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Sleep apnea symptoms and management devices

Ready to get more z’s? Learn more about this sleep disorder and how to tame it.

Written by: Melanie Mannarino

Illustration of a couple lying in bed while one snores loudly and the other covers their ears.

If a partner complains that you keep them awake with your snoring, you might want to thank them!

That news can be the first step in recognizing that you have obstructive sleep apnea, a condition that affects about one in five U.S. adults.1 Loud snoring is one of its most common symptoms.

“Sleep apnea is almost always associated with snoring,” says Adrian M. Pristas, MD, a pulmonologist and sleep apnea specialist with Hackensack Meridian Health in New Jersey. That snoring gives way to gasping for breath. “The gasping is the apnea event, which we define as the cessation or near cessation of breathing for 10 seconds or more,” he says.

Dr. Pristas advises anyone who thinks they might have sleep apnea to see a doctor or sleep specialist.2 In the meantime, read on about the different types of sleep apnea (and what causes them), common sleep apnea symptoms and ways to reduce its effects.

In this article:

What is sleep apnea?

Sleep apnea is a disorder in which breathing is disrupted during sleep, happening for more than 10 seconds at a time, five or more times an hour. The person may wake up gasping for breath, but they’re more likely not to be consciously aware of it at all. “Commonly, it causes us to wake up for just a moment, and we usually don’t recall it,” Dr. Pristas says.

What causes sleep apnea?

The word “apnea” refers to when the airway is fully closed. There are two types of sleep apnea: obstructive sleep apnea and central sleep apnea. The two types can sometimes overlap.3

Obstructive sleep apnea is caused by the narrowing or collapse of the airway during sleep, which causes you to wake up briefly to reopen your airway. Central sleep apnea is caused by a lack of signaling from the brain to the respiratory system.

Obstructive sleep apnea

In obstructive sleep apnea, the airway might narrow just a few millimeters (called hypopnea) or collapse completely. This can happen because of the body’s position or because the muscles in the mouth and neck relax. “The area just above the larynx or Adam’s apple has a tendency to collapse,” Dr. Pristas says. “It’s a vulnerable spot, about the diameter of a Sharpie.”

A certain number of apnea and hypopnea events are considered normal. But if they happen five or more times an hour, you may have obstructive sleep apnea, Dr. Pristas explains. An estimated 90 percent of adults with sleep apnea are currently undiagnosed.4

Central sleep apnea

Central sleep apnea occurs when the brain doesn’t send signals to the chest to take a breath, Dr. Pristas notes. This condition is not as common as obstructive sleep apnea. Males, people with heart failure or a history of stroke, individuals taking opioid or narcotic medications, people of higher age and people sleeping at high altitudes may be more prone to central sleep apnea.5,6

Sleep apnea symptoms

There are many different signs of sleep apnea, though you may not experience all of them. These include:

  • Snoring. As the airway collapses, vibrations cause loud snoring sounds.
  • Gasping for air during sleep. The body reflexively tries to get the oxygen it needs into the airway.
  • Difficulty staying asleep. Apnea/hypopnea events may wake the person up, resulting in trouble falling back asleep.7
  • Frequent nighttime urination.8 The connection exists, though experts aren’t fully sure why. One theory is that low oxygen levels impact the bladder.
  • Morning headache. Carbon dioxide levels build with multiple apnea/hypopnea events, causing blood vessels to dilate and cause headaches.9
  • Excessive daytime fatigue. With dozens of episodes in one night, people may wake up feeling poorly rested.
  • Frequent daytime naps. People who can “nap anytime” are likely not getting enough quality sleep at night, says Dr. Pristas.10

If you think you might have obstructive sleep apnea, consider taking this online quiz from CVS Health.

Sleep apnea risk factors

Many things can increase the chances of sleep apnea, including genetics, lifestyle and some medical conditions.

Neck size

Having a short neck can make a person’s airways more prone to obstruction.11 So can having a thicker neck — for men, a circumference greater than 17 inches, and for women, greater than 16 inches.12

Being male

For people under the age of 60, sleep apnea is more prevalent in males than females, notes Punithavathy Vijayakumar, MBBS, MS, a neurologist and sleep physician at University of Michigan Health.13 In premenopausal women, hormones may play a protective role against developing obstructive sleep apnea.14

Family history

While sleep apnea is not necessarily hereditary, Dr. Pristas explains that if family members have it, you’re more likely to have it, too. “Physiologically, we are built like our parents,” he says. “If your parents have a structural upper airway [that is vulnerable to apnea/hypopnea], then you may have the same issue.”15

Smoking

Smoking damages the lungs and respiratory system, putting strain on the body in a way that may affect breathing,”16 Dr. Vijayakumar notes.

Obesity

Weight gain may put extra pressure on an already vulnerable airway, making it more prone to narrowing or full collapse. While Dr. Pristas says that with enough weight gain, a person can develop obstructive sleep apnea, the inverse is also true: Some patients see a reduction in sleep apnea symptoms after significant weight loss.17

Coronary disease

High blood pressure, atrial fibrillation, stroke and heart disease are all associated with sleep apnea. Dr. Vijayakumar adds that in cardiac patients who have central sleep apnea, their sleep apnea improves as their cardiac health improves.18

Testing for sleep apnea

It’s important to make an appointment with a physician or a sleep specialist to properly test for sleep apnea. They’ll ask about sleep history, symptoms and risk factors. Then they’ll likely suggest an at-home or in-lab sleep test.

“A home test is good enough to diagnose most people,” says Dr. Pristas. Typically, the person being studied wears a monitor that measures breathing and oxygen levels. Depending on what the results show, that may lead to a second, in-lab sleep study or immediate talk of treatments.19

An in-lab sleep study is more comprehensive, notes Dr. Vijayakumar. “With it, we can see brainwave activity, the stages of sleep and correlation of obstruction.”20

Sleep apnea devices

If a person thinks they might have sleep apnea, talking with a health care provider is always the right first step. The provider will discuss the options, some of which include devices that can help.

OTC sleep apnea products

A doctor may recommend over-the-counter products to help manage symptoms of snoring. These devices aim to manually keep airways clear.

Certain pillows, for instance, can offer comfortable back or side sleeping and support the head and neck with the goal of reducing snoring.

One such product is the Roscoe Medical Cervical Sleep Pillow.

CPAP therapy

A CPAP (continuous positive airway pressure) machine works by pressurizing the entire airway. Then when the muscles in the throat relax, the airway won’t collapse. “It blows air into the system, just like a bicycle tire,” Dr. Pristas explains.21

Drs. Pristas and Vijayakumar say that CPAP is currently considered the gold standard in sleep apnea treatment. “Collapse can happen behind the tongue or the pharynx or just above the nose area,” Dr. Vijayakumar says. He adds, “CPAP opens up the nose and pharynx and all areas clearly,” versus other treatments that only prevent certain types of collapse.

With a CPAP sleep apnea machine, a mask fits over the nose, or the nose and mouth, and blows air into the airways. Both doctors emphasize that being fitted for a mask that feels comfortable is essential — since comfort will determine how likely it is that patients wear the mask every time they sleep. “Sometimes it is difficult at the beginning, and someone needs time to get acclimatized to the CPAP and mask,” Dr. Vijayakumar says. But, typically, “there are CPAP therapy clinics available for patients.”22

A doctor will review different options for purchasing masks and other CPAP supplies. Many can be purchased online, including CPAP cleaner and sanitizer, replacement tubing and wipes.

Custom oral appliances for sleep apnea

Some dental devices can reposition the jaw or tongue to open the upper airway. These include mandibular advancement devices, sleep apnea mouth guards and tongue-retaining devices.

Typically, these devices can be fitted by a dentist. “The device holds the lower jaw forward a few millimeters, drawing all tissue forward just above the Adam’s apple to hold it open,” Dr. Pristas says. “In general, it’s only effective for people with a mild or moderate sleep apnea index.”

Other ways to manage sleep apnea

A health care provider, such as MinuteClinic®, might suggest alternate ways to get ahead of sleep apnea. Lifestyle changes can play a role. Doctors commonly recommend losing weight, avoiding alcohol and quitting smoking. Sleep habits are another target behavior, with side sleeping and head support recommended.23

There are also several surgical options. Some are aimed at the airway, including fixing a deviated septum, and a procedure that pulls the jaw forward. And a relatively new kind of implant in the chest claims to help the tongue stay pulled forward during sleep.24 A physician should be the first stop in exploring any of these options.

Benefits of treating sleep apnea

There’s one immediate benefit of treating sleep apnea: resting through the night. “At the very least, snoring in sleep apnea is disruptive to sleep,” Dr. Pristas says. “You wake up not feeling well, you’re tired, you want a nap. People with sleep apnea have more absences from work, and when they are at work, they may not be very effective because they’re tired.”

Diagnosis and treatment can also help alleviate longer-term, more serious outcomes of sleep apnea: a higher risk of hypertension, diabetes, atrial fibrillation, stroke, pulmonary embolism, myocardial infarction and hardening of the blood vessels.

And, of course, there’s the reason that leads many people on their sleep apnea journey in the first place — a better night’s rest for partners and family members.

This content is for informational purposes only and is not medical advice. Consult with your health care provider before taking any vitamins or supplements, and prior to beginning or changing any health care practices.