What Is Obstructive Sleep Apnea?
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Medically reviewed by Jane Kim, MD
Obstructive sleep apnea (OSA) is a chronic sleep disorder that causes repeated breathing disruptions while you sleep. People with OSA may stop (and restart) breathing up to 400 times a night, with each pause lasting 10 to 30 seconds at a time. These breathing pauses occur when your airways narrow or collapse in your throat, which leads to brief pauses in breathing (known as apneas) that prevent your body from getting enough oxygen during sleep.
An estimated 39 million adults in the United States have obstructive sleep apnea. Loud snoring or waking up gasping for air are both classic symptoms of OSA. But many people with the condition also experience daytime sleepiness, dry mouth in the morning, headaches, and irritability.
Over time, OSA increases your risk of serious health problems, including heart disease, diabetes, stroke, and depression. Lifestyle modifications and treatments that keep your airways open during sleep can help prevent apnea episodes from occurring and improve your sleep quality.
Symptoms
Loud snoring is the most common symptom of obstructive sleep apnea. In fact, about 94% of people with OSA snore. OSA symptoms can vary from person to person, but may include:
Waking up gasping for air
Feeling extra tired or sleepy throughout the day
Frequently waking up throughout the night
Having a dry mouth, excessive thirst, or a sore throat in the morning
Irritability or mood swings during the day, due to poor sleep quality
Trouble focusing or experiencing memory problems
Using the bathroom multiple times a night
Decreased libido (sex drive)
Causes
While you sleep, the muscles in your body relax, including the muscles that support your upper airway. Normally, your throat remains open enough to allow sufficient airflow to the lungs. But with obstructive sleep apnea, the airways narrow and become partially or entirely blocked. This makes it difficult for oxygen to pass through to your lungs with ease. As such, you may experience apneas, or brief pauses in breathing.
Several structural factors can block or collapse your airways, including:
Recessed jaw (or, having a lower jaw that is shorter than your upper jaw)
A large tongue that falls back into your throat and blocks the airway
Cleft lip
Abnormalities in the soft tissue of the neck
Large neck
Enlarged tonsils
Risk Factors
Obstructive sleep apnea is very common and can affect people of all ages. However, certain factors can increase your risk of developing OSA, such as:
Sex: People assigned male at birth are up to four times more likely to develop OSA
Age: The risk of OSA increases with age and is most common in adults between the ages of 50 to 70
Obesity: Extra body weight can lead to fatty deposits around the neck that can press on the airways during sleep, blocking airflow
Family history: Your risk of OSA increases if you have a family member with the condition
Hormonal changes: During menopause, people assigned female at birth may have changes to muscle tone and airway stability, increasing the risk of this condition
Underlying conditions: Certain medical conditions increase the risk of OSA, including hypothyroidism, heart disease, kidney disease, and polycystic ovarian syndrome (PCOS)
Diagnosis
Diagnosing obstructive sleep apnea is a multi-step progress. Your healthcare provider will review your symptoms and medical history, perform a physical exam, and order a sleep study to provide an accurate diagnosis.
Medical History and Physical Exam
Your healthcare provider will ask about your sleep habits, family history, and personal medical history to assess your risk factors for OSA. They will also ask about your symptoms and how long you've been experiencing them. Keeping a sleep diary for a week or two before your appointment can be helpful. This will give your provider a general idea of your sleep habits and patterns. New technologies, such as smartwatches or rings can also help track your sleep data.
Once your provider learns more about your symptoms, they'll perform a physical examination. During this test, you can expect your provider to assess your facial structure, mouth, and throat for any features that may be contributing to a blockage in your airway.
Sleep Studies
Sleep studies are the gold standard for diagnosing OSA. These tests help rule out other possible causes of your symptoms and help your provider understand your breathing habits and overall sleep quality throughout the night. Sleep studies may take place at a medical center (such as a sleep lab) or in your home.
Polysomnography (PSG): A PSG is a type of sleep test that occurs when you spend the night in a sleep lab and are hooked up to several wires that measure different mechanisms in your body. During this study, a provider can monitor your heart rate, eye movements, breathing patterns, brain waves, oxygen levels, and muscle activity while you sleep.
Home sleep apnea testing (HSAT): A home sleep apnea test is a simplified version of polysomnography. Your provider will explain how to use the portable testing machine, which measures your breathing patterns, oxygen levels, and heart rate while you sleep at home.
Treatment
There is no cure for obstructive sleep apnea, but treatment can help keep your airways open during sleep to restore normal breathing patterns, relieve symptoms, and prevent long-term health complications. Treatment options vary, depending on the cause and severity of your condition.
Continuous Positive Airway Pressure (CPAP)
Continuous positive airway pressure (CPAP) therapy is the leading treatment for OSA. A CPAP machine is a breathing device that delivers a steady flow of pressurized air to keep your airway open during sleep. This treatment involves wearing nasal prongs or a mask that covers your nose and/or mouth while you sleep. Using your CPAP machine every night is the best way to ensure effective treatment and improve your sleep quality.
Oral Appliances
If a structural issue in the anatomy of your jaw, mouth, or nose is causing OSA, your healthcare provider may recommend an oral device. These custom-fit dental devices hold your mouth and jaw in position to keep your airways open. Oral devices for treating OSA include:
Mandibular repositioning mouthpiece: Fits over your teeth and brings your lower jaw forward to keep your airway open
Tongue retraining devices: These plastic devices sit on your lips to hold your tongue in place and prevent your tongue from sliding back and blocking your airway
Surgery
When other treatment options are ineffective, your healthcare provider may recommend surgery. Surgical treatments for OSA include:
Adenotonsillectomy: The removal of your tonsils
Tissue removal: Removes extra soft tissue in the throat and mouth to reduce pressure on the airway during sleep
Jaw advancement: If an anatomical jaw difference is causing OSA, surgery to move the lower jaw forward may prevent your jaw from blocking the airway
How to Prevent OSA
Healthy lifestyle habits may help prevent obstructive sleep apnea or reduce the number of apnea episodes you experience if you have OSA. Healthcare providers recommend the following prevention techniques:
Manage weight: If extra body weight contributes to airway blockages, maintaining or achieving a weight that is right for you can help relieve pressure on your airways during sleep.
Sleep on your side: OSA often worsens when sleeping on your back. That said, your provider may recommend adjusting your sleep position or using wedge pillows to encourage you to sleep on your side.
Quit smoking: Smoking causes inflammation and narrowing of the airways. Quitting smoking can help control OSA and improve your overall health.
Avoid alcohol and sedatives: Alcohol and sedative sleep medications relax the muscles in your throat, which increases the likelihood of the tissues collapsing and blocking your airway during sleep.
Related Conditions
Frequent breathing interruptions during sleep deprive your brain and body of oxygen, which can reduce your overall functioning. Over time, decreased blood oxygen levels and a lack of high-quality sleep increase the risk of serious health problems, such as:
Heart disease: Repeated drops in blood-oxygen levels stress your cardiovascular system, increasing the risk of heart disease. OSA is a significant risk factor for cardiovascular diseases, including hypertension (high blood pressure), arrhythmia (irregular heartbeat), coronary artery disease (CAD), and stroke.
Type 2 diabetes: Repetitive decreases in oxygen levels during sleep affect how your body metabolizes glucose (blood sugar). Over time, OSA can increase the risk of insulin resistance, prediabetes, and type 2 diabetes.
Mood disorders: Poor quality sleep and chronic sleep deprivation increase the risk of mood disorders, such as anxiety and depression.
Cognitive decline: OSA is associated with an increased risk of problems with memory, focus, and executive functioning. People with untreated OSA also have a higher likelihood of developing age-related cognitive disorders, such as dementia.
Chronic pain: Evidence suggests OSA increases the risk of developing chronic pain conditions, including headaches, fibromyalgia, and temporomandibular disorders (TMJ). Disrupted sleep can also worsen pain and worsen existing health conditions associated with chronic pain.
Living With Obstructive Sleep Apnea
Between chronic fatigue, mood swings, problems with memory and focus, and decreased productivity, untreated obstructive sleep apnea can affect your personal and professional life and reduce your physical and mental well-being. Fortunately, early diagnosis and consistent treatment with CPAP therapy or other treatments can improve your sleep and quality of life.
It's a good idea to see your healthcare provider if your partner or other loved one mentions you snore, you frequently wake up gasping for air, or you always feel tired throughout the day. Ignoring OSA can lead to more than just feeling tired and moody, but can also increase the risk of serious health complications.
Frequently Asked Questions
What is the difference between sleep apnea and obstructive sleep apnea?
Sleep apnea is a broad and general term describing different breathing-related sleep disorders. Obstructive sleep apnea (OSA) is a specific form of sleep apnea that occurs when your airway becomes blocked or collapses, which obstructs the flow of oxygen.
Does a CPAP machine cure sleep apnea?
A CPAP (continuous positive airway pressure) machine doesn’t cure sleep apnea but is a highly effective treatment for managing the condition. CPAP therapy provides a constant flow of pressurized air to keep your airway open during sleep, which can prevent apnea episodes to improve your sleep quality.
Does your heart stop when you have OSA?
No, your heart does not stop during sleep when you have OSA. But OSA causes your breathing to stop and start throughout the night frequently. Although your heart doesn’t stop when this happens, your heart rate may slow down. Plus, frequent apnea episodes increase the risk of high blood pressure, irregular heartbeats (arrhythmia), and heart diseases.
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