Sleep Apnea

Sleep apnea is a common disorder in which breathing repeatedly stops and starts during sleep. Untreated, it can cause daytime sleepiness, high blood pressure, and a higher risk of heart problems.

Table of Contents

Quick Facts

  • Type: Sleep-related breathing disorder
  • ICD-10: G47.3
  • Most common form: Obstructive sleep apnea (OSA)
  • Main treatment: CPAP therapy

Overview

Sleep apnea is a sleep disorder characterized by repeated interruptions in breathing during sleep. Each pause may last from a few seconds to over a minute and can occur dozens or hundreds of times per night. These interruptions fragment sleep and lower oxygen levels in the blood.

The most common form is obstructive sleep apnea (OSA), in which the throat muscles relax and block the airway. Central sleep apnea, less common, occurs when the brain doesn't send the right signals to the muscles that control breathing.

Types of Sleep Apnea

  • Obstructive sleep apnea (OSA) — the airway physically collapses or becomes blocked during sleep.
  • Central sleep apnea — the brain temporarily stops sending breathing signals.
  • Complex (mixed) sleep apnea — features of both obstructive and central types.

Symptoms

Symptoms during sleep (often noticed by a bed partner)

  • Loud, chronic snoring
  • Witnessed pauses in breathing followed by gasping or choking
  • Restless sleep, frequent awakening
  • Night sweats

Daytime symptoms

  • Excessive daytime sleepiness
  • Morning headache
  • Difficulty concentrating
  • Irritability or low mood
  • Dry mouth or sore throat on waking

Causes

In obstructive sleep apnea, the throat muscles relax during sleep and the soft tissues at the back of the throat — including the tongue and soft palate — partially or fully block the airway. In central sleep apnea, the breathing control centers in the brainstem briefly fail to trigger inhalation.

Risk Factors

  • Excess weight (a major risk factor for OSA)
  • Large neck circumference
  • Narrowed airway anatomy
  • Male sex
  • Older age
  • Family history of sleep apnea
  • Alcohol, sedatives, or tranquilizer use
  • Smoking
  • Nasal congestion
  • Heart failure or stroke (for central sleep apnea)

Diagnosis

Diagnosis is based on symptoms plus an objective sleep study.

  • Polysomnography (in-lab sleep study) — the gold standard; records breathing, oxygen levels, brain activity, and movements overnight.
  • Home sleep apnea test — a simpler at-home recording for selected patients.
  • Apnea–Hypopnea Index (AHI) — the number of breathing events per hour; categorizes severity.

Treatment

Lifestyle measures

  • Weight loss (often the most impactful for mild-to-moderate OSA)
  • Avoid alcohol and sedatives close to bedtime
  • Sleep on your side rather than your back
  • Treat nasal congestion

Medical devices

  • CPAP (continuous positive airway pressure) — the first-line treatment for moderate-to-severe OSA; a mask delivers gentle air pressure to keep the airway open.
  • BiPAP (bilevel positive airway pressure) — used when CPAP is not well tolerated or in some central apnea cases.
  • Adaptive servo-ventilation (ASV) — for certain central apnea patterns.
  • Oral appliances — repositioning the jaw to keep the airway open, for milder cases.

Surgical and other options

  • Upper airway surgery (e.g., uvulopalatopharyngoplasty)
  • Hypoglossal nerve stimulator implants
  • Treatment of underlying conditions (heart failure, hypothyroidism)

Prevention

  • Maintain a healthy weight
  • Exercise regularly
  • Limit alcohol
  • Don't smoke
  • Treat allergies or chronic nasal congestion

When to See a Doctor

  • Loud snoring with pauses or gasping reported by a partner
  • Persistent daytime sleepiness despite adequate sleep time
  • Morning headaches or unrefreshing sleep
  • Falling asleep during routine activities (e.g., driving — seek prompt care)

Related Conditions

Obstructive Sleep Apnea

The most common form of sleep apnea

 Insomnia

Difficulty falling or staying asleep

 High Blood Pressure

Often worsened by untreated sleep apnea

 Heart Disease

Risk increased by untreated sleep apnea

Frequently Asked Questions

Can sleep apnea kill you?

Severe untreated sleep apnea is associated with higher rates of heart attack, stroke, and accidents from drowsy driving. While dying directly from an apnea event during sleep is rare in otherwise healthy people, the long-term cardiovascular risk is significant.

Do I have to wear a CPAP forever?

If your sleep apnea is caused by weight or another reversible factor, treating that cause can improve or even resolve it. For many people, however, CPAP is an ongoing treatment that prevents complications as long as it's used.

Why does sleep apnea cause high blood pressure?

Each apnea event briefly lowers blood oxygen and triggers a stress response that raises blood pressure. Repeated cycles, night after night, contribute to chronic hypertension.

Can children have sleep apnea?

Yes. Enlarged tonsils and adenoids are the most common cause in children. Treatment often involves their removal.

Does losing weight cure sleep apnea?

Weight loss can substantially reduce severity and sometimes resolve mild OSA, but more severe cases often need ongoing treatment even after weight loss.

Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. If you are experiencing a medical emergency, call your local emergency number immediately.

References

  • American Academy of Sleep Medicine. International Classification of Sleep Disorders.
  • National Heart, Lung, and Blood Institute. Sleep Apnea.
  • Mayo Clinic. Sleep apnea — Symptoms and causes.