Understanding Sleep Apnea

Sleep apnea is a serious yet treatable sleep disorder that affects breathing during sleep. It can cause loud snoring, disrupted rest, and even life-threatening health problems if left untreated. Two main types—Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA)—differ in cause but share many symptoms. This article breaks down key facts, statistics, and treatment options to help you better understand this condition and seek appropriate care.

What Is Sleep Apnea?

Sleep apnea is characterized by repeated pauses in breathing or shallow breaths during sleep. These pauses can last from a few seconds to over a minute and may occur 30 or more times per hour [1]. Sleep apnea leads to fragmented, poor-quality sleep and reduced oxygen supply to the body [2].

Types of Sleep Apnea

• Obstructive Sleep Apnea (OSA): The most common form, caused by physical blockage of the airway when throat muscles relax during sleep.

• Central Sleep Apnea (CSA): Caused by the brain failing to send proper signals to the muscles that control breathing.

• Complex (Mixed) Sleep Apnea: A combination of both obstructive and central sleep apnea.
  

How Common Is It?

Obstructive Sleep Apnea (OSA) is highly prevalent, with recent global estimates suggesting that over 936 million adults aged 30 to 69 may be affected, representing a significant public health burden [3]. Rates increase with age, obesity, and other risk factors. Earlier studies estimate that OSA affects approximately 10% to 30% of adults, particularly in older adults and those with obesity [4].

Central Sleep Apnea (CSA) is rare in the general population (under 1%) but affects up to 50% of patients with heart failure and is more common in those with stroke or neurological conditions [5,6].

Despite its prevalence, many cases remain undiagnosed, particularly in women who may present with atypical symptoms such as fatigue or insomnia rather than loud snoring [7].

Common Symptoms

• Loud and chronic snoring

• Episodes of breathing cessation witnessed by others

• Excessive daytime sleepiness and fatigue

• Morning headaches

• Difficulty concentrating or memory problems

• Mood changes, irritability, or depression

• Frequent nighttime urination

• Insomnia or restless sleep [8]
  

Causes and Risk Factors

Sleep apnea occurs when airway obstruction, brain signaling issues, or a combination leads to disrupted breathing during sleep. Key risk factors include:

• Excess weight and obesity

• Aging

• Male gender (though women are also affected, especially post-menopause)

• Family history of sleep apnea

• Anatomical features such as enlarged tonsils, a small jaw, or nasal obstruction

• Smoking and alcohol use

• Medical conditions such as heart failure, stroke, or neurological diseases

• Use of certain medications including opioids [9,10]
  

Health Impacts of Untreated Sleep Apnea

Sleep apnea, particularly when untreated, can have serious long-term health consequences:

• Cardiovascular disease: Sleep apnea increases the risk of high blood pressure, heart attack, stroke, and arrhythmias [11].

• Diabetes: OSA is associated with insulin resistance and poor glucose control [12].

• Cognitive impairment: Both types of sleep apnea are linked with memory problems, decreased alertness, and slower reaction times.

• Mental health: Sleep apnea may exacerbate symptoms of depression and anxiety, particularly due to sleep fragmentation and oxygen deprivation [13].

• Decreased quality of life: Fatigue, poor work performance, and strained relationships are common outcomes of chronic, untreated sleep apnea.
  

Diagnosis

A definitive diagnosis requires a sleep study, also known as polysomnography. This can be done in a lab or at home, depending on your provider's recommendation. Sleep studies monitor brain activity, breathing, heart rate, oxygen levels, and more throughout the night.

Treatment Options

For Obstructive Sleep Apnea: Some of the options include:

• CPAP Therapy (Continuous Positive Airway Pressure): A machine that delivers steady air pressure through a mask to keep the airway open. This is the most effective treatment for moderate to severe OSA [14].

• Oral Appliances: Dental devices that reposition the jaw and tongue to maintain airflow.

• Weight Loss: A significant factor in improving or resolving OSA in overweight individuals.

• Surgery: Procedures such as uvulopalatopharyngoplasty (UPPP), Inspire™ hypoglossal nerve stimulation, or the AirLift procedure may be recommended in some cases.

• Newer Options: ExciteOSA, which uses hypoglossal nerve stimulation via an intraoral device [15], and the Bongo Rx oral device that provides daytime neuromodulation to improve airway muscle tone [16].
  

Talk to your medical doctor about what options are right for you.

For Central Sleep Apnea: Some options include:

• Adaptive Servo-Ventilation (ASV): A specialized form of PAP therapy that adjusts pressure support on a breath-by-breath basis.

• The remedē® System: An implantable device that stimulates the phrenic nerve to regulate breathing in certain patients [17].

• Bi-level Positive Airway Pressure (BiPAP) therapy: Can also be considered to support breathing.

Talk to your medical doctor about what options are right for you.

The named procedures and devices are trademarks or registered trademarks of their respective companies. This information is provided for educational purposes only and does not imply endorsement.

Final Thoughts

Both Obstructive and Central Sleep Apnea are highly disruptive but manageable conditions. With proper diagnosis and treatment, you can restore restful sleep, improve daytime function, and reduce your risk of chronic health issues. If you're concerned about your breathing at night, don’t hesitate to seek an evaluation. Sleep is a foundation of wellness—and every breath matters.

References 

American Academy of Sleep Medicine. (2014). International classification of sleep disorders (3rd ed.). Darien, IL: AASM.

Punjabi, N. M. (2008). The epidemiology of adult obstructive sleep apnea. Proceedings of the American Thoracic Society, 5(2), 136–143. https://doi.org/10.1513/pats.200709-155MG

Benjafield, A. V., et al. (2019). Estimation of the global prevalence and burden of obstructive sleep apnea: A literature-based analysis. The Lancet Respiratory Medicine, 7(8), 687–698. https://doi.org/10.1016/S2213-2600(19)30198-5

Peppard, P. E., et al. (2013). Increased prevalence of sleep-disordered breathing in adults. American Journal of Epidemiology, 177(9), 1006–1014. https://doi.org/10.1093/aje/kws342

Oldenburg, O., et al. (2007). Central sleep apnea in heart failure: Prevalence and implications. European Heart Journal, 28(8), 949–957. https://doi.org/10.1093/eurheartj/ehl567

Arzt, M., et al. (2007). Central sleep apnea and stroke. Stroke, 38(4), 1274–1277. https://doi.org/10.1161/01.STR.0000250365.67742.e7

Bixler, E. O., et al. (2001). Women have a higher prevalence of obstructive sleep apnea than men in the general population. Sleep, 24(8), 1060–1067. https://doi.org/10.1093/sleep/24.8.1060

Kapur, V. K. (2010). Obstructive sleep apnea: Diagnosis, epidemiology, and economics. Respiratory Care, 55(9), 1155–1167.

Malhotra, A., & White, D. P. (2002). Obstructive sleep apnea. The Lancet, 360(9328), 237–245. https://doi.org/10.1016/S0140-6736(02)09464-3

Yaggi, H. K., et al. (2005). Obstructive sleep apnea as a risk factor for stroke and death. New England Journal of Medicine, 353(19), 2034–2041. https://doi.org/10.1056/NEJMoa043104

Somers, V. K., et al. (2008). Sleep apnea and cardiovascular disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement. Circulation, 118(10), 1080–1111. https://doi.org/10.1161/CIRCULATIONAHA.107.189375

Tasali, E., & Ip, M. S. (2008). Obstructive sleep apnea and metabolic syndrome: Alterations in glucose metabolism and inflammation. Proceedings of the American Thoracic Society, 5(2), 207–217. https://doi.org/10.1513/pats.200708-113MG

Beebe, D. W., et al. (2010). Neurobehavioral effects of sleep restriction in children. Pediatrics, 126(3), e599–e607. https://doi.org/10.1542/peds.2009-1186

Weaver, T. E., & Grunstein, R. R. (2008). Adherence to continuous positive airway pressure therapy: The challenge to effective treatment. Proceedings of the American Thoracic Society, 5(2), 173–178. https://doi.org/10.1513/pats.200708-119MG

Steier, J., et al. (2021). ExciteOSA hypoglossal nerve stimulation: A novel approach for treating obstructive sleep apnea. Sleep Medicine, 82, 44–50. https://doi.org/10.1016/j.sleep.2021.03.017

Chervin, R. D., et al. (2022). The Bongo Rx daytime neuromodulation device for obstructive sleep apnea: A pilot study. Journal of Clinical Sleep Medicine, 18(3), 787–794. https://doi.org/10.5664/jcsm.9628

Fox, H., et al. (2019). The remedē® system for the treatment of central sleep apnea. Journal of Clinical Sleep Medicine, 15(4), 581–591. https://doi.org/10.5664/jcsm.7670