Obstructive Sleep Apnea (OSA): Everything You Need to Know

Upper airway blockage during sleep can lead to episodes of interrupted breathing

Medically reviewed by Daniel Combs, MD

Obstructive sleep apnea (OSA), the most common type of sleep apnea, is very common, affecting approximately 15% to 20% of adults. Apnea is an interruption in breathing. Sleep apnea is interrupted breathing during sleep.

The apneic episodes of OSA are specifically caused by blockage of the upper airway during sleep. These brief periods of interrupted breathing result in a low blood oxygen level, which triggers waking up, catching your breath, and falling asleep again.

If you have OSA, you may experience headaches and tiredness during the day, as well as snoring while sleeping. This article describes the symptoms, diagnosis, treatments, and how to cope with OSA.

Obstructive Sleep Apnea Symptoms

While OSA is a sleep disorder, the symptoms and effects can also impact your daytime quality of life. You might not notice your symptoms of OSA, but a person who is awake in the same room as you while you are asleep may notice your snoring, gasping for breath, or brief periods of pauses in your breathing while you sleep.

Symptoms and effects of OSA include:

• Daytime tiredness

• Headaches

• Trouble concentrating

• Snoring

• Interrupted breathing during sleep

• Gasping for air during sleep

Long-term, untreated OSA has been associated with health complications, including hypertension (high blood pressure), heart disease, and mood disorders.

Learn More: What Causes Mild Obstructive Sleep Apnea?

What Causes Obstructive Sleep Apnea?

The main cause of OSA is obstruction, or blockage, of the upper airways during sleep. The muscles throughout the body relax during sleep, including the throat muscles. Certain risk factors can increase the likelihood of upper airway blockage during sleep when the muscles naturally relax.

If your upper airways become physically blocked during sleep, this leads to interrupted breathing and decreased oxygen. If your body senses reduced oxygen levels, you will wake up, catch your breath again, and quickly fall asleep.

These periods of waking and falling asleep throughout a night of sleep will last for just a few seconds —and most people do not notice their episodes of wakefulness due to OSA.

Risk Factors for Obstructive Sleep Apnea

Certain risk factors can increase the likelihood of OSA, although having a risk factor does not necessarily mean that you will develop OSA. Less often, some people may have OSA without these risk factors.

Known risk factors for OSA include:

• Obesity

• Enlarged tonsils

• Smoking

• Alcohol use or drug use

• Advancing age

• Family history of sleep apnea

Sleeping on your back may increase the likelihood of upper airway obstruction during sleep.

Males are more prone to OSA than females.

A Note on Gender and Sex Terminology

Verywell Health acknowledges that sex and gender are related concepts, but they are not the same. To reflect our sources accurately, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.

How Is Obstructive Sleep Apnea Diagnosed?

Obstructive sleep apnea is diagnosed using medical history, symptoms, risk factors, and diagnostic tests. A combination of snoring, gasping for air during sleep, and daytime fatigue are highly suggestive of OSA.

A polysomnogram (sleep study) can identify episodes of low oxygen, interrupted breathing, and wakefulness during sleep.

Polysomnography (PSG)

A polysomnogram is a diagnostic test involving multiple devices used to measure various parameters during sleep. You may be asked to go to a sleep lab to have your sleep study, or you may be given a device to use at home.

Features of a polysomnogram include:

• Electroencephalogram (EEG): This noninvasive test can identify your sleep stages and periods of wakefulness. If you have OSA, you will likely have some episodes of wakefulness throughout a full night of sleep.

• Extraocular movement measurements (EOM): This part of a sleep study measures eye movements. Typically, your eyes move while you are dreaming, which helps define the dreaming stage of sleep.

• Electromyography (EMG): This test measures muscle function. During a sleep study, a small metal plate is placed on either the arm or leg to detect movements during sleep. Typically, muscle movements, such as tossing and turning, occur when you are asleep and not dreaming. Generally, your muscles do not move while you are dreaming.

• Pulse oximetry: This test measures approximate blood oxygen levels using a plastic device that is placed on the fingertip. If you are being evaluated for OSA, this test is important for detecting the episodes of low oxygen that will occur whenever you stop breathing.

• Electrocardiogram (EKG): This non-invasive test involves the placement of metal discs on the chest to evaluate heart function. This is usually part of an in-lab sleep study but usually not part of a home sleep study.

If you have OSA, your polysomnogram may identify episodes of choking or shallow breathing leading to low oxygen levels. More frequent episodes indicate more severe OSA.

OSA and Central Sleep Apnea

There are three types of sleep apnea: OSA, central sleep apnea, and mixed or complex sleep apnea. Central sleep apnea is when pauses in breathing during sleep occur due to disruptions in the brain's control over breathing patterns.

Obstructive Sleep Apnea Treatment

Several different medical treatments are available for OSA. Some of them can be combined to achieve a better outcome. Lifestyle modifications are an important part of managing OSA.

Lifestyle modifications and medical treatments for OSA include:

• Lose weight if you have excess weight.

• Sleep on your side instead of on your back.

• Sleep with the head of the bed raised or your head raised on pillows.

• Stop smoking if you smoke.

• Don’t drink alcohol.

• Do not use recreational drugs.

• Discuss your medication list with your healthcare providers to determine if any medications, supplements, or herbal remedies could contribute to OSA.

• An oral device can be prescribed. These devices are worn in the mouth during sleep and can keep the airway open to prevent apnea episodes.

• A continuous positive airway pressure device (CPAP) can be prescribed to provide slight air pressure to maintain open upper airways.

• In some situations, surgery may benefit people with enlarged tonsils or excessive tissue in the back of the throat.

You will have to discuss your treatment options with your healthcare provider. Some people benefit from treatment options that may not help other people. Additionally, you may need to try one or more treatments to see which option is effective.

Related: An Overview of Sleep Apnea Devices

Obstructive Sleep Apnea Complications

Untreated OSA has been associated with a number of serious health complications. In addition to the symptoms of daytime tiredness, headaches, and potentially even trouble concentrating—the effects of low oxygen may have consequences for your health.

Medical issues that have been associated with OSA include:

• Hypertension (high blood pressure)

• Heart disease

• Pulmonary (lung) disease

• Stroke

• Cognitive (thinking) difficulties

• Mood changes

It’s not known exactly how long it would take for you to develop such complications, and several of these conditions may also correlate with other risk factors of OSA. For example, obesity can contribute to hypertension and heart disease, and OSA can amplify these health issues.

More severe OSA that is untreated for a long time increases the chance of developing serious complications or even death.

Learn More: Is Sleep Apnea Brain Damage Reversible?

Tips for Managing Obstructive Sleep Apnea

While seeking medical help for OSA is vital, managing lifestyle risk factors and incorporating lifestyle measures that improve overall health and wellness are important. You can do many things to improve your overall sleep and help reduce the impact of OSA on your health.

Practical tips for living with OSA include:

• Make sure your bed and bedroom are comfortable.

• Reduce noise, lights, or sounds that could be disturbing your sleep.

• Make sure you don’t consume caffeine or alcohol before sleep because these can interfere with your sleep.

• Avoid stress or anxiety before sleep, and try relaxing before bedtime.

• Try to maintain a regular sleep schedule.

These tips can help improve your overall sleep patterns and help you get rest while sleeping.

When to Contact a Healthcare Provider

If you are experiencing symptoms of sleep apnea or have been told by a sleeping partner you are having them, you should talk to a healthcare provider. People do not often notice their own snoring or brief awakenings gasping for breath.

Gasping for air, tiredness during the day, and snoring can all be caused by OSA, but other health conditions can also cause them. If you notice these symptoms in someone else, such as a sleeping partner, encourage them to see a healthcare provider.

Whether you have OSA or another illness, a medical evaluation and treatment plan will help you improve your overall health and reduce these symptoms.

Summary

Sleep apnea is a condition that causes interruptions in breathing during sleep, with OSA being the most common type of sleep apnea. Many people do not notice their own OSA symptoms, and usually, someone else will notice snoring or gasping for air during sleep.

If you or someone else is having symptoms that could be sleep apnea—snoring, gasping for air, tiredness during the day, persistent headaches, irritability, or mental fogginess—it’s important to seek medical attention.

Most people living with OSA experience improvement in symptoms and substantial improvement in quality of life with treatment.

Read the original article on Verywell Health.