Published: 18 Jun 2025

ICD9: 327.23      ICD10: G47.33      ICD11: 7A41

Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.
These pauses can last from a few seconds to minutes and may occur 30 times or more an hour. These interruptions disrupt your sleep, leading to daytime fatigue and other health problems.

Here's a breakdown of key aspects of sleep apnea:

What Happens During Sleep Apnea:

Pauses in Breathing (Apnea): The word "apnea" means "cessation of breathing." During an apnea episode, breathing stops completely.
Shallow Breaths (Hypopnea): "Hypopnea" refers to abnormally shallow breathing.
Reduced Oxygen Levels: When breathing stops or becomes shallow, the amount of oxygen in your blood can decrease.
Brain Arousal: Your brain senses the drop in oxygen and briefly arouses you from sleep to restart breathing. Often, you're not fully aware of these awakenings, but they disrupt your sleep cycles.
Snoring and Gasping: Loud snoring is a common symptom, often followed by gasping, choking, or snorting sounds as you struggle to breathe again.

Types of Sleep Apnea:

There are three main types:

Obstructive Sleep Apnea (OSA): This is the most common type. It occurs when the muscles in the back of your throat relax, causing the soft tissues to collapse and block your airway. Think of it like a hose being pinched shut. Contributing factors can include excess weight, a large neck circumference, a recessed chin, and enlarged tonsils or adenoids.
Central Sleep Apnea (CSA): This type is less common. It happens because the brain doesn't send proper signals to the muscles that control breathing. There's no physical blockage; it's a problem with the brain's breathing control center. It can be caused by certain medical conditions (e.g., heart failure, stroke), medications (e.g., opioids), or high altitude.
Complex Sleep Apnea (Mixed Sleep Apnea): This is a combination of both obstructive and central sleep apnea.

Symptoms of Sleep Apnea:

Loud snoring: This is a hallmark symptom, although not everyone who snores has sleep apnea. Often, it's the *interrupted* snoring with gasps that's more indicative.
Daytime sleepiness/fatigue: Feeling excessively tired during the day, even after a full night's sleep.
Morning headaches: Often due to decreased oxygen levels overnight.
Difficulty concentrating: Impaired focus and memory problems.
Irritability and mood changes: Sleep deprivation can affect mood.
Dry mouth or sore throat upon waking: Due to mouth breathing.
Gasping or choking during sleep: This can be reported by a bed partner.
Frequent nighttime urination: Hormonal changes and fragmented sleep can increase nighttime urination.
Decreased libido: Sleep apnea can affect hormone levels.

Risk Factors for Sleep Apnea:

Excess weight/Obesity: Extra tissue around the neck can narrow the airway.
Large neck circumference: A thicker neck often indicates increased tissue around the airway.
Male sex: Men are more likely to develop sleep apnea than women. (However, after menopause, the risk in women increases.)
Older age: The risk increases with age.
Family history: Having a family member with sleep apnea increases your risk.
Nasal congestion: Chronic nasal congestion or allergies can contribute.
Use of alcohol, sedatives, or tranquilizers: These can relax throat muscles.
Smoking: Smoking can cause inflammation and swelling in the upper airway.
Certain medical conditions: High blood pressure, type 2 diabetes, heart failure, and stroke are associated with increased risk.
Certain physical characteristics: A recessed chin, enlarged tonsils or adenoids, or a large tongue can contribute to airway obstruction.

Diagnosis:

Medical history and physical exam: Your doctor will ask about your symptoms and risk factors.
Sleep study (Polysomnography): This is the gold standard for diagnosis. It involves monitoring your brain waves, eye movements, heart rate, breathing patterns, and blood oxygen levels while you sleep. It can be done in a sleep lab (in-lab polysomnography) or at home (home sleep apnea test - HSAT).
Home Sleep Apnea Test (HSAT): A simplified sleep study that you can do at home. It usually measures heart rate, blood oxygen levels, airflow, and breathing patterns. HSATs are generally used for people suspected of having moderate to severe OSA.

Treatment:

The goals of treatment are to restore normal breathing during sleep and relieve symptoms. Treatment options include:

Lifestyle changes:
Weight loss: Even a modest weight loss can improve symptoms.
Sleeping on your side: Avoid sleeping on your back, which can worsen airway obstruction.
Avoiding alcohol and sedatives before bed: These can relax throat muscles.
Quitting smoking: Smoking irritates and inflames the airways.
Continuous Positive Airway Pressure (CPAP): This is the most common and effective treatment for OSA. It involves wearing a mask over your nose or mouth that delivers a constant stream of air, keeping your airway open during sleep.
Oral appliances (Mandibular Advancement Devices): These are mouthpieces that shift your lower jaw forward, helping to open your airway. They are usually fitted by a dentist.
Surgery: Surgery may be an option in some cases to remove excess tissue or correct structural problems in the airway. Examples include tonsillectomy, adenoidectomy, and maxillomandibular advancement.
Adaptive Servo-Ventilation (ASV): A more advanced type of positive airway pressure therapy used primarily for central sleep apnea.
Positional Therapy: Devices or techniques that help you stay off your back while sleeping.
Nasal Decongestants or Allergy Medications: To improve nasal breathing.

Why is Sleep Apnea Important?

Untreated sleep apnea can have serious health consequences, including:

High blood pressure: Sleep apnea increases the risk of hypertension.
Heart disease: Increased risk of heart attack, stroke, and heart failure.
Type 2 diabetes: Sleep apnea is linked to insulin resistance and increased risk of diabetes.
Depression: Sleep deprivation can contribute to depression.
Accidents: Daytime sleepiness increases the risk of car accidents and workplace injuries.
Liver problems: Sleep apnea can lead to non-alcoholic fatty liver disease.
Cognitive impairment: Memory and concentration problems.

In summary, sleep apnea is a serious sleep disorder characterized by pauses in breathing during sleep. It's important to be aware of the symptoms and risk factors and to seek medical evaluation if you suspect you have sleep apnea. Effective treatments are available to improve your sleep and reduce the risk of health complications.

It's crucial to consult with a doctor for diagnosis and treatment of sleep apnea. Self-treating can be dangerous and may not address the underlying cause of the problem.