People with sleep apnea frequently wake up snoring and gasping for breath. They may feel tired and irritable throughout the day, even after getting a full night’s sleep.

Untreated, obstructive sleep apnea can lead to high blood pressure and heart problems. It can also raise the risk of type 2 diabetes, stroke and arrhythmias (abnormal heart rhythms). Loud snoring is a warning sign.

Symptoms

Obstructive sleep apnea causes your airway to close or narrow while you are breathing in. That lowers your oxygen level and can cause a buildup of carbon dioxide. Your brain senses this and briefly rouses you from sleep to breathe again. This waking can be so brief that you don’t remember it, or it might be accompanied by a gasping or choking sound.

Other symptoms of obstructive sleep apnea include snoring, morning headaches and poor concentration. It can also lead to irritability and trouble staying awake during the day, putting you at higher risk for high blood pressure, heart problems or strokes.

People who have certain factors, such as obesity or a thick neck, may be more likely to develop obstructive sleep apnea. In some cases, a mouthpiece or surgery to remove the tonsils or adenoids might reduce snoring and improve sleep apnea. Changing your sleeping position or avoiding alcohol before bed can also help. It’s important to inform new doctors of any history with obstructive sleep apnea so they can be aware of it and monitor you carefully.

Diagnosis

If you have symptoms of sleep apnea, your doctor can refer you to a specialist in treating sleep disorders. GPs may also prescribe at-home sleep tests, using devices that monitor your breathing and heart rate while you sleep.

The data from an at-home test is uploaded to a website and sent to your doctor, who can then analyse it to see how often you stop breathing and wake up during the night. This can help determine whether you have obstructive sleep apnea or central sleep apnea and how severe it is.

In more serious cases of obstructive sleep apnea, your health care provider might recommend an in-lab sleep study called polysomnography. During this overnight stay in a sleep laboratory, multiple sensors track your breathing, oxygen levels, heart rate, muscle movement, and other aspects of your sleep. These tests are the most dependable way to diagnose both obstructive and central sleep apnea. Depending on your results, treatment might include lifestyle changes such as weight loss and quitting smoking, a device to aid breathing, or surgery.

Treatment

Untreated sleep apnea can cause a variety of short- and long-term health problems. It can put you at a higher risk for accidents such as car crashes or work-related injuries because of excessive daytime sleepiness, and may affect your performance at school, work, or home. It can also lead to depression and memory problems. It increases your risk for heart disease, high blood pressure, and abnormal heartbeats. And it can change your liver function test results.

Effective treatment can help you feel more alert, rested, and healthy. A CPAP machine provides constant air pressure through your upper airways to keep them open and prevent them from collapsing during sleep. Other options include jaw surgery (uvulopalatopharyngoplasty), which can subtly change the shape of your mouth and throat; nasal surgeries that can improve air flow; and medications such as hypnotics and respiratory-stimulating drugs. A tracheostomy is a last resort for people with life-threatening sleep apnea, in which a surgeon creates an opening into the neck and inserts a tube you can breathe through.

Prevention

If untreated, sleep apnea can make it hard to concentrate and perform well at work or in other activities that require attention. It may also increase your risk of accidents, such as car crashes or work-related injuries.

The risk of sleep apnea increases with age, but the rate increases much more rapidly for people who are obese or have excess weight. The risk is greater for men than for women, especially in the earlier parts of adulthood. People with certain anatomic features of the head and neck are more likely to have obstructive sleep apnea, including enlarged tonsils or a shortened lower jaw.

Over-the-counter medications such as nasal sprays and adhesive strips can help improve breathing during sleep by reducing congestion. Weight loss can also reduce symptoms of OSA. Avoid back sleeping, and use special pillows or products that can help you sleep in a more comfortable position. Avoid drinking alcohol or taking sedatives before bedtime, as they can worsen your breathing.