Causes and Risk Factors
During sleep, the soft tissues at the back of the throat can collapse and narrow or close the airway. Several factors make this more likely:- Excess body weight: Fat deposits around the upper airway are the single most important risk factor in adults.
- Anatomy: A thick neck, large tonsils, a large tongue, a small or recessed jaw, or chronic nasal congestion can narrow the airway.
- Age and sex: Sleep apnea becomes more common with age and affects men more often, although risk in women rises after menopause.
- Alcohol and sedatives: These relax the throat muscles and worsen airway collapse, especially near bedtime.
- Smoking and family history: Both increase the likelihood of developing the condition.
Symptoms
Many people learn about their symptoms from a bed partner. Common signs include:- Loud, chronic snoring: Often interrupted by silent pauses followed by gasping or choking sounds.
- Excessive daytime sleepiness: Dozing off while reading, watching television, or driving despite a full night in bed.
- Morning headaches and dry mouth: Frequent on waking.
- Poor concentration, irritability, or low mood: Fragmented sleep affects memory and mental health.
- Frequent nighttime urination: Waking several times a night to urinate can be a clue.
Diagnosis
Diagnosis is made with a sleep study, either a home sleep apnea test or an overnight study in a sleep laboratory. These tests count how many times per hour breathing pauses or becomes shallow and measure how far blood oxygen levels drop. Your physician will also review your blood pressure, heart health, and medications, since untreated apnea makes conditions such as diabetes and hypertension harder to control.Treatment
Effective treatment restores restful sleep and lowers cardiovascular risk.- CPAP therapy: Continuous positive airway pressure, delivered through a small mask, holds the airway open and is the most effective treatment for moderate to severe OSA.
- Oral appliances: Custom dental devices that move the jaw forward can help mild to moderate cases or people who cannot tolerate CPAP.
- Weight loss and lifestyle changes: Losing even 10 percent of body weight, avoiding alcohol before bed, and sleeping on your side can meaningfully reduce apnea severity.
- Wake-promoting medications: For people who remain sleepy despite good CPAP use, medications such as solriamfetol, modafinil, or armodafinil may be prescribed to improve daytime alertness.
- Surgery or implanted nerve stimulators: Options for selected patients when other measures fail.