What is Sleep Apnea?
Sleep apnea is a common sleep disorder characterized by repeated interruptions in breathing during sleep. These interruptions can lead to poor-quality, non-restorative sleep and a range of health issues.
Common Symptoms of Sleep Apnea
- Loud snoring (not everyone who snores has sleep apnea)
- Daytime fatigue and sleepiness
- Memory problems or difficulty concentrating
- Mood changes such as irritability or depression
- Pauses in breathing or gasping for air during sleep
How is Sleep Apnea Diagnosed?
Doctors typically diagnose sleep apnea using a combination of a physical examination and a sleep study (polysomnography). Sleep studies are conducted in a clinic or hospital and measure heart, lung, and brain activity during sleep.
Types of Sleep Apnea
Obstructive Sleep Apnea (OSA)
Obstructive Sleep Apnea (OSA) is the most common type of sleep apnea. It occurs when the muscles in the throat relax excessively, narrowing or blocking the airway. This can involve the muscles in the back of the throat, the tongue, the uvula (the tissue hanging from the soft palate), tonsils, and the side walls of the throat.
When these muscles relax, airflow is restricted, causing breathing to slow or stop for 10 seconds or longer. This leads to decreased oxygen levels and increased carbon dioxide in the blood. The brain senses this and briefly wakes you to reopen the airway, often without your awareness. This cycle can repeat many times each hour, resulting in fragmented, shallow sleep.
OSA increases the risk of severe health problems, including:
- High blood pressure
- Heart disease
- Impaired alertness, affecting activities like driving or operating machinery
Risk factors for OSA include:
- Being overweight
- Having a thick neck circumference
- Older age
- Male gender
- Physical features such as a snub-nosed profile, enlarged tonsils, or a narrowed throat
- Pregnancy
Central Sleep Apnea (CSA)
Central Sleep Apnea is less common and occurs when the brain fails to send the correct signals to the muscles that control breathing. Unlike OSA, there is no physical blockage of the airway; instead, the problem lies in the communication between the brain and the respiratory muscles.
Symptoms of CSA include:
- Loud snoring
- Intermittent pauses in breathing
- Gasping for air during sleep
- Daytime fatigue
According to Johns Hopkins Medicine, people with CSA can stop breathing up to 30 times per hour.
Risk factors for CSA include:
- Severe obesity
- Heart failure or other heart conditions
- Diabetes
- Parkinson’s disease
- Stroke
- Use of opioids or benzodiazepines
- High altitude
Diagnosis is typically confirmed with overnight polysomnography, which records oxygen levels, brain activity, and chest and abdominal movements. A CPAP titration study may also be performed to determine the optimal pressure for treatment.
Complex Sleep Apnea
Complex Sleep Apnea (also called treatment-emergent central sleep apnea) is a combination of obstructive and central sleep apnea. It often develops when someone with OSA starts using CPAP therapy and then begins to experience central apneas.
Causes can include:
- Low oxygen levels at high altitudes
- Certain medications
- Neurological conditions such as ALS (Lou Gehrig's disease)
- Stopping CPAP therapy after treating OSA
People with complex sleep apnea may experience loud snoring, severe daytime fatigue, and are at increased risk for heart attack, stroke, high blood pressure, and diabetes.
Untreated sleep apnea increases the risk of accidents. Studies in 2026 continue to show that sleep apnea contributes to truck and train crashes, prompting organizations like the FMCSA and Federal Railroad Administration to advocate for screening among drivers and conductors.
For more information on sleep apnea treatment and advocacy, the National Center for Complementary and Integrative Health (NCCIH) and the American Sleep Apnea Association offer helpful resources and education.
Treatment Options for Sleep Apnea
Treatment depends on the type and severity of sleep apnea. After a sleep study, your doctor may recommend one or more of the following:
- Lifestyle changes (weight loss, avoiding alcohol, quitting smoking)
- Breathing devices (such as CPAP or BiPAP machines)
- Oral appliances to keep the airway open
- Surgery to remove or alter tissue in the throat or jaw
- Targeted exercises for the tongue and facial muscles
- Implanted nerve stimulators to activate airway muscles
Obstructive Sleep Apnea is the most common form, caused by airway blockage that can result in hundreds of breathing interruptions per night. Over time, untreated OSA can contribute to heart disease, stroke, high blood pressure, obesity, diabetes, depression, irritability, and increased accident risk.
Central Sleep Apnea is less common and results from the brain not sending proper signals to the breathing muscles, which can also lead to heart disease and stroke.
Weight loss, limiting alcohol, and quitting smoking are especially effective for chronic sleep apnea. In some cases, surgery or nerve stimulation devices may be recommended.
Frequently Asked Questions
What are the main types of sleep apnea?
The three main types are Obstructive Sleep Apnea (OSA), Central Sleep Apnea (CSA), and Complex Sleep Apnea. OSA involves physical airway blockage, CSA involves brain signaling issues, and Complex Sleep Apnea is a combination of both.
What are the most common symptoms of sleep apnea?
Common symptoms include loud snoring, pauses in breathing during sleep, gasping for air, excessive daytime sleepiness, memory issues, and mood changes.
How is sleep apnea diagnosed?
Sleep apnea is diagnosed through a physical exam and a sleep study (polysomnography) that monitors breathing, heart rate, oxygen levels, and brain activity during sleep.
What are the health risks of untreated sleep apnea?
Untreated sleep apnea can lead to high blood pressure, heart disease, stroke, diabetes, depression, and an increased risk of accidents due to daytime fatigue.
What are the treatment options for sleep apnea in 2026?
Treatment options include lifestyle changes, CPAP or other breathing devices, oral appliances, surgery, and nerve stimulation devices. The best treatment depends on the type and severity of sleep apnea and should be determined by a healthcare professional.
