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Sleep apnea is a common sleep-related breathing disorder in which breathing repeatedly stops and starts during sleep. Many people do not realize they have it because the symptoms occur while they are asleep. Loud snoring, gasping during sleep, morning headaches, dry mouth, poor concentration, and excessive daytime sleepiness are some of the commonly searched symptoms associated with sleep apnea. However, not everyone with sleep apnea snores, and symptoms can vary between individuals.

What Is Sleep Apnea?

Sleep apnea is a condition in which breathing is repeatedly interrupted during sleep. These interruptions can occur because the airway becomes blocked or because the brain temporarily fails to send the correct signals to the muscles responsible for breathing.

When breathing stops or becomes significantly reduced, the body may briefly wake up or move into lighter sleep to restore normal breathing. These interruptions can happen repeatedly throughout the night, making restful sleep difficult.

What Does “Apnea” Mean?

An apnea is a temporary pause in breathing during sleep. A person may not remember these brief awakenings, but they can repeatedly disturb normal sleep.

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What Are the Main Types of Sleep Apnea?

Obstructive Sleep Apnea (OSA)

Obstructive sleep apnea is the most common type. It occurs when the muscles in the throat relax during sleep and partially or completely block the upper airway. This can lead to pauses in breathing, snoring, choking sounds, or gasping.

Central Sleep Apnea (CSA)

Central sleep apnea occurs when the brain does not properly send signals to the muscles that control breathing. Unlike obstructive sleep apnea, the primary problem is not necessarily a physical blockage of the airway.

Treatment-Emergent Central Sleep Apnea

In some cases, central breathing pauses may develop or become apparent during treatment for obstructive sleep apnea. This is sometimes referred to as treatment-emergent central sleep apnea and requires professional evaluation.

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What Are the Common Symptoms of Sleep Apnea?

Symptoms can occur during sleep and during the day. Some people may not notice their nighttime symptoms, so a partner or family member may be the first person to recognize a problem.

Symptoms During Sleep

Common nighttime signs may include:

• Loud or frequent snoring
• Breathing that stops and starts
• Gasping or choking during sleep
• Restless sleep
• Frequent awakenings
• Dry mouth after waking
• Waking up to urinate frequently

A person may have sleep apnea without loud snoring, so the absence of snoring does not necessarily rule it out.

Daytime Symptoms

Possible daytime symptoms include:

• Excessive sleepiness
• Feeling tired despite spending enough time in bed
• Difficulty concentrating
• Problems with attention and memory
• Morning headaches
• Irritability or mood changes
• Difficulty staying awake during routine activities

Because these symptoms can also occur with other health conditions, they cannot by themselves confirm sleep apnea. (NHLBI, NIH)

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Can You Have Sleep Apnea Without Snoring?

Yes. Not everyone with sleep apnea snores. Snoring is common, particularly with obstructive sleep apnea, but some people may mainly experience fatigue, morning headaches, insomnia, or daytime sleepiness.

This is one reason sleep apnea can go undiagnosed, particularly when a person sleeps alone and no one observes breathing pauses during the night.

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What Causes Sleep Apnea?

The causes depend on the type of sleep apnea.

Causes and Risk Factors for Obstructive Sleep Apnea

Factors that may increase the risk include:

• Narrowing of the upper airway
• Relaxation of throat muscles during sleep
• Excess body weight
• Certain facial or airway structures
• Enlarged tonsils or other physical obstructions
• Nasal congestion
• Family history
• Increasing age

However, sleep apnea can occur in people of different body types and ages.

Causes and Risk Factors for Central Sleep Apnea

Central sleep apnea may be associated with certain medical conditions, nervous-system problems, medications, or other factors affecting breathing control. The cause needs to be assessed by a healthcare professional.

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Is Sleep Apnea More Common in Women?

Sleep apnea can affect women, but it may sometimes be overlooked because symptoms can differ from the classic image of loud snoring and witnessed breathing pauses.

Women may more commonly report symptoms such as:

• Daytime tiredness
• Fatigue
• Morning headaches
• Insomnia
• Anxiety
• Depression
• Frequent waking during sleep

The risk of sleep apnea may increase during pregnancy and during or after menopause.

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Sleep Apnea During Pregnancy: What Should You Know?

Pregnancy can change the airway and breathing patterns, which may increase the risk of sleep apnea or worsen existing sleep apnea. The condition may be more serious later in pregnancy and can be associated with complications such as high blood pressure, gestational diabetes, preterm birth, and low birth weight.

Anyone who is pregnant and has symptoms of sleep apnea should discuss them with a qualified healthcare professional. Do not start or stop any treatment or breathing device without medical guidance.

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Can Children Have Sleep Apnea?

Yes. Sleep apnea can occur in children. In children, symptoms may sometimes look different from those seen in adults.

Possible signs include:

• Snoring
• Mouth breathing
• Breathing pauses during sleep
• Difficulty paying attention
• Daytime sleepiness
• Behavioral changes
• Morning headaches or dry mouth

Children with suspected sleep apnea should be evaluated by an appropriate healthcare professional.

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How Is Sleep Apnea Diagnosed?

A healthcare professional usually considers symptoms, sleep history, physical examination, and appropriate testing.

Sleep Study

A sleep study, also known as polysomnography, may monitor several body functions during sleep, including breathing patterns, oxygen levels, heart activity, brain activity, and body movements.

Home Sleep Apnea Test

Some people may be suitable for a home sleep test. These tests monitor selected signals related to breathing during sleep. However, a home test may not detect every case, and a healthcare professional may recommend further testing when appropriate.

Can a Smartwatch Diagnose Sleep Apnea?

Smartwatches and fitness trackers may provide useful information about sleep patterns, heart rate, or oxygen levels, depending on the device. However, consumer devices should not be considered a replacement for professional evaluation and appropriate sleep testing.

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What Is AHI in Sleep Apnea?

AHI stands for Apnea-Hypopnea Index. It is a measurement used during sleep evaluation to describe the number of breathing pauses and reduced-breathing events detected per hour of sleep.

A healthcare professional interprets AHI together with symptoms, test quality, medical history, and other findings. One number alone does not provide the complete picture of a person’s health or treatment needs.

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What Is the Treatment for Sleep Apnea?

Treatment depends on the type and severity of sleep apnea, the person’s symptoms, other health conditions, and individual circumstances.

CPAP Therapy

CPAP, or continuous positive airway pressure, uses a machine to deliver pressurized air through a mask to help keep the airway open during sleep. It is one of the most commonly used treatments for obstructive sleep apnea.

Other Positive Airway Pressure Devices

Some people may be prescribed other forms of positive airway pressure therapy depending on their specific condition.

Oral Appliances

Certain dental or oral devices may help reposition the jaw or tongue to improve airflow in selected people with obstructive sleep apnea.

Lifestyle Changes

Depending on the individual situation, a healthcare professional may recommend measures such as:

• Maintaining a healthy weight
• Treating nasal congestion
• Avoiding smoking
• Reviewing alcohol intake
• Following a regular sleep schedule
• Sleeping in a position recommended by a healthcare professional

Lifestyle measures may be helpful, but they are not a universal substitute for prescribed treatment.

Surgery

In selected cases, surgery may be considered to address specific anatomical problems contributing to airway obstruction.

Treatment for Central Sleep Apnea

Treatment may involve addressing an underlying medical condition, reviewing medicines that may affect breathing, or using a suitable breathing device or other therapy recommended by a specialist.

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Is CPAP the Only Treatment for Sleep Apnea?

No. CPAP is an important treatment option, but it is not the only possible approach. Depending on the individual, treatment may include other positive airway pressure devices, oral appliances, lifestyle measures, surgery, or treatment of an underlying condition.

The most appropriate option should be determined with a qualified healthcare professional.

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What Happens If Sleep Apnea Is Not Treated?

Untreated sleep apnea can cause ongoing sleep disruption and daytime symptoms. Sleep apnea is also associated with important health risks, including cardiovascular problems. Effective treatment can improve sleep and daytime well-being and may reduce certain health risks.

If you regularly feel excessively sleepy during the day, have witnessed breathing pauses during sleep, or wake up gasping for air, it is sensible to discuss these symptoms with a healthcare professional.

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Can Sleep Apnea Cause Morning Headaches?

Yes, morning headaches can occur in people with sleep apnea. However, headaches have many possible causes. A morning headache alone does not prove that someone has sleep apnea.

If morning headaches are frequent or occur together with loud snoring, breathing pauses, gasping during sleep, or excessive daytime sleepiness, discussing the symptoms with a healthcare professional may be appropriate.

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Can Sleep Apnea Cause Daytime Sleepiness?

Yes. Repeated sleep interruptions can contribute to excessive daytime sleepiness and tiredness. Some people may also experience difficulty focusing, problems with attention, or irritability.

If sleepiness is severe, avoid driving or operating machinery when you feel unable to remain alert.

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Can Sleep Apnea Be Cured?

The answer depends on the cause and type of sleep apnea. Some people may experience significant improvement after addressing contributing factors, while others may require long-term treatment.

A person should not stop CPAP or another prescribed therapy simply because they feel better. Any change in treatment should be discussed with the healthcare professional managing the condition.

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What Can You Do If You Think You Have Sleep Apnea?

If you suspect sleep apnea:

1. Make a list of your symptoms.
2. Ask a sleep partner or family member whether they have noticed snoring or breathing pauses.
3. Discuss your concerns with a qualified healthcare professional.
4. Follow recommended testing and evaluation.
5. Use prescribed treatment as directed.
6. Do not rely on self-diagnosis from symptoms or wearable devices alone.

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Frequently Asked Questions About Sleep Apnea

Is sleep apnea dangerous?

Sleep apnea can be a serious health condition, particularly when it is untreated. The seriousness depends on the type, severity, symptoms, and overall health of the individual.

Is loud snoring always sleep apnea?

No. Loud snoring can have many causes, and not everyone who snores has sleep apnea. However, loud snoring combined with gasping, choking, or observed breathing pauses should be discussed with a healthcare professional.

Can thin people have sleep apnea?

Yes. Although certain risk factors can increase the likelihood of obstructive sleep apnea, it can occur in people with different body types.

Can sleep apnea cause insomnia?

Sleep apnea and insomnia can occur together. Some people with sleep apnea may experience difficulty staying asleep or frequent awakenings.

Can sleep apnea cause dry mouth?

Yes. Dry mouth after waking can occur, particularly when a person breathes through the mouth during sleep. However, dry mouth has many possible causes.

Can sleep apnea go away on its own?

It depends on the underlying cause. Symptoms may change over time, but suspected sleep apnea should not simply be ignored. Proper evaluation can determine whether treatment is needed.

Should I buy a CPAP machine without a diagnosis?

It is better to obtain appropriate medical evaluation before starting treatment. The correct device and settings depend on the individual’s condition.

Can sleep apnea be treated without CPAP?

Sometimes. Depending on the diagnosis, other options may be considered, including oral appliances, lifestyle measures, surgery, or other therapies. The appropriate treatment depends on the individual.

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When Should You See a Doctor?

Consider speaking with a healthcare professional if you experience:

• Repeated breathing pauses during sleep
• Gasping or choking at night
• Persistent loud snoring
• Excessive daytime sleepiness
• Frequent morning headaches
• Ongoing fatigue despite adequate time in bed
• Difficulty concentrating or staying awake

If you are so sleepy that you may fall asleep while driving, do not drive. Seek appropriate medical advice and arrange safe transportation.

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Final Takeaway

Sleep apnea is more than ordinary snoring. It is a sleep-related breathing disorder that can repeatedly interrupt breathing and disturb restorative sleep. The most common type is obstructive sleep apnea, but central sleep apnea also occurs. Symptoms can include snoring, gasping, breathing pauses, daytime sleepiness, morning headaches, insomnia, and difficulty concentrating. Diagnosis generally requires professional evaluation and may involve a sleep study or home sleep testing. Effective treatments are available, including CPAP and other options selected according to the individual’s condition.