When a person has sleep apnea, their breathing repeatedly stops and starts during sleep. Symptoms include daytime sleepiness, loud snoring, and restless sleep.
Most people with sleep apnea have obstructive sleep apnea (OSA). This happens when there is a physical blockage in the upper airway. Another type, central sleep apnea (CSA), is due to a signaling problem in the nervous system.
When the airway closes, or the signal is held up, the person will stop breathing. This will happen temporarily but repeatedly during sleep. When they breathe again, they may snort, take a deep breath, or awaken completely with a sensation of gasping, smothering, or choking.
Here, learn more about the symptoms, causes, when to see a doctor, and treatment options.
A person with sleep apnea may be unaware of their symptoms, but another person may notice that while sleeping the person:
- stops breathing for a while, followed by a noisy breath
- gasps for air
- snores loudly
The individual may notice that they experience:
- restless sleep or insomnia
- difficulty concentrating
- waking up several times a night to urinate
- awakening with a dry mouth or sore throat
- decreased libido and erectile dysfunction
Treatment aims to normalize breathing during sleep and address any underlying health problems. The options will depend on the cause and severity of symptoms.
Lifestyle modifications are essential to normalizing breathing and are critical first steps in treatment.
- following a heart-healthy diet
- developing healthy sleeping habits
- limiting alcohol consumption
- quitting smoking
- managing weight
- sleeping on the side
Other treatment options include:
Continuous positive airway pressure (CPAP) therapy
This is the main treatment for sleep apnea. It keeps the airway open by gently providing a constant stream of positive pressure air through a mask.
Some people have trouble using CPAP and stop the treatment before achieving any lasting benefit. However, many measures can help make the equipment more comfortable, and the adjustment period smooth.
A person can adjust the mask and its settings. Adding moisture to the air as it flows through the mask can relieve nasal symptoms.
Various surgical procedures can widen the airway in people with OSA. Surgery can stiffen or shrink obstructing tissue, or remove excess tissue or enlarged tonsils.
Depending on the extent of the surgery, the person may undergo the procedure in a doctor’s office or a hospital.
Mandibular repositioning device (MRD)
This is a custom-made oral appliance suitable for individuals with mild or moderate OSA.
The mouthpiece holds the jaw in a forward position during sleep to expand the space behind the tongue. This helps keep the upper airway open, preventing apnea and snoring.
Side effects of an MRD may include jaw or tooth pain, and potential aggravation of temporomandibular joint disease.
Some drugs may help with CSA but should only be used after consultation with a sleep specialist. Examples include:
However, these may have severe adverse effects and may not be suitable for everyone.
Various factors can contribute to the blocking or collapse of the airway. They include the following:
- lax muscles and other tissues in the mouth and throat
- nasal congestion
- thickened tissues and additional fat stores around the airway
- an underlying neurological problem
These can result from:
- genetic factors
- colds and allergies
- thyroid problems
- heart or kidney failure
- large or swollen tonsils
Infants born preterm may have sleep apnea, but this usually resolves with age.
Risk factors for sleep apnea include:
- older age
- alcohol consumption
- nasal congestion
- thyroid and hormonal problems
- a large neck circumference
- large tonsils or adenoids
- Down syndrome
- family history of sleep apnea
- recessed chin or large overbite
In the United States, Black people, Hispanic people, and Native Americans are more likely to have sleep apnea than white people.
A 2020 study suggests that inflammation may play a role in sleep apnea.
Experts have linked CSA with the following:
- diseases that affect the central nervous system, such as encephalitis
- neurological and kidney disorders
- heart failure
- acclimatizing to high altitude
- use of opioids and other depressant drugs
- recent ascent to high altitude
- the use of pain relief medication
Sleep apnea may increase the risk of the following:
- asthma symptoms
- atrial fibrillation
- chronic kidney disease
- ability to focus, memory problems, and other cognitive functions
- cardiovascular problems due to a reduced oxygen supply
- pregnancy complications
- eye disorders, such as glaucoma
- metabolic syndrome, including type 2 diabetes and hypertension
The link between the conditions is not always clear, but a person with sleep apnea should seek medical advice, as it may indicate an underlying problem.
The individual may not know that they have sleep apnea, but a sleeping partner or other household member may notice it and can let them know.
Anyone who feels persistently tired or groggy during the day should consult a medical provider to find out why and take steps to address the problem.
The medical provider may start by asking a number of questions, such as:
- What is your typical sleep schedule on weekdays and weekends?
- How long does it take you to fall asleep?
- Are you taking any medications to help you sleep?
- How much sleep do you think you get each night?
- Has anyone told you that you snore?
- Do you wake up with a feeling of panic or jolt awake?
- How do you feel when you wake up?
- Do you fall asleep while watching television or reading?
- Does anyone in your immediate family have a diagnosed sleep disorder?
- What is your sleep environment like?
Next, the doctor may recommend a sleep study. The person may sleep overnight at a sleep laboratory while special equipment records brain waves, eye and leg movements, oxygen levels, airflow, and heart rhythm. A sleep specialist will then interprets the results.
Some people can do the test at home. However, if a doctor suspects that a person may have an underlying health condition, they will recommend an in-lab sleep study.
Sleep apnea is a common problem that causes people’s breathing to pause during sleep. It can lead to fatigue and difficulty focusing, and it may be a sign of an underlying condition.
Often a person does not know they have sleep apnea, but someone who lives with them will notice.
Anyone who experiences daytime sleepiness should see a doctor, who can help them find out the reason and the steps to take to solve it.