If you’ve ever woken up feeling exhausted before you even got out of bed, there’s a good chance you may be suffering from obstructive sleep apnea (OSA).
One of the most common, but often overlooked, sleep disorders in the United States, OSA affects an estimated 30 million Americans. Yet, according to the American Academy of Sleep Medicine, up to 80% of cases have never been diagnosed.
What Is Obstructive Sleep Apnea?
OSA is a disorder in which breathing repeatedly stops and starts during sleep due to a physical blockage of the upper airway. It occurs when the muscles that support the soft tissues in the back of the throat relax excessively during sleep, allowing the airway to narrow or collapse.
As a result, airflow is reduced or completely blocked, even though the body continues trying to breathe. These episodes, called apneas (complete blockages) or hypopneas (partial blockages), can happen many times per night.
Common Symptoms of OSA:
- Loud, chronic snoring
- Witnessed pauses in breathing during sleep
- Gasping or choking awakenings
- Morning headaches
- Excessive daytime sleepiness or fatigue
- Difficulty concentrating
- Mood changes or irritability
- Insomnia or restless sleep
Many people are unaware they have sleep apnea until a bed partner or family member notices the signs.
How Is OSA Diagnosed?
OSA is diagnosed through a combination of clinical assessment, screening tools, and specialized sleep studies that monitor breathing and other physiological functions during sleep. These include:
- Home Sleep Apnea Test:
A portable test done at home that measures breathing, oxygen levels, and respiratory effort during sleep. - In-Lab Polysomnography:
Preferred for complex cases or when other sleep disorders are suspected, in-lab polysomnography involves a comprehensive overnight sleep study in a sleep lab.
How Is OSA Treated?
The most common and effective treatment for obstructive sleep apnea is Positive Airway Pressure (PAP) therapy. PAP therapy works by delivering a gentle stream of pressurized air through a mask worn during sleep, which keeps the airway open and prevents apneas and hypopneas from occurring.
Two popular types of PAP therapy are:
- CPAP (Continuous Positive Airway Pressure):
CPAP delivers a constant, fixed level of air pressure throughout the night through a fitted mask. This steady pressure helps prevent the airway from collapsing during sleep and is highly effective for treating most cases of OSA. The prescribed pressure is determined during a sleep study or titration. - APAP (Auto-titrating Positive Airway Pressure):
APAP also delivers a constant, fixed level of air pressure throughout the night through a fitted mask. APAP automatically adjusts the air pressure throughout the night based on your breathing patterns and airway resistance. It increases pressure when needed (such as during REM sleep or when lying on your back) and lowers it when less support is required, making it a more flexible and often more comfortable option for many patients.
Many people associate OSA with snoring, but it’s much more than that. OSA is a medical condition that can significantly affect your health and daily life. The good news? It’s treatable. With proper diagnosis and the right therapy, most people experience dramatic improvements in their sleep, energy, and overall well-being.
If you suspect you may have sleep apnea, talk to your healthcare provider about a sleep evaluation.
Caitlin E. deBros, DNP, AGACNP-BC, is a member of the pulmonology team at Southwestern Vermont Medical Center.