Signs and symptoms of obstructive sleep apnea include:
- Excessive daytime sleepiness
- Loud snoring
- Observed episodes of breathing cessation during sleep
- Abrupt awakenings accompanied by shortness of breath
- Awakening with a dry mouth or sore throat
- Awakening with chest pain
- Morning headache
- Difficulty concentrating during the day
- Experiencing mood changes, such as depression or irritability
- Difficulty staying asleep (insomnia)
- Having high blood pressure
When to see a doctor
Consult a medical professional if you experience, or if your partner observes, the following:
- Snoring loud enough to disturb your sleep or that of others
- Shortness of breath that awakens you from sleep
- Intermittent pauses in your breathing during sleep
- Excessive daytime drowsiness, which may cause you to fall asleep while you're working, watching television or even driving a vehicle
Many people don't think of snoring as a sign of something potentially serious, and not everyone who snores has obstructive sleep apnea. However, be sure to talk to your doctor if you experience loud snoring, especially snoring that's punctuated by periods of silence.
With obstructive sleep apnea, snoring usually is loudest when you sleep on your back, and it quiets when you turn on your side.
Ask your doctor about any sleep problem that leaves you chronically fatigued, sleepy and irritable. Excessive daytime drowsiness may be due to other disorders, such as narcolepsy.
Obstructive sleep apnea occurs when the muscles in the back of your throat relax too much to allow normal breathing. These muscles support structures including the soft palate, the uvula — a triangular piece of tissue hanging from the soft palate, the tonsils and the tongue.
When the muscles relax, your airway narrows or closes as you breathe in and breathing may be inadequate for 10 to 20 seconds. This may lower the level of oxygen in your blood. Your brain senses this impaired breathing and briefly rouses you from sleep so that you can reopen your airway. This awakening is usually so brief that you don't remember it.
You can awaken with a transient shortness of breath that corrects itself quickly, within one or two deep breaths. You may make a snorting, choking or gasping sound.
This pattern can repeat itself five to 30 times or more each hour, all night long. These disruptions impair your ability to reach the desired deep, restful phases of sleep, and you'll probably feel sleepy during your waking hours.
People with obstructive sleep apnea may not be aware that their sleep was interrupted. In fact, many people with this type of sleep apnea think they slept well all night.
Anyone can develop obstructive sleep apnea. However, certain factors put you at increased risk, including:
Being overweight. Around half of people with obstructive sleep apnea are overweight. Fat deposits around the upper airway may obstruct breathing. Also, people with obstructive sleep apnea tend to have a larger waist.
However, not everyone with obstructive sleep apnea is overweight and vice versa. Thin people can develop the disorder, too.
Having a large neck. The size of your neck may indicate whether you have an increased risk.
A thick neck may narrow the airway and may be an indication of excess weight. A neck circumference greater than 17 inches for men and 16 inches for women is associated with an increased risk of obstructive sleep apnea.
- Having high blood pressure (hypertension). Obstructive sleep apnea is relatively common in people with hypertension.
- Having a narrowed airway. You may inherit a naturally narrow throat. Or your tonsils or adenoids may become enlarged, which can block your airway.
- Having chronic nasal congestion. Obstructive sleep apnea occurs twice as often in those who have consistent nasal congestion at night, regardless of the cause. This may be due to narrowed airways.
- Having diabetes. Obstructive sleep apnea may be more common in people with diabetes.
- Being male. In general, men are twice as likely to have obstructive sleep apnea.
- Being black. Among people under age 35, obstructive sleep apnea is more common in blacks.
- Being a certain age. Obstructive sleep apnea usually occurs in adults who are ages 18 to 60, but it can occur at any age.
- Having a family history of sleep apnea. If you have family members with obstructive sleep apnea, you may be at increased risk.
- Smoking. People who smoke are more likely to have obstructive sleep apnea.
- Using alcohol. Alcohol may worsen obstructive sleep apnea.
Obstructive sleep apnea is considered a serious medical condition. Complications may include:
Cardiovascular problems. Sudden drops in blood oxygen levels that occur during obstructive sleep apnea increase blood pressure and strain the cardiovascular system.
Many people with obstructive sleep apnea develop high blood pressure (hypertension), which can increase the risk of heart disease.
The more severe the obstructive sleep apnea, the greater the risk of coronary artery disease, heart attack, heart failure and stroke. In a study, men with obstructive sleep apnea appeared to be at risk of heart failure, but women with obstructive sleep apnea didn't appear to have a higher risk of heart failure.
People with obstructive sleep apnea are much more likely to develop abnormal heart rhythms (arrhythmias).
If there's underlying heart disease, these repeated multiple episodes of low blood oxygen (hypoxia or hypoxemia) could lead to sudden death from a cardiac event.
Daytime fatigue. The repeated awakenings associated with obstructive sleep apnea make normal, restorative sleep impossible. People with obstructive sleep apnea often experience severe daytime drowsiness, fatigue and irritability. They may have difficulty concentrating and find themselves falling asleep at work, while watching TV or even when driving.
Children and young people with obstructive sleep apnea may do poorly in school and commonly have attention or behavior problems.
Treatment of obstructive sleep apnea can improve these symptoms, restoring alertness and improving quality of life.
Complications with medications and surgery. Obstructive sleep apnea also is a concern with certain medications and general anesthesia. These medications, such as sedatives, narcotic analgesics and general anesthesia, relax your upper airway and may worsen your obstructive sleep apnea.
If you have obstructive sleep apnea, you may experience worse breathing problems after major surgery, especially after being sedated and lying on your back.
People with obstructive sleep apnea may be more prone to complications after surgery.
Before you have surgery, tell your doctor if you have obstructive sleep apnea or symptoms related to obstructive sleep apnea. If you have obstructive sleep apnea symptoms, your doctor may test you for obstructive sleep apnea prior to surgery.
- Eye problems. Some research has found a connection between obstructive sleep apnea and certain eye conditions, such as glaucoma. Eye complications can usually be treated.
- Sleep-deprived partners. Loud snoring can keep those around you from getting good rest and eventually disrupt your relationships. It's not uncommon for a partner to choose to sleep in another room. Many bed partners of people who snore are sleep deprived as well.
People with obstructive sleep apnea may also complain of memory problems, morning headaches, mood swings or feelings of depression, and a need to urinate frequently at night (nocturia).