Sleep Apnea

Overview

Sleep apnea refers to repeated pauses in breathing, or very shallow breaths, that happen while you sleep. Each pause can last several seconds to a minute and may occur dozens or even hundreds of times a night. The pauses briefly drop the body's oxygen level and pull the brain out of deep sleep, so a person can spend a night in bed yet still wake up unrefreshed.

Because it happens during sleep, many people do not realize they have it. Often a bed partner notices the loud snoring, the silent pauses, and the sudden gasping or choking that ends each pause. Sleep apnea is common and treatable, but when left unaddressed it can contribute to daytime sleepiness, high blood pressure, and other health problems. Recognizing the signs is the first step toward better sleep and lower long-term risk.

Common Causes

There are two main forms of sleep apnea, with different underlying mechanisms:

• Obstructive sleep apnea: The most common type, in which the muscles at the back of the throat relax too much and the airway narrows or collapses during sleep. Excess weight, a large neck, enlarged tonsils, nasal congestion, and the natural relaxation of throat muscles all contribute.
• Central sleep apnea: Less common, in which the brain temporarily fails to send the signals that drive breathing. This can occur with certain heart conditions, after a stroke, or with some medications.
• Mixed apnea: A combination of both types.

Factors that raise the risk include being overweight, older age, being male, alcohol or sedative use before bed, smoking, and a family history of sleep apnea.

Associated Symptoms

Sleep apnea affects both nighttime and daytime well-being. Common associated symptoms include:

• Loud, chronic snoring
• Witnessed pauses in breathing followed by gasping or choking
• Waking suddenly feeling short of breath
• Morning headaches and a dry mouth or sore throat on waking
• Excessive daytime sleepiness, even after a full night in bed
• Trouble concentrating, memory problems, and irritability
• Waking often to urinate during the night

Over time, untreated sleep apnea is linked to high blood pressure, irregular heartbeat, and a higher risk of heart problems, which is why evaluation matters.

Diagnosis & Evaluation

A clinician will ask about your sleep, snoring, and daytime energy, often using a short questionnaire, and may want to speak with your bed partner. Confirming the diagnosis usually involves a sleep study:

• In-lab sleep study (polysomnography): An overnight test that records breathing, oxygen levels, heart rate, brain waves, and movement.
• Home sleep apnea test: A simpler device worn at home that measures breathing and oxygen for suitable cases.
• Examination: Checking the nose, throat, and tonsils for narrowing, and reviewing weight and medical history.

The study measures how many times breathing pauses per hour, which determines whether apnea is mild, moderate, or severe.

Treatment & Management

Treatment aims to keep the airway open and restore steady breathing during sleep.

• CPAP therapy: A continuous positive airway pressure machine delivers a gentle stream of air through a mask to keep the airway open, and is the most effective treatment for moderate to severe obstructive apnea.
• Oral appliances: Custom mouthpieces that hold the jaw forward, helpful for milder cases.
• Lifestyle changes: Weight loss, sleeping on your side, avoiding alcohol and sedatives before bed, and quitting smoking can reduce apnea.
• Treating nasal or throat problems: Managing congestion or removing enlarged tonsils when they contribute.
• Surgery or nerve stimulation devices: Considered when other treatments are not enough.

For central sleep apnea, treating the underlying heart or neurological condition is also key.

Self-Care & Prevention

• Maintain a healthy weight, since even modest weight loss can reduce apnea
• Sleep on your side rather than your back
• Avoid alcohol and sedatives in the evening, which relax throat muscles
• Quit smoking, which inflames and narrows the airway
• Treat nasal congestion and allergies so you can breathe through your nose
• Keep a regular sleep schedule and use CPAP or appliances as prescribed

When to See a Doctor

See a doctor if you snore loudly and feel sleepy during the day, or if a partner has noticed you stop breathing or gasp during sleep. Seek prompt evaluation if you have:

• Witnessed breathing pauses with choking or gasping
• Severe daytime sleepiness that affects driving, work, or safety
• Morning headaches, poor concentration, or mood changes alongside snoring
• High blood pressure or heart problems together with these sleep symptoms

If you ever feel so sleepy that you risk falling asleep while driving, do not drive and arrange evaluation right away.

Related Topics

Frequently Asked Questions

References

1. National Heart, Lung, and Blood Institute (NHLBI). Sleep Apnea.
2. Mayo Clinic. Sleep apnea — Symptoms and causes.
3. American Academy of Sleep Medicine. Obstructive sleep apnea.
4. MedlinePlus, U.S. National Library of Medicine. Sleep apnea.