It certainly wasn’t the only factor in her death, but it’s a health issue that often goes under the radar.

As the Los Angeles County coroner’s office announced late last week, sleep apnea and a combination of other factors contributed to Carrie Fisher’s death in December. Sleep apnea certainly wasn’t the only factor in her death — the toxicology report also found cocaine, alcohol, opiates and ecstasy in her system, and per the coroner’s report, Fisher also suffered from heart disease— but it’s an important one to understand.

Fisher, who died at the age of 60, is best remembered for her role as Princess Leia in the Star Wars film series. She was also a tireless advocate for destigmatizing mental illness and addiction, issues she openly struggled with her whole life. Fisher’s death may also shed light on another too-infrequently addressed issue: That of the serious health implications of sleep disorders. Here’s what you should know about sleep apnea.

The Basics on Sleep Apnea
Having sleep apnea means your breathing stops and starts (sometimes hundreds of times) during the night, according to the Cleveland Clinic. There two main types of sleep apnea: Obstructive and central.

As the name implies, obstructive sleep apnea is due to a physical blockage of the airway caused by a collapse of soft tissue in the back of the throat. The more common type of sleep apnea, obstructive sleep apnea causes the diaphragm and chest muscles to work harder to try and open the airway. These episodes — which often wake people up with bodily jerks or gasps — can make it hard to get a good night’s rest, but also “reduce the flow of oxygen to vital organs, and cause heart rhythm irregularities,” according to the Cleveland Clinic.

In central sleep apnea, the airway remains clear but the brain fails to tell the body to breathe because of problems in the respiratory control center. This type of apnea is more common in patients with neuromuscular diseases or heart problems.

The Symptoms
Some common symptoms of sleep apnea include loud snoring, daytime drowsiness, waking up with a feeling like you’re choking as well as cognitive side effects like mood disturbances, forgetfulness and trouble concentrating, according to the Cleveland Clinic. Sleep disorders are hard to diagnose in the first place (most are first noticed by a partner, the Cleveland Clinic points out), but if left untreated sleep apnea can have serious effects including hypertension, stroke, heart problems, obesity and diabetes.

Because of the daytime sleepiness it causes, sleep apnea also poses a safety risk, especially for people with jobs that require operating heavy machinery. In the past few years, sleep apnea has been identified as a factor in a few major train crashes, prompting the New York City MTA to begin screening engineers for the disorder.

Who’s At Risk?
There are a variety of traits that could make you more prone to having sleep apnea: Being a man, being overweight, having sinus issues or a variety of jaw and tonsil issues, which is one of the reasons why dentists can help identify the disorder.

Image courtesy of Unsplash

How Do You Treat It?
If your doctor (or partner) suspects that you have sleep apnea, you’ll have to undergo a sleep study to confirm the diagnosis. That includes staying overnight at a sleep lab while a technician monitors things like eye movement, brain function, heart rate and blood oxygen levels. Treatments for sleep apnea vary depending on the severity, but most often they include the use of a Positive Airway Pressure machine, called PAP for short. These machines help keep your airway open while you sleep as they “gently force air through the nose and/or mouth,” according to the Cleveland Clinic.

Can It Really Kill You?
Research suggests that there’s a fairly strong link between sleep apnea and increased risk of death. A study from the Yale Center for Sleep Medicine in 2005 found that “sleep apnea doubles the risk for the development of stroke and death, and severe sleep apnea more than triples the risk,” lead author H. Klar Yaggi, assistant professor of medicine at Yale, said in the study’s press release. There’s also evidence that sleep apnea can cause heart problems, as this Cleveland Clinic article details. In the article Reena Mehra, MD, director of Sleep Disorders Research in the Sleep Center of the Neurologic Institute at the Cleveland Clinic, said “there is a very strong association between sleep apnea and cardiac arrhythmia,” adding that research shows that repeated episodes of “upper airway collapse in sleep apnea may trigger arrhythmia events.”

While Fisher’s death was a loss for all of us, hopefully it can help spread further awareness about the seriousness of sleep apnea, and encourage you (or your snoring partner) to seek medical help if you need it.

For more information on sleep apnea, head here.

This post has been updated to reflect the full findings of the coroner’s report and toxicology report.

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