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Obstructive Sleep Apnea

Look for the subtle signs of sleep apnea and learn how to treat it to reduce your fatigue.

What is obstructive sleep apnea?

Pro Tip

People often think that obstructive sleep apnea is not a big deal and just a nuisance. On the contrary, it can increase your risk of heart attacks, strokes, heart failure, and more. —Dr. Bina Choi

Obstructive sleep apnea is when you stop breathing while you’re asleep. It’s usually just for a moment but it happens repeatedly. It causes low oxygen levels and disrupted sleep.

When a person is sleeping, their muscles rest, too. But they can become too relaxed. When this happens, the muscles close in on the windpipe. (The windpipe is how the air travels from the throat to the lungs.) It causes you to snore and sometimes to stop breathing.

Usually, this wakes you up a little, though you will probably not even remember it. But the interruption of sleep can make you feel tired during the day, even when you think you had a full night’s rest.

What is causing your symptoms?

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What are the warning signs of sleep apnea?

  • Snoring
  • Waking up at night gasping for air or short of breath
  • Extreme sleepiness or tiredness during the day. Even though you think you had a full night’s sleep.
  • Waking up with a dry mouth
  • Waking up with a headache

Other symptoms you may have

Some less-common warning signs of sleep apnea.

  • You’ve been told you snore or sound like you are choking at night
  • Waking up frequently at night to use the bathroom

Dr. Rx

An important question to ask your doctor: Can you refer me to a sleep specialist? —Dr. Choi

What causes obstructive sleep apnea?

When you sleep, your muscles relax. But if you have obstructive sleep apnea, the nose, tongue, and throat relax too much. The muscles collapse and block air from passing from your throat to your lungs.

With less airflow, you may snore or have slow and shallow breathing. Sometimes you can stop breathing. Usually, this is followed by a gasp or a snort. The noise is a sign your brain has been triggered to start breathing again.

When this happens, you wake up for a moment, which interrupts your sleep. If you share your bed with someone, they may notice the snoring, snorting, and gasping.

Certain diseases or just your natural anatomy can make it harder for air to flow while you’re sleeping. Being overweight or obese, for example, means you have more tissue around and in the neck, throat, and airway.

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What is the best treatment for obstructive sleep apnea?

Pro Tip

Wearing your CPAP is the most important thing you can do. And once you find a treatment that works for you, you will find yourself waking up more rested than ever before! —Dr. Choi

The first treatment for mild obstructive sleep apnea is weight loss. Because losing weight can reduce some of the extra tissue around your airway area. Also, don’t drink alcohol or take sleeping medication.

If your obstructive sleep apnea doesn’t get better after making some lifestyle changes, or if it’s really bad, you might need a CPAP machine. A CPAP Is a Continuous Positive Airway Pressure. You wear a mask or nasal prongs (tubes that go in your nose) to bed. While you sleep, it blows air into your airways.

Use your CPAP whenever you sleep—every night and even for a nap.

The reason people stop using their CPAP is often because of the mask. Some find it uncomfortable. Talk to your doctor if you are having problems. There are many different masks and nasal prongs to choose from. It is important to find the one that fits you best to increase your chances of success.

After a few weeks of using the CPAP machine, your sleep doctor will check the machine settings and make any changes that are needed.

Other treatments

If CPAP doesn’t work, you can try other treatment options, but they don’t work as well.

  • Oral device. Similar to a mouth guard, but the device is custom fitted for your mouth. It moves your jaw and tongue from their natural position. And makes it less likely to block airways.
  • Various kinds of surgeries. Several procedures remove tissue from your nose, mouth, and/or tongue. Another type moves the jaw forward to help keep it from blocking airways.
  • Upper airway stimulation therapy. An electrical stimulator is placed permanently in your tongue. It senses when your airway is blocked and tells the tongue to move.

Risk factors

You’re more likely to have obstructive sleep apnea if you are/have:

  • Male
  • A woman who has gone through menopause
  • Older than 50
  • Overweight or obese
  • African-American, Hispanic, or Asian
  • High blood pressure (hypertension)
  • Atrial fibrillation (AFib), which is an abnormal heart rhythm
  • Heart failure
  • Type two diabetes
  • Drinking alcohol can make the condition worse.

What is the difference between central sleep apnea and obstructive sleep apnea?

There are two main types of sleep apnea: obstructive and central. All types of sleep apnea mean you stop breathing while you’re asleep, leading to disrupted sleep.

Obstructive sleep apnea is when your muscles relax too much. Central sleep apnea happens when your brain isn't telling your respiratory muscles to breathe and can be associated with other medical conditions such as severe heart failure, stroke, or certain medications.

How can I stop sleep apnea?

Keeping a healthy weight, or losing weight to reach a healthy weight, are the best ways to avoid obstructive sleep apnea. If you already have sleep apnea, don’t drink alcohol or take any sleep medication. Sleeping on your side can also help.

Follow the instructions and therapies your doctor prescribes. Make sure you go to your follow-up visits as scheduled.

What happens with untreated sleep apnea?

Obstructive sleep apnea needs to be treated. When it isn’t treated, it increases your risk of heart attacks, strokes, and heart failure (pulmonary hypertension, sudden cardiac death).

Also, if you’re sleepy during the day, you’re less productive at work, at school, or even just around the house. And if you drive, being drowsy behind the wheel puts you at a higher risk of having a car accident.

If your partner complains that you snore a lot or you feel tired even after getting a full night’s rest, make an appointment with your doctor.

They may send you to a sleep specialist. The specialist will check your oxygen levels and blood. And do an echocardiography (echo), which is an ultrasound of the heart.

They might also have you do a sleep study. There are many kinds. But the most helpful one is polysomnography (PSG), a test that records your brain waves, the oxygen level in your blood, and other key sleep metrics. You’ll be hooked up to a machine while you stay overnight at a sleep center.

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