Sleep apnea is a chronic breathing disorder that causes your breathing to stop and restart repeatedly while you sleep. These breathing pauses can last ten seconds or longer at a time and occur up to hundreds of times every night. Sleep apnea usually happens when your airway becomes partially or entirely blocked. In some cases, the condition occurs because the brain does not send proper signals to the muscles that control breathing during sleep.

An estimated 30 million people in the United States have sleep apnea. Loud snoring, gasping for air during sleep, and waking up feeling tired are some of the most common symptoms. If left untreated, sleep apnea can lead to serious health problems, including diabetes, heart attack, and stroke. Fortunately, treatment can help restore normal breathing patterns and improve sleep quality.

Types of Sleep Apnea

There are three main types of sleep apnea: obstructive, central, and complex. While they share similar symptoms, the causes and treatments differ.

Obstructive sleep apnea (OSA)
OSA is the most common type. It happens when the muscles in the throat relax and soft tissues collapse onto the airway, restricting airflow. Depending on severity, people may stop breathing between five and thirty times per hour or more.

Central sleep apnea (CSA)
CSA occurs when the brain briefly fails to send signals to the muscles responsible for breathing. People may breathe shallowly, slowly, or stop breathing for short periods. Neurological issues, injuries, and certain medications are common causes.

Complex sleep apnea
This form is a mix of both OSA and CSA. It is often discovered when people receiving CPAP therapy for OSA continue to experience apnea episodes.

Symptoms

Common signs of sleep apnea include:

  • Loud snoring

  • Gasping for air or choking during sleep

  • Waking up tired despite enough hours of sleep

  • Excessive daytime sleepiness

  • Morning headaches

  • Dry mouth

  • Trouble focusing or forgetfulness

  • Mood changes, irritability, depression, or anxiety

  • Decreased libido

  • Frequent nighttime urination

  • Restless sleep with frequent awakenings

Causes

Sleep apnea occurs when breathing repeatedly pauses during sleep, lowering oxygen levels until the brain signals the body to resume breathing.

Causes of OSA

  • Enlarged tonsils or adenoids

  • Obesity

  • Anatomical differences such as small jaw, deviated septum, or narrow airway

  • Thick neck structure

  • Hormonal changes

  • Metabolic or endocrine disorders, such as diabetes or hypothyroidism

Causes of CSA

  • Heart diseases such as heart failure or arrhythmias

  • Neurological conditions such as stroke, ALS, or brain injury

  • Opioid medications that suppress the nervous system

  • Genetic disorders like Prader-Willi or Rett syndrome

  • Kidney disease or failure

Risk Factors

Risk factors that increase the likelihood of developing sleep apnea include:

  • Age (more common in middle-aged and older adults)

  • Gender (higher risk in males)

  • Obesity

  • Family history of sleep apnea

  • Smoking

  • Excessive alcohol or drug use

Diagnosis

Diagnosis is based on symptoms, medical history, and sleep patterns.

Polysomnography (sleep study)
This overnight test monitors brain activity, breathing, heart rate, oxygen levels, and body movements while you sleep.

Home sleep apnea test
A simplified version of a sleep study done at home with a portable device that measures airflow, oxygen levels, and breathing patterns.

Treatment

Treatment helps keep the airway open and reduces apnea events. Options include:

Lifestyle changes

  • Maintain a healthy weight

  • Avoid alcohol and smoking

  • Sleep on your side instead of your back

Breathing devices

  • CPAP: constant airflow to keep the airway open

  • BiPAP: two airflow pressures, one for inhalation and one for exhalation

  • APAP: automatically adjusts pressure during the night

Oral appliances

  • Mandibular repositioning device (keeps lower jaw forward)

  • Tongue stabilizing device (holds tongue in place)

Medications
Respiratory stimulants may be prescribed for CSA in certain cases.

Surgery
For severe cases:

  • Tonsil or adenoid removal

  • Soft tissue removal in throat or mouth

  • Jaw advancement surgery

How to Prevent Sleep Apnea

Although not always preventable, you can reduce your risk by:

  • Maintaining a healthy weight

  • Sleeping on your side

  • Quitting smoking

  • Avoiding alcohol and sedatives before bed

Related Conditions

Over time, sleep apnea increases the risk of:

  • Cardiovascular disease (stroke, high blood pressure, coronary artery disease, heart failure)

  • Type 2 diabetes (linked with inflammation and glucose intolerance)

  • Mood disorders (depression and anxiety due to poor sleep quality)

Living With Sleep Apnea

Sleep apnea is a chronic but treatable condition. Healthy lifestyle choices, combined with proper medical treatment, can improve sleep quality and reduce health risks. If symptoms persist despite treatment, consult your healthcare provider to adjust your plan.