Sleep apnea causes the breathing to repeatedly stop and start during sleep, which can result in low oxygen levels. Symptoms include daytime sleepiness, loud snoring, restless sleep, and more.
Most people with sleep apnea have obstructive sleep apnea (OSA). This occurs 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 signaling issues occur, the person stops breathing. This happens 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.
Untreated sleep apnea may lead to complications such as heart disease and depression. It can also leave a person feeling drowsy, increasing the risk of accidents while driving or working.
Symptoms of sleep apnea
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Someone with sleep apnea may be unaware of their symptoms. However, another person may notice that, while sleeping, the person:
repeatedly stops breathing
gasps for air
snores loudly
The affected individual may experience:
fatigue
restless sleep or insomnia
difficulty concentrating
waking up several times a night to urinate
awakening with a dry mouth or sore throat
headaches
Irritability
What causes sleep apnea?
The underlying cause of sleep apnea may depend on the type that a person has.
Obstructive sleep apnea
Various factors can contribute to the blocking or collapse of the airway in OSA, including:
structural issues, such as a large tongue or tonsils
large fat deposits in the neck
changes to the size and shape of the face due to hormonal issues, such as polycystic ovary syndrome
fluid buildup in the neck due to kidney or heart failure
relaxed muscles in the throat and mouth
Central sleep apnea
CSA occurs due to an interruption of signaling in the brain that tells a person to breathe. Potential causes include:
heart failure
stroke
myasthenia gravis
Infants born preterm may have CSA, but this usually resolves with age.
Risk factors for sleep apnea
A 2024 review highlights the following risk factors for sleep apnea:
overweight and obesity
age over 40 years
a thick neck circumference
family history of sleep apnea
smoking and alcohol consumption
use of sedatives and tranquilizers
chronic nasal congestion
How do doctors diagnose sleep apnea?
To diagnose sleep apnea, a healthcare professional will typically start with a physical exam to rule out any other potential underlying conditions. They will also ask about a person’s symptoms.
If they suspect sleep apnea, they may refer the person to a sleep clinic where they can have a sleep study.
During a sleep study, a device records a person overnight, measuring factors such as their:
brain waves
eye and leg movements
oxygen levels
airflow
heart rhythm
A sleep specialist then interprets the results.
Some people can do the test at home. Research in a 2022 study suggests home testing with the same test devices can be as good as laboratory testing for sleep apnea.
However, if a doctor suspects a person may have an underlying health condition, they may recommend an in-lab sleep study.
Treatment and management
Treatment for sleep apnea aims to regulate breathing during sleep and address any underlying health problems. The options will depend on the cause and severity of symptoms, but may include:
Breathing devices: Devices such as a continuous positive airway pressure (CPAP) machine, which keeps the airway open by gently providing a constant stream of positive pressure air through a mask, may regulate breathing.
Oral devices: These devices hold the jaw and tongue in certain positions to keep the airways open. Examples include a mandibular repositioning device (MRD).
Facial therapy: Facial therapy involves exercises for the facial and mouth muscles, which may improve airflow.
Medications: If someone has moderate or severe sleep apnea and obesity, they may be able to
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 take the FDA-approved injectable medication tirzepatide (Zepbound) as part of their treatment.
Surgery: Various surgical procedures can widen the airway in people with OSA, including a tonsillectomy or surgery to remove excess tissue from the throat.
Lifestyle changes
Healthcare professionals often recommend lifestyle changes, whether this is alongside other treatments or not. This may include:
maintain or achieve a moderate weight
sleep lying on the side, not the back
limit alcohol consumption
avoid sedative medications
quit smoking, if applicable
When to see a doctor
People with signs of sleep apnea should seek medical advice, as it may indicate an underlying problem. Diagnosis and treatment can also help reduce a person’s risk of complications, which can be severe.
People may not know that they have sleep apnea, but a sleeping partner or other household member may notice it and let them know.
Conclusion
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