Sleep Apnea Explained: Symptoms, Diagnosis & Care

What is sleep apnea?

Sleep apnea is a sleep disorder in which breathing repeatedly stops and starts throughout the night. These pauses can be brief but frequent, fragmenting sleep and reducing oxygen levels. There are different types, including obstructive sleep apnea (OSA), caused by physical blockages in the airway, and central sleep apnea, which involves the brain failing to signal the muscles that control breathing.

Common signs and potential health impacts

Typical symptoms of sleep apnea include:

• Loud, persistent snoring
• Episodes of gasping, choking, or interrupted breathing during sleep
• Excessive daytime sleepiness and fatigue
• Morning headaches
• Trouble focusing or memory problems
• Mood swings, irritability, or depressive symptoms
• Elevated blood pressure

When left untreated, sleep apnea raises the risk of serious conditions such as cardiovascular disease, type 2 diabetes, and worsening mood disorders. It can also increase the likelihood of accidents due to daytime drowsiness.

How is sleep apnea diagnosed?

Diagnosis usually begins with a consultation with a sleep specialist who reviews your medical history and performs a physical exam. Key diagnostic tools include:

1. Polysomnography (in-lab sleep study) — a comprehensive overnight test that records brain waves, eye movements, heart rate, respiratory effort, airflow, and blood oxygen levels to assess sleep stages and breathing disruptions.

2. Home sleep apnea testing — a simplified, portable option that measures breathing, oxygen levels, and other parameters over a night in your own bed. These tests are convenient and often used for suspected moderate-to-severe obstructive sleep apnea.

3. Additional tests — in some cases, further evaluations (such as imaging or cardiology consults) are needed to rule out other disorders or to determine the severity and underlying causes.

Your clinician will use the test results, symptoms, and risk factors to recommend an appropriate treatment plan.

Treatment devices and medical options

Medical devices are central to managing many cases of sleep apnea. The most commonly prescribed therapy is Continuous Positive Airway Pressure (CPAP), which delivers a steady stream of air through a mask to keep the airway open while sleeping. CPAP is considered the gold standard for obstructive sleep apnea and often dramatically improves symptoms and sleep quality.

Other device-based options include:

• Bi-level Positive Airway Pressure (BiPAP): provides two pressure settings (higher on inhalation, lower on exhalation) and may be preferred for people who have trouble with CPAP or who have central sleep apnea.

• Adaptive Servo-Ventilation (ASV): a specialized device that adjusts pressure support breath-by-breath and can be used for complex or central sleep apnea in select patients.

• Oral appliances: custom-fitted dental devices reposition the jaw and tongue to help keep the airway open; these are portable and useful for mild-to-moderate OSA or for those who cannot tolerate CPAP.

• Hypoglossal nerve stimulators: implantable systems that deliver mild stimulation to the nerve controlling tongue position, reducing airway collapse during sleep; typically reserved for specific candidates who meet clinical criteria.

The right device depends on the type of sleep apnea, severity, tolerance, and other medical considerations.

How clinical trials advance care

Clinical research helps expand treatment choices and deepen our understanding of sleep apnea. Trials may:

• Test the safety and effectiveness of new devices, drugs, or surgical techniques
• Explore underlying causes and genetic or environmental risk factors
• Study links between sleep apnea and other conditions such as heart disease and metabolic disorders
• Evaluate long-term outcomes and adherence strategies for existing therapies

Participation in clinical studies can offer access to innovative treatments, but patients should weigh potential benefits and risks and discuss options with their healthcare provider.

Lifestyle changes that can help

Alongside medical therapy, several behavioral modifications can reduce symptoms and improve outcomes:

• Weight management: shedding excess weight, particularly around the neck, can lessen airway obstruction.
• Regular physical activity: exercise supports overall health and can improve sleep quality.
• Limiting alcohol and sedative use: these substances relax throat muscles and may worsen apnea.
• Sleeping position: avoiding supine sleeping (on the back) and favoring side sleeping can reduce airway collapse.
• Quitting smoking: smoking increases airway inflammation and irritation.
• Consistent sleep schedule: maintaining regular bed and wake times supports restorative sleep.

Combined with device therapy or other medical interventions, these changes often lead to meaningful symptom improvement.

Prices, rates, or cost estimates mentioned in this article are based on the latest available information but may change over time. Independent research is advised before making financial decisions.

This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.