Obstructive Sleep Apnea: Symptoms, Causes, and Treatments

Obstructive Sleep Apnea (OSA) occurs when the upper airway collapses during sleep, temporarily halting breathing. This disorder is common and mainly affects older males but can occur in anyone, including children. Snoring, often interrupted by silent periods, is a common symptom due to narrowed airways.

However, not all snorers have OSA. Left untreated, OSA can lead to serious health issues like high blood pressure, heart disease, stroke, diabetes, and abnormal heart rhythms.

Complications can be prevented with prompt diagnosis and treatment.

What Is Obstructive Sleep Apnea?

Obstructive Sleep Apnea

Obstructive sleep apnea occurs when your upper airway is blocked during sleep, making breathing difficult. This can lead to shallow breathing or brief pauses in breathing, often accompanied by gasping or snorting sounds.

You might not realize this is happening, but it can disrupt your sleep and decrease oxygen flow to your organs, possibly causing irregular heartbeats.

Symptoms of Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) symptoms are noticeable both by the affected individual and their bed partner:

Affected individuals often experience:

  • Daytime sleepiness due to poor sleep quality caused by decreased oxygen supply.
  • Morning headaches and a grumpy mood.
  • Forgetfulness and repetitive awakenings during the night.

Bed partners may notice:

  • Loud snoring, gasping, choking, or snorting sounds.
  • Pauses in breathing while sleeping.

Other symptoms may include:

  • Hyperactivity in children, worsening depression, and poor performance at work or school.
  • Loss of interest in sex.

Daytime drowsiness increases the risk of accidents. Treatment can effectively alleviate these symptoms.

Causes of Obstructive Sleep Apnea

During sleep, muscles relax, including those in the throat that keep it open for airflow.

In some individuals with a narrow throat, relaxed upper throat muscles can cause tissues to close in, blocking airflow—a condition known as apnea.

Loud snoring often accompanies OSA as air struggles through the narrowed airway.

Factors that increase OSA risk include:

  • Short lower jaw compared to the upper jaw
  • Certain shapes of the palate or airway that collapse more easily
  • Large neck or collar size (17 inches or more in men, 16 inches or more in women)
  • Enlarged tongue that may block the airway
  • Obesity
  • Enlarged tonsils and adenoids obstructing the airway
  • Sleeping on the back, which can further narrow or block the airway

Central sleep apnea is a distinct disorder where breathing stops due to temporary interruptions in brain signals to breathing muscles.

How is Obstructive Sleep Apnea Diagnosed?

Obstructive sleep apnea (OSA) diagnosis typically involves:

  1. Medical History and Examination: Your doctor will inquire about symptoms like daytime sleepiness and snoring, while also examining your head and neck for physical signs of OSA.

  2. Questionnaire: You might fill out a questionnaire detailing your sleep patterns, quality, and daytime drowsiness.

  3. Home Sleep Apnea Testing: In some cases, testing may be done at home without a technician present. However, this method is only suitable for specific cases and isn’t a substitute for other diagnostic tests if other sleep disorders are suspected.

  4. Diagnostic Tests: Various tests may be used to diagnose OSA, including:

    • Polysomnography (PSG): This involves an overnight stay at a sleep center or hospital, connected to monitors that record physiological variables during sleep, such as brain waves, eye movement, muscle activity, heart rate, rhythm, and blood oxygen levels.
    • Electroencephalogram (EEG) and Electrooculogram (EOM): EEG monitors brain waves, while EOM records eye movement, aiding in understanding sleep phases.
    • Electromyography (EMG): Measures muscle activity, indicating muscle tone and movement during sleep.
    • Electrocardiogram (ECG): Records heart rate and rhythm.
    • Pulse Oximetry: Monitors blood oxygen levels, which can drop during apnea episodes.

Treatment Options For OSA

Treatment Options for Obstructive Sleep Apnea (OSA):

  1. Weight Loss: Recommended for individuals with obesity and OSA. While it may not completely cure OSA, weight loss has been proven to decrease its severity, improve blood pressure, quality of life, and reduce daytime sleepiness.

  2. Continuous Positive Airway Pressure (CPAP): CPAP therapy is the primary treatment for OSA. It involves wearing a face mask at night to deliver a gentle flow of air, keeping the airways open. CPAP is highly effective, but if it’s not suitable, an oral appliance can be considered for mild to moderate cases.

  3. Bilevel Positive Airway Pressure (BPAP): BPAP machines, also known as BiPAP, provide two pressure levels to accommodate inhalation and exhalation. They are an alternative for those who can’t tolerate CPAP.

  4. Sleeping Position Adjustment: Positional therapy encourages sleeping on the side instead of the back, which can worsen OSA for some. This simple adjustment can help alleviate symptoms.

  5. Surgery: Surgery is considered when CPAP, BPAP, or oral appliances fail. It’s most effective for individuals with severe, surgically correctable upper airway obstruction. Surgical evaluation involves physical exams and sometimes endoscopic procedures to assess the airway anatomy. Surgery can provide long-term benefits, but complete elimination of OSA isn’t always achieved. Factors for being a surgical candidate include willingness, health status, and correctable issues in the upper airway.

For mild cases of Obstructive Sleep Apnea, you may consider using some anti-snoring devices or anti-snoring mouthpieces.

How Does Obstructive Sleep Apnea Affect Your Sleep?

Obstructive Sleep Apnea (OSA) disrupts your sleep cycle by causing blockages in your airway. This happens because the muscles in your throat relax too much during sleep, leading to the collapse of soft tissues and obstruction of the windpipe. This results in pauses in breathing known as apneas or shallow breathing episodes called hypopneas.

Your brain detects drops in oxygen levels and prompts you to wake up slightly, just enough to tighten the muscles and reopen the airway. However, these interruptions disrupt the normal sleep cycle, occurring most frequently during deep sleep (stage 3) and REM sleep (when dreaming occurs). People often don’t remember these events, but they can lead to fragmented sleep patterns.

The severity of OSA is measured by the Apnea-Hypopnea Index (AHI), which counts the number of breathing interruptions per hour:

  • Mild OSA: AHI between 5-15 events per hour.
  • Moderate OSA: AHI between 15-29 events per hour.
  • Severe OSA: AHI of 30 or more events per hour.

Higher AHI values indicate more severe OSA, with severe cases involving frequent awakenings throughout the night, impacting overall sleep quality and leading to daytime symptoms such as fatigue and decreased cognitive function.

Living with Sleep Apnea

Living with obstructive sleep apnea (OSA) requires understanding and proper management. While it can’t be cured, treatment can significantly improve sleep quality and minimize health risks. Here are some essential tips for managing OSA:

  1. Find support: Join online communities or support groups to connect with others facing similar challenges and find accurate information and social support.

  2. Be cautious when driving: OSA can impair concentration and alertness, increasing the risk of accidents. Avoid driving or operating machinery if feeling drowsy or unfocused.

  3. Regular follow-up with a doctor: Stay in touch with your doctor or sleep specialist for guidance on using PAP therapy, addressing challenges, monitoring treatment effectiveness, and managing any side effects.

  4. Avoid aggravating substances: Steer clear of sedatives, muscle relaxants, benzodiazepines, narcotics, and alcohol, as they can worsen breathing problems during sleep.

  5. Inform medical professionals: Discuss your OSA diagnosis with all healthcare providers, especially before undergoing anesthesia or taking pain medications.

  6. Prioritize sleep: Aim for sufficient sleep each night, following your treatment plan, and adopting good sleep hygiene practices for better overall sleep quality.

By incorporating these strategies into daily life, managing OSA can become more manageable, leading to improved well-being and quality of life.


1. Can obstructive sleep apnea be prevented?

Yes, avoiding alcohol, sedatives, and maintaining a healthy weight can help prevent apnea episodes.

2. When should I call my healthcare provider?

Call your doctor if your bed partner notices symptoms of apnea or if you experience frequent drowsiness or falling asleep during the day.

3. What are the complications of obstructive sleep apnea?

Untreated obstructive sleep apnea can lead to serious accidents, increased blood pressure, oxygen level instability, insulin and glucose response changes, mental function and mood alterations, and cardiovascular issues.

4. How common is obstructive sleep apnea?

Obstructive sleep apnea affects 5% to 10% of people worldwide, with higher rates in older adults, but many are unaware they have it.

5. Is obstructive sleep apnea contagious?

No, obstructive sleep apnea is not contagious.

Need professional help to diagnose and address your sleep problems? Schedule an online consultation with sleep specialist Dr. John Williams.

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