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A restful night’s sleep is vital to a healthy lifestyle but an Indiana physician said most Americans are not getting enough of it and are setting the stage for more long-term serious health conditions.

America's Health Rankings reports nearly 38 percent of Hoosier adults sleep less than seven hours in a 24-hour period. Sleep apnea causes multiple breathing pauses during sleep. It is caused by a partially or completely blocked airway.

Doctors determine levels using the Apnea-Hypopnea Index or AHI, calculating the number of pauses per hour of sleep. A normal AHI for an adult is 5 per hour, and 30 indicates obstructive sleep apnea, or OSA, the most severe form.

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Dr. Harish Rao, associate professor in clinical pediatrics at the Indiana School of Medicine and associate director of the pediatric sleep program at Riley Hospital for Children, described the frequently undiagnosed telltale signs.

"Loud snoring, choking, gasping during sleep," Rao outlined. "They may have excessive daytime fatigue, sleepiness, waking up with headaches in the morning, difficulty concentrating."

Rao explained a bidirectional relationship occurs between obstructive sleep apnea and diabetes. Sleep apnea can contribute to weight gain, which in turn can worsen sleep apnea. A Science Health Daily study found inconsistent bedtimes and a disruption of the body’s internal sleep-wake cycle are tied to higher risks for circulatory disorders, liver cirrhosis, gangrene, high blood pressure and heart disease.

Rao noted obstructive sleep apnea is common in children with large tonsils and adenoids. For children, a normal AHI is 1, while 10 per hour is considered severe. Pediatric obesity rates are increasing, with more cases documented in the first decade of a child’s life. A popular diabetic medication has been shown to help with sleep disorders linked to weight gain, but the Food and Drug Administration has not approved the drug for use by anyone under age 18.

"A lot of studies have shown if you lose a significant amount of weight, your sleep apnea gets better and that was the rationale in getting FDA approval for treating sleep apnea," Rao observed. "There's a medication called Zepbound. So you start Zepbound to lose weight, and that reduces OSA."

Rao pointed out any risk related to sleep apnea can be reduced with the use of a continuous positive airway pressure, or CPAP machine. Rao added a delay in a sleep disorder diagnosis occurs more in underserved populations, especially communities of color.