Sleep apnea is a chronic sleep disorder characterized by repeated interruptions in breathing while you sleep. These pauses, which can last 10 seconds or longer, may occur hundreds of times each night and often go unnoticed by the person affected. Despite being underdiagnosed, sleep apnea is a serious medical condition that can lead to daytime fatigue, cardiovascular disease, diabetes, and other health complications if left untreated.

This article breaks down the different types of sleep apnea, how they affect your body, the causes, symptoms, and current treatment strategies to help manage this potentially dangerous condition.

Types of Sleep Apnea

There are three primary types of sleep apnea, each defined by the cause of the breathing interruptions.

Obstructive Sleep Apnea (OSA)

This is the most common form of sleep apnea. It occurs when the muscles in the back of the throat relax during sleep, causing the airway to narrow or collapse. As a result, airflow is restricted, which disrupts normal breathing patterns and reduces oxygen levels in the blood. People with OSA may stop breathing anywhere from 5 to over 30 times per hour.

Central Sleep Apnea (CSA)

CSA is less common and is caused by a failure of the brain to send proper signals to the muscles that control breathing. It is usually associated with underlying conditions affecting the brainstem, such as stroke, brain injury, or certain medications that suppress the central nervous system.

Complex (Mixed) Sleep Apnea

This type combines elements of both OSA and CSA. People often discover they have complex sleep apnea when OSA symptoms persist even after using continuous positive airway pressure (CPAP) therapy.

Common Symptoms

Many people with sleep apnea are unaware they have it, as symptoms typically manifest during sleep. However, sleep apnea can also cause significant daytime problems.

Key symptoms include:

  • Loud snoring

  • Choking, gasping, or snorting during sleep

  • Frequent awakenings throughout the night

  • Dry mouth or sore throat upon waking

  • Morning headaches

  • Daytime fatigue and excessive sleepiness

  • Difficulty concentrating or memory problems

  • Irritability or mood swings

  • Anxiety or depression

  • Reduced libido or sexual dysfunction

  • Nocturia (frequent nighttime urination)

The severity of these symptoms often depends on the type of sleep apnea and how many times breathing stops each night.

What Causes Sleep Apnea?

Sleep apnea results from the airway becoming blocked (in OSA) or the brain failing to regulate breathing (in CSA). A variety of factors can contribute to both forms.

Obstructive Sleep Apnea Causes

  • Enlarged tonsils or adenoids

  • Obesity or excess body fat around the neck

  • Anatomical abnormalities (e.g., small jaw, thick neck, deviated septum)

  • Hormonal imbalances (e.g., hypothyroidism)

  • Metabolic conditions like diabetes

Central Sleep Apnea Causes

  • Congestive heart failure

  • Stroke or traumatic brain injury

  • Neurological disorders (e.g., ALS)

  • Opioid pain medications

  • Genetic syndromes (e.g., Prader-Willi, Rett syndrome)

  • Kidney failure or other chronic illnesses

Risk Factors

Several factors increase the likelihood of developing sleep apnea:

  • Age: More common in adults over 40

  • Sex: More frequent in males than females

  • Obesity: A leading contributor to OSA

  • Family history: Genetic predisposition increases risk

  • Smoking: Causes airway inflammation

  • Alcohol and sedative use: Relax throat muscles, worsening OSA

  • Nasal congestion or allergies

Awareness of these risk factors can help with early detection and prevention.

How Sleep Apnea Is Diagnosed

Diagnosis usually begins with a clinical evaluation of symptoms, sleep history, and risk factors. If sleep apnea is suspected, your provider will order specific diagnostic tests.

Polysomnography (Sleep Study)

This overnight test is conducted at a sleep lab where sensors monitor your brain waves, heart rate, oxygen levels, breathing patterns, and muscle activity during sleep. It provides a comprehensive analysis of your sleep cycles and helps determine the type and severity of apnea.

Home Sleep Apnea Testing (HSAT)

A simplified version of polysomnography, HSAT uses portable equipment to measure breathing, airflow, and oxygen levels at home. It's less comprehensive but more accessible and often used for suspected OSA.

Sleep studies yield an Apnea-Hypopnea Index (AHI) score, which helps classify the condition:

  • Mild: 5–15 events/hour

  • Moderate: 15–30 events/hour

  • Severe: 30+ events/hour

Treatment Options

Effective sleep apnea treatment aims to restore normal breathing, improve sleep quality, and reduce associated health risks.

Lifestyle Modifications

Making certain changes in behavior and daily routine can significantly improve or even resolve mild sleep apnea:

  • Weight management: Losing excess weight can relieve pressure on the airway.

  • Limit alcohol and sedatives: These relax throat muscles and increase the risk of airway blockage.

  • Sleep position: Sleeping on your side reduces airway collapse.

  • Quit smoking: Reduces inflammation and improves breathing.

Breathing Devices

These are the gold standard for moderate to severe OSA.

  • CPAP (Continuous Positive Airway Pressure): Delivers a steady flow of air through a mask to keep airways open.

  • BiPAP (Bilevel Positive Airway Pressure): Provides different air pressures for inhaling and exhaling.

  • APAP (Auto-Adjusting Positive Airway Pressure): Automatically adjusts pressure based on real-time needs during sleep.

Oral Appliances

Custom dental devices can reposition the jaw or tongue to prevent airway blockage. These are often used for people who cannot tolerate CPAP therapy.

  • Mandibular advancement devices

  • Tongue-retaining mouthpieces

Medications

Medication is not typically used for OSA but may help manage CSA. Drugs like acetazolamide or theophylline stimulate breathing and regulate the respiratory center.

Surgical Interventions

Surgery is considered when other treatments fail or in anatomical cases:

  • Adenotonsillectomy: Removes enlarged tonsils and adenoids.

  • Uvulopalatopharyngoplasty (UPPP): Removes excess soft tissue in the throat.

  • Maxillomandibular advancement (MMA): Repositions the jaw to expand the airway.

  • Implantable devices: Inspire therapy (nerve stimulation) for moderate to severe OSA.

How to Prevent Sleep Apnea

Though not always preventable, you can reduce your risk with the following strategies:

  • Maintain a healthy BMI

  • Avoid alcohol and heavy meals before bed

  • Sleep on your side

  • Exercise regularly

  • Treat allergies and nasal congestion

  • Stop smoking

Consistent preventive measures can protect your sleep quality and overall health.

Related Health Risks

When untreated, sleep apnea can significantly increase the risk of:

  • High blood pressure

  • Heart disease and stroke

  • Type 2 diabetes

  • Cognitive decline and memory issues

  • Mood disorders (e.g., depression, anxiety)

  • Daytime accidents due to fatigue

Early intervention is essential to reduce these risks.

Living With Sleep Apnea

Sleep apnea is a lifelong condition for many, but with proper treatment, it can be effectively managed. Most individuals report better energy, mood, and cognitive function after beginning therapy.

Tips for living well with sleep apnea:

  • Stick to your CPAP or oral device regimen

  • Monitor your sleep quality with a diary or app

  • Follow up regularly with a sleep specialist

  • Make sleep hygiene a priority—limit screen time, caffeine, and stress before bed

If symptoms persist despite treatment, consult your healthcare provider for adjustments.