What is Sleep Apnea?
Sleep apnea is a sleep disorder characterized by repeated interruptions in breathing during sleep. Common symptoms include:
- Loud snoring (though not everyone who snores has sleep apnea)
- Feeling tired or fatigued during the day
- Poor quality or non-restorative sleep
- Memory problems or mood changes
Doctors diagnose sleep apnea through a physical exam and a sleep study (polysomnography), often performed in a clinic or hospital. This test measures heart, lung, and brain activity during sleep.
Types of Sleep Apnea
Obstructive Sleep Apnea (OSA)
Obstructive Sleep Apnea is the most common type. It occurs when throat muscles relax excessively, causing a blockage in the airway. The affected muscles include:
- Muscles at the back of the throat
- The front part of the tongue
- The uvula (the tissue hanging from the soft palate)
- Tonsils
- Side walls of the throat
When these muscles relax, airflow is restricted, and breathing can slow or stop for 10 seconds or longer. This leads to lower oxygen levels and a buildup of carbon dioxide. The brain senses this and briefly wakes you up to reopen the airway, though you may not remember these awakenings. This cycle can repeat many times per hour, resulting in shallow, unrestful sleep.
Symptoms of OSA can be severe and may include high blood pressure and heart disease. Daytime drowsiness can also affect activities that require alertness, such as driving or operating machinery.
Risk factors for OSA include:
- Being overweight
- Having a thick neck circumference
- Older age
- Male gender
- Enlarged tonsils, a snub-nosed shape, or a narrowed throat
- Pregnancy
If you have these risk factors, it is important to seek evaluation and treatment.
Central Sleep Apnea (CSA)
Central Sleep Apnea occurs when the brain fails to send the proper signals to the muscles that control breathing. Unlike OSA, there is no physical blockage of the airway. Instead, the issue is with the communication between the brain and the breathing muscles.
CSA leads to brief interruptions in breathing, causing fragmented and shallow sleep. This can result in daytime fatigue, difficulty concentrating, and, if untreated, increased risk of heart disease and high blood pressure.
Common symptoms include:
- Loud snoring
- Pauses in breathing
- Gasping for air during sleep
- Daytime tiredness
According to Johns Hopkins Medicine, people with CSA may stop breathing up to 30 times per hour.
Risk factors for CSA include:
- Severe obesity
- Medical conditions such as heart failure, diabetes, Parkinson’s disease, or history of stroke
- Use of opioids or benzodiazepines
- High altitude
Diagnosis is typically made using overnight polysomnography at a sleep center, which measures oxygen levels, brain activity, and chest and abdominal movements. A CPAP titration study may also be performed to determine the most effective treatment pressure.
Complex Sleep Apnea
Complex sleep apnea, also known as treatment-emergent central sleep apnea, occurs when both obstructive and central sleep apnea features are present. This can happen when the brain fails to send regular signals to breathing muscles, often triggered by:
- Low oxygen levels at high altitudes
- Certain medications
- Neurological conditions such as ALS (amyotrophic lateral sclerosis)
- Stopping CPAP therapy after treating OSA
People with complex sleep apnea often snore loudly, wake up feeling very tired, and face increased risks for heart attack, stroke, high blood pressure, and diabetes.
Untreated sleep apnea can increase the risk of accidents. Organizations such as the FMCSA and Federal Railroad Administration have called for screening requirements to detect sleep apnea among professional drivers and conductors.
The National Center for Complementary and Alternative Medicine (NCCIH) and the American Sleep Apnea Association offer resources on sleep apnea treatments and advocacy programs.
Treatment Options
Treatment for sleep apnea depends on the type and severity of the condition. Options include:
- Lifestyle changes: Weight loss, avoiding alcohol, and quitting smoking
- Breathing devices: CPAP (continuous positive airway pressure) or other oral appliances
- Surgery: Procedures to remove or reposition tissue, or reconstruct the jaw or throat
- Targeted exercises: Strengthening tongue and facial muscles
- Nerve stimulation: Implanted devices that help keep the airway open
Your doctor will recommend a treatment plan after a thorough evaluation and sleep study.
Obstructive Sleep Apnea (OSA) is the most common form, often resulting in repeated breathing interruptions of 10 seconds or more, sometimes occurring over 100 times per hour. This can lead to low oxygen levels, frequent awakenings, and increased risk for heart disease, stroke, high blood pressure, obesity, diabetes, depression, and accidents.
Central Sleep Apnea (CSA) is less common and is caused by the brain not sending the right signals to the breathing muscles, which can also contribute to heart disease and stroke.
Frequently Asked Questions
What are the main symptoms of sleep apnea?
The main symptoms include loud snoring, frequent pauses in breathing during sleep, gasping for air, daytime fatigue, and difficulty concentrating.
How is sleep apnea diagnosed?
Doctors diagnose sleep apnea through a physical exam and a sleep study (polysomnography), which monitors breathing, heart rate, oxygen levels, and brain activity during sleep.
What are the risks if sleep apnea is left untreated?
Untreated sleep apnea can increase the risk of heart disease, high blood pressure, stroke, type 2 diabetes, depression, and accidents due to daytime sleepiness.
What lifestyle changes can help with sleep apnea?
Losing weight, quitting smoking, reducing alcohol intake, and sleeping on your side can help reduce sleep apnea symptoms.
Are there different types of sleep apnea?
Yes. The main types are Obstructive Sleep Apnea (OSA), Central Sleep Apnea (CSA), and Complex Sleep Apnea, which combines features of both OSA and CSA.
Is sleep apnea common in 2026?
Sleep apnea continues to be a common and serious health issue in 2026, affecting millions of adults worldwide.
