What Is Sleep Apnea?

Reviewed by: HU Medical Review Board | Last reviewed: June 2020

Obstructive sleep apnea is the most common sleep disorder related to breathing. With sleep apnea, breathing is interrupted for short periods while a person sleeps. These periods last for at least 10 seconds. People with sleep apnea tend to snore loudly and make gasping or choking noises in their sleep.1-3

Sleep apnea causes low oxygen levels in the blood and poor sleep. Left untreated, this combination can lead to high blood pressure, heart disease, diabetes, kidney disease, depression, and more.4

How common is sleep apnea?

In the United States, about 30 million people have sleep apnea. While obstructive sleep apnea is more common in men and people who are older, even children can have sleep apnea.2,5

Types of sleep apnea

There are a few types of sleep-related breathing disorders, or breathing problems that happen while you sleep, including:6

  • Obstructive sleep apnea – a temporary stop in breathing during sleep caused by tissue blocking the airway. It causes heavy snoring, choking, and gasps while sleeping. This is the most common sleep-related breathing disorder.
  • Central sleep apnea – a temporary stop in breathing during sleep caused when the heart or brain does not send a signal to breathe.
  • Sleep-related hypoventilation disorders – low blood oxygen levels during sleep from shallow breathing.

What causes obstructive sleep apnea?

When you sleep, the muscles in the upper airway relax. This causes the tissues in the back of the throat to collapse or the tongue to fall back. This limits the amount of air reaching your lungs. Snoring is caused by the tissue moving back and forth as you breathe.

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People who may have a greater risk of developing sleep apnea include:7

  • A small airway, large tongue, or large tonsils
  • A recessed chin, small jaw, or large overbite
  • Large neck (over 17 inches for men, 16 inches for women)
  • Smoke or drink alcohol
  • Over age 40
  • African Americans, Pacific Islanders, Asians, and Hispanics

What are the symptoms of sleep apnea?

People with sleep apnea often wake up feeling tired even after a full 7 to 9 hours of sleep. Other signs of sleep apnea include:7

  • Daytime sleepiness, fatigue
  • Morning headaches
  • Need to pee in the night
  • Insomnia

Many people are unaware they have a problem until a sleep partner reports that they snore, choke, gasp, or stop breathing during sleep.

How is sleep apnea diagnosed?

To diagnose you with sleep apnea, your doctor will conduct a physical exam and take your medical history first. This is done to make sure your symptoms are not caused by a health condition. Your doctor may also ask you questions from the STOP-Bang test or Epworth Sleepiness Scale.7

A home sleep apnea test or laboratory sleep study will also be needed to diagnose sleep apnea. A home study may be an alternative for people who do not have a complicated case or who may have moderate to severe sleep apnea. A full lab test at a sleep clinic is called polysomnography. It may be needed for people in certain jobs or if your doctor suspects you have more than 1 sleep disorder. Your insurance coverage may play a role in which test you get.7

Treatments for sleep apnea

Sleep apnea can be treated with a combination of lifestyle changes, devices to help breathing, and sometimes surgery.

Lifestyle changes

Lifestyle changes include losing weight, changing sleep positions, and avoiding alcohol and any drugs that may make sleep apnea worse. Exercise can also improve sleep apnea, even without weight loss.8

Devices and oral appliances

Continuous positive airway pressure (CPAP) machines gently force air through a mask and into your airway. These machines are the main treatment for most obstructive sleep apnea. There are other types of positive airway pressure machines, but CPAP is the one most often used.8,9

Dental appliances are devices you put in your mouth to keep your airway open.8,10

Surgery

Surgery may be recommended if a person has a lesion, tonsils, adenoids, or birth defect that partly blocks the airway.8

Hypoglossal nerve stimulator is a device that moves your tongue forward while you sleep and keeps your airway open. It requires surgery.11

Medications

While many drugs have been tested, none have been found to improve sleep apnea better than the CPAP machine, dental appliances, hypoglossal nerve stimulation, surgery, or weight loss.8