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Clues You Might Have Obstructive Sleep Apnea

By Arthur Allen
WebMD Feature

Do you wake up in the morning with a headache, feeling just as tired as when you went to sleep? Has your spouse moved to the room next door, exhausted by listening to you snore, gasp, and choke every night?

If so, you may have obstructive sleep apnea (OSA) -- a condition where the upper passages of your airway close off, interrupting your breathing and depriving you of oxygen until you wake up and start breathing again. Sleep apnea affects more than 18 million American adults. 

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Causes of Obstructive Sleep Apnea

Obstructive sleep apnea is a common and serious disorder in which breathing repeatedly stops for 10 seconds or more during sleep. The disorder results in decreased oxygen in the blood and can briefly awaken sleepers throughout the night. Sleep apnea has many different possible causes. In adults, the most common cause of obstructive sleep apnea is excess weight and obesity, which is associated with soft tissue of the mouth and throat. During sleep, when throat and tongue muscles are more relaxed,...

Read the Causes of Obstructive Sleep Apnea article > >

How can you tell if you have sleep apnea? The only real way is to have a sleep study, a test that records what happens while you sleep. But there are some common signs of sleep apnea, experts say.

Sleep Apnea Signs: Snoring, Gasping, Sleepiness

The three main warning signs of obstructive sleep apnea are:

  • Loud, persistent snoring
  • Pauses in breathing, accompanied with gasping episodes when sleeping
  • Excessive sleepiness during waking hours

Should everyone who snores see a sleep specialist? No, say the experts. “Most people who snore don’t have obstructive sleep apnea, but most people who have apnea snore,” says Robert L. Owens, MD, of the Sleep Disorders Research Program at Brigham and Women’s Hospital in Boston. If you have chronic snoring that is loud enough to wake a bed partner, talk to your doctor. 

Like snoring, the most definitive sign of sleep apnea -- waking up to breathe -- is often witnessed by a bed partner. People with sleep apnea frequently wake up for a few seconds to gasp for air. This can happen hundreds of times a night in people with severe sleep apnea, Owens says.

“If someone witnesses you waking up repeatedly at night, it’s very suggestive of obstructive sleep apnea,” he tells WebMD. “Increasingly, I get wives who come in with little movies on their cell phones that show what their husband looks like at night. That’s very convincing.”

If you don’t have a bed partner to catch your gasping or snoring on camera, the only signs of sleep apnea you may notice are morning headaches or extreme sleepiness during the day, says Lisa Shives, MD, medical director of Northshore Sleep Medicine in Evanston, Ill. 

Sleep specialists use the Epsworth Sleepiness Scale to measure daytime sleepiness. People with extreme sleep apnea are likely to doze off in the middle of meals or conversations, Shives tells WebMD. Moderate daytime sleepiness, such as the desire to take an afternoon nap, doesn’t necessarily mean you have obstructive sleep apnea.

Other Signs of Sleep Apnea: Mouth Breathing and Excessive Urination

If you wake up with a very dry mouth and gummy front teeth, it may also be a sign of sleep apnea, Shives says. “My little phrase is, ‘It’s very hard to gasp through your nose.’ People who have obstructive sleep apnea tend to sleep with their mouths open.”

After treatment with continuous positive airway pressure (CPAP) devices – the gold standard for treating sleep apnea – patients keep their mouths closed at night, Shives says.

A less common symptom of sleep apnea is waking up frequently with a desperate need to urinate. When a person’s breathing is disrupted, it puts pressure on the heart. This, in turn, affects a hormone that normally controls urine production in the kidneys, says Vishesh K. Kapur, MD, MPH, medical director of the Sleep Institute at the University of Washington in Seattle. “This tends to occur when obstructive sleep apnea is really extreme,” Kapur tells WebMD. 

Once you treat the apnea, Shives says, “This problem is immediately eradicated.”

Some other symptoms -- such as lower pain threshold, mood changes or irritability, depression, or problems concentrating -- often show up in people with obstructive sleep apnea. But they aren’t particularly good diagnostic hints, Kapur says, because they are associated with so many other problems and conditions.

Reviewed on May 16, 2014

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