Sleep Apnea

Sleep apnea is a sleep disorder in which breathing repeatedly stops or becomes too shallow during sleep. These interruptions may last long enough to reduce oxygen and briefly wake the brain, even when the person does not remember waking. Adults and children can both develop sleep apnea. The most common type in adults is obstructive sleep apnea, which occurs when the upper airway becomes blocked.

Some symptoms of sleep apnea are noticed by the person during the day, while others are first observed by a bed partner during sleep. Nighttime breathing changes may be especially important because the person may not remember them the next morning.

How breathing becomes interrupted

In obstructive sleep apnea, muscles and tissues in the throat relax during sleep, causing the upper airway to narrow or close and limiting airflow. In central sleep apnea, the airway may be open, but the brain’s signals to the breathing muscles are interrupted or reduced. Both types can cause repeated changes in breathing, sleep disruption, and drops in oxygen.

Risk varies by sleep apnea type, age, anatomy, and overall health. Having one or more risk factors does not confirm a diagnosis, and people without obvious risk factors can still develop sleep apnea.

Repeated oxygen drops, disrupted sleep, and untreated breathing events can contribute to high blood pressure and cardiovascular disease. Sleep apnea may also make glucose control more difficult and contribute to mood, memory, or concentration problems. Excessive daytime sleepiness can increase the risk of driving or workplace accidents.

The apnea-hypopnea index, or AHI, describes the number of apneas and hypopneas recorded per hour of sleep. It helps estimate breathing-event severity, but clinicians interpret it alongside symptoms, oxygen levels, other test findings, and the person’s medical context.

Evaluation usually includes a review of symptoms, bed-partner observations, medical history, medicines, and factors that may affect breathing during sleep. A clinician may also examine the nose, mouth, throat, jaw, and other features related to the airway. A sleep study is generally needed to confirm suspected sleep apnea and identify its type and severity.

AHI is the number of apnea and hypopnea events per hour of sleep. Clinicians also consider oxygen levels, symptoms, sleep position, the amount of sleep recorded, and whether events are obstructive or central when interpreting sleep apnoea studies.

Devices and procedures

Continuous positive airway pressure (CPAP) or another form of positive airway pressure can keep the airway open during sleep. Oral appliances, positional therapy, nerve stimulation, and selected upper-airway or jaw surgery may be considered for appropriate patients. Treatment is individualized according to the type and severity of sleep apnea, anatomy, symptoms, health conditions, and preferences, with follow-up to assess effectiveness, comfort, and ongoing use.

Anatomy, age, family history, and some medical conditions cannot be changed, so prevention is not always possible. However, addressing manageable risk factors may lower the likelihood or severity of obstructive sleep apnea.

Sleep apnea is often manageable, and symptoms and health risks can improve substantially when treatment is effective. Untreated disease may persist or worsen as weight, age, medicines, or other risk factors change. Regular follow-up helps confirm that treatment continues to control breathing events.

Some obstructive cases improve or resolve after a targeted intervention, but many people need ongoing treatment and periodic follow-up. Whether sleep apnea can be cured depends on its type, cause, severity, and response to treatment.