability and bad temper

What are the health problems associated with obstructive sleep apnea?

In addition to impacting your quality of life, this condition can lead to the following health problems:

Hypertension (high blood pressure)
Heart attacks
Stroke
Depression
Dementia
Type II Diabetes
Irregular heartbeat (arrhythmias)

Early treatment can minimise the risk of developing heart attacks and strokes as complications of untreated sleep apnea.

How is obstructive sleep apnea diagnosed?

As there are many reasons why an individual might have sleep disturbances, it is not always easy for your family doctor to suspect that you have sleep apnea. A referral is usually made to an ENT doctor to examine the airway for signs of nose or throat narrowing. Taking your sleep partner along can be helpful as he or she will be able to give an insight on your breathing pattern while asleep and snoring episodes.

Your ENT sleep specialist will take a detailed medical history and perform a physical examination of your nose and throat. Your blood pressure and Body Mass Index (BMI) may also be checked. Additional tests like sleep studies may be needed to confirm the diagnosis.

Polysomnography is a sleep study where your heart, lung and brain activity patterns are measured and oxygen levels monitored while you sleep. Nowadays, most patients usually undergo a home sleep study with a portable device. This used to be done as a hospital-warded procedure where you might have to have yourself monitored all night but a home sleep study can now reliably provide enough good quality sleep data to accurately diagnose and detect sleep apnea.

What is the treatment for obstructive sleep apnea?

First and foremost, your ENT doctor will advise on lifestyle modifications. These include losing weight if you are obese, through a diet and regular exercise regimen. Avoiding alcohol and smoking especially prior to bedtime is strongly recommended. Nasal sprays and antihistamines may be prescribed if you have a blocked nose. If sleep apnea persists even after these measures, then personalised treatment measures will be considered to keep the airways open, with a thorough discussion about CPAP, surgery or a special mouthguard.

In CPAP or continuous positive airway pressure, a special machine delivers pressurised air through the nose and mouth via a fitted mask while the individual is sleeping. These devices help to keep the upper airway passages open while air is continuously pumped in. This prevents the symptoms of snoring and sleep apnea. This is the most widely used method to treat obstructive sleep apnea, but it may not suit everyone. Some people find it uncomfortable and may not attain the right fit. It is important to try different nasal or face masks to find the right fit. Talk to your ENT doctor to check on what suits you the best.

Alternatives to CPAP machines are oral devices or mouthpieces which help to keep the throat open during mild to moderate conditions. Some devices hold the tongue in a different position. Nasal pillow masks are another option if you feel claustrophobic in masks that cover the entire face. Close follow-up helps to achieve successful treatment in patients with obstructive sleep apnea.

If none of these conservative methods work, then your sleep apnea specialist will suggest surgery where excess throat tissue will be removed in a procedure called Uvulopalatopharyngoplasty (UPPP). For very severe cases, upper airway stimulation is another method where an impulse generator detects breathing patterns and controls tongue movement but this is rarely used in clinical practice.

There are many treatment options for obstructive sleep apnea. What is important is to meet an experienced ENT physician without delay and discuss a treatment plan if you are diagnosed with sleep apnea. Dr. Annabelle Leong specialises in treating sleep apnea in Singapore and is a great ENT doctor to visit if you are suffering from sleep apnea.

Health

The Scientist as Storyteller: How Steven Quay Makes Complex Medicine Relatable

Published

1 month ago

July 23, 2025

Michelle Langton

Scientific discovery often struggles to reach the people it is meant to serve. The distance between research and public understanding can be vast. For most scientists, publishing in peer-reviewed journals is the endpoint. For Dr. Steven Quay, it is only the beginning. His career has been defined not just by what he has discovered, but by how he communicates it.

Scientific trust today faces growing skepticism and misinformation spreads faster than facts, Quay has embraced a rare role. He is both a scientist and a storyteller. His ability to bridge the technical and the human is what makes his voice resonate across disciplines, institutions, and communities.

Writing as a Lens into the Human Side of Science

One of the clearest examples of Quay’s narrative instinct lies in his writing. He has authored three major books, each rooted in a different part of his life and expertise. Together, they show how a medical researcher can also be an accessible public thinker.

In Stay Safe: A Physician’s Guide to Survive Coronavirus, published June 5, 2020, during the first days of the pandemic, Quay offered plainspoken, evidence-based guidance on protecting oneself and one’s family. It was not framed as a political statement or a policy directive. It was personal and grounded in the daily realities people faced. He wrote it not just as a scientist, but as someone who wanted to help others navigate a frightening time with clarity and calm.

His second book, The Origin of the Virus, tackled a more complex and controversial subject: the question of how SARS-CoV-2 emerged. Rather than speculate, Quay walked readers through the scientific evidence with the kind of transparency that is often lacking in public discourse. The tone was methodical, never alarmist. What set the book apart was its balance, engaging to a lay reader, yet rigorous enough to be taken seriously by professionals.

Then there is A Ride Through Northville, a deeply personal departure from the world of virology and oncology. Here, Quay revisits his childhood in Michigan, capturing the streets, friendships, and quiet moments that shaped him long before he entered a lab. The structure of the book mimics the experience of riding a bike through town, evoking memory not as a chronology, but as a sensory journey. For a scientist whose career has involved high-stakes research and global debates, this book offers a rare window into the reflective, grounded person behind the work.

Speaking Clearly Without Speaking Down

Quay’s communication skill is not limited to the written word. He has also become a frequent guest on health-focused podcasts and a speaker at public science forums. His TEDx talk on breast cancer prevention is one of the most viewed videos on the subject, and for good reason. He does not rely on drama or abstract theory. Instead, he explains mammographic density, hormonal risk, and clinical trial design in a way that makes the science both comprehensible and actionable.

In interviews, Quay has a habit of slowing things down. He avoids jargon unless he defines it. He is comfortable saying, “We don’t know yet,” which, in the realm of public science, is a kind of honesty that builds trust. He often discusses Atossa Therapeutics’ trials in plain terms, describing how experimental drugs like (Z)-endoxifen might help certain patients respond better to treatment. He emphasizes that these are ongoing studies, not marketing pitches, which sets him apart from many biotech executives.

Educating the Public Without Oversimplifying

One of the challenges of public-facing science is resisting the urge to oversimplify. Many well-intentioned scientists flatten complexity to fit the constraints of social media or mainstream news. Quay does not follow that path. He explains mechanisms and hypotheses with nuance, trusting that readers and listeners are capable of understanding more than they are often given credit for.

His social media presence reflects the same philosophy. He shares articles and research updates, but rarely with alarm or bravado. When he comments on current medical debates, he tends to lead with evidence rather than opinion. That steady tone has earned him a following that spans across ideological and professional divides.

During the pandemic, this approach stood out. While others chased headlines, Quay focused on distilling evolving guidance into practical advice. He acknowledged the limits of current knowledge, updated his views as new data emerged, and emphasized science as an iterative process. His voice became one that many people turned to not for certainty, but for clarity.

A Scientist’s Responsibility Beyond the Lab

Quay has often said that science does not exist in isolation. It is part of society. That belief informs why he writes, speaks, and engages in public discourse as actively as he does. He sees the scientist’s role not just as a producer of knowledge, but as a custodian of its meaning.

He has testified before the U.S. Congress and advised the State Department, not as a politician but as a physician-scientist committed to accuracy. In each case, his contribution has been grounded in data but shaped by a recognition of the human implications of policy and research.

This is especially evident in his work on breast cancer. By advocating for better screening tools and more personalized treatments, Quay speaks not only to clinicians and investors but to women facing real fears about their health. He explains the science behind mammographic density and hormonal modulation not just with charts, but with stories about what those risks mean in someone’s life.

Storytelling as a Form of Service

What makes Quay’s communication style compelling is that it never feels performative. He is not branding himself or building a media empire. He is doing what he believes scientists should do: make their work useful.

In every form of his storytelling, from the deeply personal to the technically specific, there is a throughline of responsibility. He understands that science touches people’s lives in ways that go far beyond the lab. For him, that means speaking clearly, writing honestly, and never underestimating the audience.