What Is Obstructive Sleep Apnea?
Obstructive sleep apnea is when something blocks part or all of your upper airway while you sleep. So, your diaphragm, a muscle that helps you breathe in and out, and chest muscles have to work harder to open your airway and pull air into your lungs. Your breath can become very shallow, or you may even stop breathing briefly. You usually start to breathe again with a loud gasp, snort, or body jerk. You may not sleep well, but you probably won't be aware of it.
But just because different breathing patterns at night may not be obvious doesn't mean they're not important. Sleep apnea can also reduce oxygen flow to your organs and cause uneven heart rhythms.
Obstructive Sleep Apnea Symptoms
Common obstructive sleep apnea warning signs include:
- Daytime sleepiness or fatigue
- Dry mouth or sore throat when you wake up
- Headaches in the morning
- Trouble concentrating, forgetfulness, depression, or crankiness
- Night sweats
- Restlessness during sleep
- Problems with sex, such as a low sex drive
- Snoring
- Waking up suddenly and feeling like you're gasping or choking
- Trouble getting up in the mornings
- Waking up often in the middle of the night to pee
- High blood pressure
- Gastroesophageal reflux disease (GERD)
If you share a bed with someone, they'll probably notice your sleep apnea before you do.
Sleep apnea symptoms in children
Symptoms in children may not be as clear. They may include:
- Bed-wetting
- Choking or drooling
- Sweating a lot at night
- Rib cage moves inward when they breathe out
- Learning and behavior problems
- Problems at school
- Sluggishness or sleepiness (often seen as laziness)
- Snoring
- Teeth grinding
- Restlessness in bed
- Breathing that pauses or stops
- Unusual sleeping positions, such as sleeping on their hands and knees, or with their neck bent far back
Many other medical conditions can also cause these symptoms. Talk to your doctor to rule them out.
Obstructive Sleep Apnea Causes
Obstructive sleep apnea usually happens when the muscles that control your airway relax too much, narrowing your throat. This reduces your oxygen levels, so your brain wakes you up to reopen your airway. You’ll probably wake up for such a short time that you won’t even remember it, although some people will have shortness of breath, snorting, or gasping. This usually goes away in one or two breaths. These breathing problems, or apnea events, might happen dozens of times each hour, preventing you from getting a good night’s sleep, even if you don’t notice it.
Causes of obstructive sleep apnea include:
- Obesity. The extra weight in your neck can press down on your airway, causing breathing problems.
- Age. As you get older, fat can build around your airway and cause apnea.
- Jaw issues. An underbite or very small lower jaw can affect your airway, increasing your risk for apnea.
- Large or swollen tonsils, tongue, or adenoids. These structural issues can block your airway, making it hard to breathe. The risk for apnea also increases if your neck circumference is greater than 16 inches.
- Genetics. Your genes affect many things, including the size and shape of your head. Because of this, sleep apnea can run in families. In addition, genetic conditions such as Down syndrome and Prader-Willi syndrome can affect the way your head and neck are shaped.
- Endocrine problems. Hormones influence the shape of your face, airway, and skull. For example, low thyroid hormones, high insulin, or high growth factor levels can contribute to sleep apnea.
- Heart or kidney failure. These problems can lead to fluid settling in your neck, disrupting your airway.
- Drinking or smoking. Alcohol causes the muscles in your upper airway to relax, causing it to narrow. Meanwhile, smoking can lead to redness and swelling (inflammation) in your airway.
Obstructive Sleep Apnea Risk Factors
Anyone can have obstructive sleep apnea. It’s more likely if you:
- Are male
- Are older
- Are Black, Hispanic, or Asian
- Have a family history of sleep apnea
- Have asthma
- Smoke or drink alcohol
- Have diabetes
- Have high blood pressure
- Have a higher risk of heart failure or stroke
- Are overweight or obese
- Have a large or thick neck
- Have smaller airways in your nose, throat, or mouth
- Have too much tissue at the back of your throat that hangs down to block your airway
- Have a large tongue
Obstructive Sleep Apnea Complications
Complications of obstructive sleep apnea can include:
- Sleepiness during the day and trouble concentrating.
- Cardiovascular problems such as heart attack, high blood pressure, unusual heart rhythms, or stroke.
- Eye problems such as glaucoma and dry eye
- Metabolic disorders such as type 2 diabetes
- Problems with pregnancy such as gestational diabetes or low-birth-weight babies
Complications after surgery. Adults may have a higher risk of accidents at work or on the road, and children may have a hard time at school.
Adults may have a higher risk of accidents, and children may have a hard time at school.
Obstructive Sleep Apnea Diagnosis
Your doctor will give you a physical exam and ask about your sleep. They may also want to ask people who live with you about your sleep habits.
You may need to spend a night in a sleep lab or have a sleep study done at your house. You’ll wear monitors to measure things such as:
- Airflow
- Blood oxygen levels
- Breathing patterns
- Electrical activity in your brain
- Eye movement
- Heart rate or rhythm
- Muscle activity and movement of your arms and legs
The study will track how many times you had breathing problems while you slept.
Obstructive Sleep Apnea Treatment
Possible treatment options for obstructive sleep apnea include:
Weight loss, if needed. Losing even 10% of your weight can make a difference.
Avoiding alcohol or sleeping pills. These substances make your airway more likely to close during sleep and keep you from breathing like you should for longer periods.
Sleeping on your side. This can help if you get mild sleep apnea only when you sleep on your back.
Nasal sprays. These can help if sinus problems or nasal congestion make it harder to breathe while you sleep.
CPAP machine. This device includes a mask that you wear over your nose, mouth, or both. An air blower forces constant air through your nose or mouth. The air pressure is just enough to keep your upper airway tissues from relaxing too much while you sleep. A similar device is the BPAP, which has two levels of airflow that change when you breathe in and out.
Oral devices. If you have mild sleep apnea, you might get dental appliances or oral "mandibular advancement" devices that keep your tongue from blocking your throat or bring your lower jaw forward. That may help keep your airway open while you sleep. A trained dental expert can decide which type of device may be best for you.
Surgery. This is for people who have extra or uneven tissue that blocks airflow through the nose or throat. For example, if you have a deviated nasal septum, swollen tonsils or adenoids, or a small lower jaw that causes your throat to be too narrow, surgery might help you. Doctors usually try other treatments first.
Types of surgery for obstructive sleep apnea include:
Upper airway stimulator. This device, called Inspire, has a small pulse generator that your surgeon puts under the skin in your upper chest. A wire leading to your lung tracks your natural breathing pattern. Another wire, leading up to your neck, delivers mild signals to nerves that control your airway muscles, keeping them open. You can use a remote to turn it on before bed and turn it off in the morning.
Somnoplasty. Your doctor uses radiofrequency energy to tighten the tissue at the back of your throat.
UPPP, or UP3. This procedure takes out soft tissue in the back of your throat and palate, making your airway wider at your throat opening. (UPPP stands for uvulopalatopharyngoplasty.)
Nasal surgery. These operations correct obstructions in your nose, such as a deviated septum (when the wall between your nostrils is off-center).
Mandibular/maxillary advancement surgery. Your doctor moves your jawbone and face bones forward to make more room in the back of your throat. It’s a complex procedure used only for people who have severe sleep apnea and problems with their head or face.
Takeaways
Obstructive sleep apnea happens when a structural problem makes it hard for you to breathe while asleep, causing you to wake up frequently. Although it may not cause obvious symptoms, it can harm your health and raise your risk for other medical problems. If you regularly snore or wake up with shortness of breath, talk to your doctor about getting a sleep study.
Obstructive Sleep Apnea FAQs
What is obstructive sleep apnea?
It is when a structural problem blocks your airway during sleep, causing you to wake up to breathe.
How do you treat obstructive sleep apnea?
Obstructive sleep apnea can be treated with lifestyle changes, an oral device, a CPAP machine, and more.
Can sleep apnea be cured?
Sometimes, losing weight can make it go away. Otherwise, there is no cure for sleep apnea, but treatments can help you get better sleep and avoid complications.
What is the life expectancy of someone with sleep apnea?
Moderate to severe sleep apnea raises your risk of dying from any cause if left untreated. If you have severe sleep apnea, you may have up to three times the risk of dying from any cause compared to those who don't have sleep apnea.