Dog Sleep Apnea

Most people are aware of some of the sleep disorders that can affect humans, but not many of them carry over into veterinary medicine nor are described in animal studies. Most veterinarians are aware of conditions that dogs may experience such as narcolepsy and insomnia. Sleep apnea, however, is not often discussed, but it turns out it may affect many of our doggie patients! 

In human medicine, sleep apnea is known as a condition where breathing stops and starts again during periods of sleep. Because this pattern of non-breathing can affect the depth of our sleep cycles, people who suffer from sleep apnea cannot fall into deeper stages of sleep known as REM sleep. This results in people feeling tired or restless in the morning, and they may suffer from frequent headaches or moodiness.

There are two different types of sleep apnea. The most common form, obstructive sleep apnea, occurs when the airways collapse or become physically obstructed. During sleep, the muscles around the throat and upper airway relax, resulting in the collapse of soft tissues. People who are overweight are more likely to suffer from this form due to excess fat and soft tissue.

The second form of sleep apnea is known as central sleep apnea. In this form, the brain doesn’t send proper signals to the muscles that control breathing. Underlying health problems like heart disease and kidney failure can cause this, and it can also occur in very young babies for brief periods. Human patients can also experience both forms of sleep apnea.  

Sleep apnea is not a common term that is used in veterinary medicine. However, it can occur due to a number of various conditions. For example, dogs who are overweight or obese can have the same respiratory problems that humans can.

Excess body weight will contribute to more prominent upper airway soft tissues in the throat, and it is harder for dogs to breathe while lying down on one side.

Brachycephalic dogs breeds such as English Bulldogs, Pugs, and French Bulldogs are known to have respiratory problems due to their short snouts. These dog breeds often suffer from narrow nostrils or stenotic nares, and they may have elongated soft palates that can become entrapped by the opening to the airway known as the epiglottis. These abnormalities can cause the obstructive form of sleep apnea, and you may notice that your brachycephalic pup snores a lot or has trouble staying asleep.

Tracheal collapse is another airway disease that occurs when the trachea or windpipe, becomes narrow due to mineralized cartilage rings or sagging soft tissue. Once narrowed, it can significantly affect your dog’s breathing both awake and while asleep due to the trachea becoming partially obstructed. Small breed dogs such as Yorkshire Terriers, Chihuahuas, and Shih Tzus have a higher risk for developing it.

Heart disease can also cause obstructive sleep apnea in dogs. With severe heart disease, the heart muscle becomes grossly enlarged and can push up on the trachea and the mainstem bronchi. Due to this compression, the same kind of turbulence occurs as that seen in patients with tracheal collapse. Your dog may cough more, especially at nighttime.

Another form of obstructive sleep apnea is caused by laryngeal paralysis. The opening to the throat or larynx is controlled by nerves to keep the airway open while breathing and closed while eating and drinking.

When a dog has laryngeal paralysis, the muscles on one or both sides of the larynx become paralyzed and cause the airway to collapse inward. Tumors, trauma, and hormonal disorders can cause this, but there are some cases with unknown or idiopathic causes.

Sleep apnea can be dangerous in dogs. Loud snoring is one of the most common signs. Many dogs can breathe normally during the daytime but brachycephalic dogs have especially noisy breathing! The type of “snoring” sound that they make while awake is known as stertor. 

Dogs with sleep apnea are more prone to waking up during the night or too early from their naps. Lethargy even after a good night’s sleep can be an indicator that your pup isn’t getting proper rest. He may also seem depressed and not appear to be as playful as normal. Also, remember that overweight and obese dogs may at a higher risk for sleep problems. 

The most important thing in treatment is to address the underlying cause, especially since most dogs won’t tolerate wearing a CPAP mask like apneic humans!

If you have a brachycephalic dog, talk to your vet about how severe your pup’s brachycephalic features may be. Dogs with severe brachycephalic syndrome may require surgery to widen their nostrils and remove excess palatal soft tissue. Many dogs who undergo this kind of surgery tend to have markedly improved breathing and sleep patterns.

Overweight and obese dogs should receive a routine, low-impact exercise to help them lose weight. Keep in mind that running or high-impact exercise can be dangerous for them, especially when ambient temperatures are warm. Low calorie or weight loss foods are ideal.

Dogs with lower airway often respond to medical management such as bronchodilator medications and sometimes oral or inhaled steroids to reduce inflammation. You should also consider HEPA filters for your home to reduce respiratory allergens.

Dogs with tracheal collapse can also respond to these therapies, but severe cases may warrant surgical intervention.

Laryngeal paralysis patients often require surgery known as a “tie-back” to help open the collapsed opening to the airway. Surgery is especially warranted if both sides have collapsed. Some veterinarians have had success using a medication called doxepin in cases where anesthesia is contraindicated.

Sleep apnea is not often discussed in veterinary medicine, but when it comes to many of the airway disorders described in scientific literature, it makes sense that obstructive sleep apnea is a common side effect. By addressing your concerns with your veterinarian, you can help your pup feel better and get back to having a good night’s sleep!