Obstructive Sleep Apnea

What is obstructive sleep apnea?

Obstructive sleep apnea (OSA) is a condition where a blockage or narrowing in your airway keeps air from moving through your windpipe when you’re asleep.

The blockage and lack of airflow can cause your blood oxygen levels to drop. This triggers a survival reflex in your brain that wakes you up just enough to breathe again. While that reflex is key in keeping you breathing, it also disrupts your sleep.

If you have frequent wakeups at night, you won’t feel rested in the morning. That can lead to a wide range of symptoms, many of which can affect your daytime functioning. Over time, these symptoms can lead to dangerous and sometimes life-threatening complications.

A healthcare provider can help you manage symptoms of OSA.

How common is obstructive sleep apnea?

OSA affects up to 1 billion people around the world who are between the ages of 30 and 69.

What are the symptoms of obstructive sleep apnea?

Symptoms of obstructive sleep apnea that you or a sleeping partner will notice at night include:

• Frequent wakeups in the middle of the night
• Pauses in breathing while asleep
• Waking up out of breath (like you’re choking)
• Snoring
• Night sweats
• Feeling restless

Daytime symptoms may include:

• Fatigue, sleepiness or exhaustion
• Mood changes (depression and anxiety)
• Difficulty concentrating or remembering
• Headaches (often when waking up)
• Sexual dysfunction

What does OSA sound like?

You might notice the following characteristics in a sleeping partner who has OSA:

• Loud snoring that usually starts soon after falling asleep
• Snoring stops suddenly (while breathing stops)
• A snort or gasp for breath before snoring starts again

What causes obstructive sleep apnea?

A blockage in your upper airway causes obstructive sleep apnea. Your muscles relax when you sleep, even the ones that allow air to flow into your lungs. But there should still be enough room for air to get into your body. With sleep apnea, relaxed muscles and tissues block the airway. This prevents airflow, which causes you to stop breathing.

What are the risk factors for obstructive sleep apnea?

OSA can happen to anyone at any age or any body size. It’s more common if you have any of the following:

• Excess body weight (obesity)
• Structural abnormalities like having an underbite, small lower jaw, large tongue, large tonsils or large adenoids, a large neck or collar size (16-17 inches/41-43 centimeters)
• Genetic conditions that affect how your head and neck develop (like Down syndrome or Prader-Willi syndrome)

OSA is more common as you age but it can also affect children.

What are the complications of obstructive sleep apnea?

Obstructive sleep apnea can lead to dangerous and sometimes life-threatening complications that may include:

• Daytime drowsiness (dangerous if you’re driving or doing something that needs your full, undivided attention)
• Heart damage and heart failure
• Chronic health conditions like high blood pressure (hypertension) or Type 2 diabetes
• Arrhythmias (atrial fibrillation)
• Stroke
• Sudden cardiac death

How is obstructive sleep apnea diagnosed?

A healthcare provider will diagnose OSA after taking your medical history, performing a physical exam and recommending tests. During the exam, your provider will examine your mouth, neck and throat. They’ll also ask you about what symptoms you experience at night and during the daytime.

Two tests can help diagnose OSA, including:

• Overnight sleep study (polysomnogram): This is an overnight test where you sleep in a medical facility where they monitor your sleep.
• Home sleep apnea testing: This is similar to an overnight sleep study but doesn’t involve brain wave monitoring and other types of sensors and you get to stay home.

If you suspect you or a loved one has OSA, you might be able to help a healthcare provider diagnose it. You can take video and audio recordings of the person sleeping with their permission. This key evidence may help speed up the diagnostic process.

How is obstructive sleep apnea treated?

Treatment for OSA may include:

• Making lifestyle changes like sleeping position adjustments (not sleeping on your back) or maintaining a weight that’s healthy for you
• Using a continuous positive airway pressure (CPAP) machine
• Wearing oral appliances (mouthpieces)
• Undergoing surgery

Obstructive sleep apnea surgery

Common types of surgeries to open your airway and treat OSA include:

• Uvulopalatopharyngoplasty (UPPP): Removing tissue from the back of your throat
• Tracheostomy: Opening your windpipe to bypass a blockage
• Tonsillectomy/adenoidectomy: Removing tonsils or adenoids
• Nerve stimulation: Implanting a device to stimulate airway muscles during sleep

How can obstructive sleep apnea be prevented?

You can’t prevent all cases of OSA. But you can take steps to reduce your risk and improve your overall sleep by:

• Eating nutritious foods and participating in regular physical activities
• Maintaining a healthy weight
• Practicing good sleep hygiene (like setting a bedtime routine and turning off electronic devices before bed)
• Managing any existing health conditions, such as high cholesterol, high blood pressure and Type 2 diabetes
• Not smoking and not drinking beverages that contain alcohol before bed
• Seeing your healthcare provider annually for a check-up

What is the life expectancy of a person with obstructive sleep apnea?

Untreated OSA may reduce your life expectancy and increase your risk of dangerous complications. But OSA is a treatable condition. A healthcare provider is the best person to talk to about what you can expect, as this answer is very unique to you.

What’s the outlook for obstructive sleep apnea?

The outlook for OSA depends on many factors like the severity and whether you have other underlying conditions, too. However, you can expect a positive outcome if you stick to your treatment plan after you and your healthcare provider find one that works best for you.

When should I see a healthcare provider?

Visit a healthcare provider if you suspect you or a loved one have symptoms of sleep apnea. It may help to record your breathing at night so your provider can learn more about what’s going on.

If you have OSA, stay regular with your follow-up appointments. Your provider will want to make sure your treatment is working effectively. Be honest with them if you’re having trouble wearing a PAP mask at night or changing your sleeping habits. They may have recommendations to make things easier.

If you have trouble breathing when you wake up or have symptoms of potentially life-threatening complications like a heart attack (chest pain, heartburn, cold sweats) or stroke (sudden weakness or numbness on one side, confusion, dizziness), contact your local emergency services number right away.

What questions should I ask my healthcare provider?

If you have OSA, you can ask your provider:

• What type of treatment do you recommend?
• Are there side effects of treatment?
• How do I comfortably wear a PAP mask?
• How do I change my sleep routine?
• Can you recommend a nutritionist to help me with weight loss?