Sleep Disorders

Obstructive Sleep Apnea

Sleep apnea is a common condition in the United States. It can occur when the upper airway becomes blocked repeatedly during sleep, reducing or completely stopping airflow. This is known as obstructive sleep apnea. If the brain does not send the signals needed to breathe, the condition may be called central sleep apnea.

Sleep apnea can be caused by a person’s physical structure or medical conditions. These include obesity, large tonsils, endocrine disorders, neuromuscular disorders, heart or kidney failure, certain genetic syndromes, and premature birth.

There are many risk factors for sleep apnea. Some risk factors, such as unhealthy lifestyle habits and environments, can be changed. Other risk factors, such as age, family history and genetics, race and ethnicity, and sex, cannot be changed. Heathy lifestyle changes can decrease your risk for developing sleep apnea.

Drinking alcohol, smoking, and overweight or obesity can increase your risk for sleep apnea. 

  • Alcohol can increase relaxation of the muscles in the mouth and throat, closing the upper airway. It can also affect how the brain controls sleep or the muscles involved in breathing.

  • Smoking can cause inflammation in the upper airway, affecting breathing, or it can affect how the brain controls sleep or the muscles involved in breathing.

  • Unhealthy eating patterns and lack of physical activity can lead to overweight and obesity, which can result in sleep apnea.

 

To screen for sleep apnea, your doctor will review your medical history and symptoms. To prevent sleep apnea, your doctor may recommend healthy lifestyle changes.

To screen for sleep apnea or other sleep disorders, your doctor may ask you about common signs and symptoms of this condition, such as how sleepy you feel during the day or when driving, and whether you or your partner has noticed that you snore, stop breathing, or gasp during your sleep. Your doctor may ask questions to assess your risk for developing this condition and take your physical measurements. Your doctor will also want to see whether you have any complications of undiagnosed sleep apnea, such as high blood pressure that is difficult to control. If the screening suggests a sleep breathing disorder, you may get a referral to a sleep specialist to help confirm a diagnosis.

Common signs of sleep apnea: 

  • Reduced or absent breathing, known as apnea events

  • Frequent loud snoring 

  • Gasping for air during sleep

 

Common symptoms of sleep apnea:

  • Excessive daytime sleepiness and fatigue 

  • Decreases in attention, vigilance, concentration, motor skills, and verbal and visuospatial memory

  • Dry mouth or headaches when waking

  • Sexual dysfunction or decreased libido

  • Waking up often during the night to urinate

Sleep apnea may increase your risk of the following disorders:

  • Asthma

  • Atrial fibrillation

  • Cancers, such as pancreatic, renal, and skin cancers

  • Chronic kidney disease

  • Cognitive and behavioral disorders, such as decreases in attention, vigilance, concentration, motor skills, and verbal and visuospatial memory, as well as dementia in older adults. In children, sleep apnea has been associated with learning disabilities.

  • Diseases of the heart and blood vessels, such as atherosclerosis, heart attacks, heart failure, difficult-to-control high blood pressure, and stroke

  • Eye disorders, such as glaucoma, dry eye, or keratoconus

  • Metabolic disorders, including glucose intolerance and type 2 diabetes

  • Pregnancy complications, including gestational diabetes and gestational high blood pressure, as well as having a baby with low birth weight

 

 

 

Your doctor may diagnose sleep apnea based on your medical history, a physical exam, and results from a sleep study. Before diagnosing you with sleep apnea, your doctor will rule out other medical reasons or conditions that may be causing your signs and symptoms.

Sleep studies can be done in a special center or at home. Studies at a sleep center can:

  • Detect apnea events, which are times when your breathing stops or slows during sleep

  • Detect low or high levels of activity in muscles that control breathing

  • Monitor blood oxygen levels during sleep

  • Monitor brain and heart activity during sleep 

 

Your doctor may be able to diagnose mild, moderate, or severe sleep apnea based on the number of sleep apnea events you have in an hour during the sleep study.

  • Mild: Five to 14 apnea events in an hour 

  • Moderate: 15 to 29 apnea events in an hour

  • Severe: 30 or more apnea events in an hour

 

If you are diagnosed with sleep apnea, your doctor may make recommendations to help you maintain an open airway during sleep. These could include healthy lifestyle changes or a breathing device such as a positive airway pressure (PAP) machine, mouthpiece, or implant. Talk to your doctor. Depending on the type and severity of your sleep apnea and your needs and preferences, other treatments may be possible.

To help control or treat your sleep apnea, your doctor may recommend that you adopt lifelong healthy lifestyle changes.

  • Make heart-healthy eating choices. This also includes limiting your alcohol intake, especially before bedtime.

  • Get regular physical activity.

  • Aim for a healthy weight. Research has shown that losing weight can reduce sleep apnea in people who were also diagnosed with obesity.

  • Develop healthy sleeping habits. Your doctor may recommend general healthy sleep habits, which include getting the recommended amount of sleep based on your age. 

  • Quit smoking. 

A breathing device, such as a CPAP machine, is the most commonly recommended treatment for patients with sleep apnea. If your doctor prescribes a CPAP or other breathing device, be sure to continue your doctor-recommended healthy lifestyle changes.

If you have been diagnosed with sleep apnea, it is important that you adopt and maintain healthy lifestyle habits and use your prescribed treatment. Read more about how to use and care for your breathing device or mouthpiece, how your doctor may monitor whether your treatment is working, and when you may need a repeat sleep study. Learn other tips to keep you safe if you have sleep apnea.

It is important that you properly use and care for your prescribed breathing device or mouthpiece. If your doctor prescribed a breathing device or CPAP machine:

  • Be patient with your breathing device or CPAP machine. It may take time to adjust to breathing with the help of a CPAP machine.

  • Use your breathing device or CPAP machine for all sleep, including naps. To benefit fully from your treatment, you should wear your device whenever and wherever you sleep. If you are traveling, be sure to bring your breathing device with you. Call your doctor or sleep specialist right away if your device stops working correctly. 

  • Talk to your doctor or supplier if you experience discomfort or have difficulty using your prescribed breathing device. Let the team or supplier know if you are having irritation from the mask, if your mask is not staying on or fitting well, if it leaks air, if you are having difficulty falling or staying asleep, if you wake with dry mouth, or if you have a stuffy or runny nose. Your doctor can explore options to improve the treatment, such as trying different masks or nasal pillows, adjusting the machine’s pressure timing and settings, or trying a different breathing device that has a humidifier chamber or provides bi-level or auto-adjusting pressure settings. Cleaning the mask and washing your face before putting your mask on can help make a better seal between the mask and your skin. 

  • Properly care for your breathing device or CPAP machine. Know how to set up and properly clean all parts of your machine. Be sure to refill prescriptions on time for all of the device’s replaceable parts, including the tubes, masks, and air filters. 

  • Properly care for your mouthpiece. If you were prescribed a mouthpiece, ask your dentist how to properly care for it. If it does not fit right or your signs and symptoms do not improve, let your dentist know so that he or she can adjust the device. It is common to feel some discomfort after a device is adjusted until your mouth and facial muscles get used to the new fit.

Side effects of CPAP treatment may include congestion, runny nose, dry mouth, dry eyes, or nosebleeds. If you experience stomach discomfort or bloating, you should stop using your CPAP machine and contact your doctor.

For more information on obstructive sleep apnea, please click to learn more.

Content provided by the National Heart, Lung, and Blood Institute.

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Diagnosis

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