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Sleep Apnea: When Breathing Stops During Sleep

Sleep apnea is a common but serious sleep disorder where breathing repeatedly stops or becomes shallow during sleep [1]. These pauses can last from a few seconds to over a minute and may occur hundreds of times per night. Many people don’t realize they have it, but untreated sleep apnea can increase risks for heart disease, diabetes, and accidents due to daytime sleepiness.

🟩 Types of Sleep Apnea

  1. Obstructive Sleep Apnea (OSA)

    • Most common type.

    • Caused by the collapse of soft tissues in the throat, blocking airflow.

  2. Central Sleep Apnea (CSA)

    • Brain fails to send proper signals to the muscles that control breathing.

  3. Complex Sleep Apnea (CompSA)

    • Combination of OSA and CSA.

🟩 Common Symptoms

  • Loud, chronic snoring

  • Choking or gasping during sleep

  • Excessive daytime sleepiness

  • Morning headaches

  • Difficulty concentrating, memory issues

  • Mood changes (irritability, depression) [2]

🟩 Risk Factors

  • Overweight or obesity

  • Large neck circumference (>40 cm in men)

  • Older age

  • Male sex (though women after menopause also at higher risk)

  • Family history

  • Alcohol or sedative use

  • Structural issues (enlarged tonsils, nasal obstruction) [3]

🟩 Health Consequences if Untreated

  • High blood pressure, stroke, heart attack [4]

  • Type 2 diabetes and insulin resistance

  • Increased risk of traffic and workplace accidents

  • Reduced quality of life and higher mortality

🟦 Diagnosis

  • Home Sleep Apnea Test (HSAT) or

  • Polysomnography (PSG) in a sleep lab, the gold standard [5].
    These tests measure breathing, oxygen levels, heart rate, and brain activity.

🟦 Treatment Options

  • Lifestyle changes: weight loss, reduced alcohol, side-sleeping.

  • CPAP (Continuous Positive Airway Pressure): the gold standard therapy for moderate-to-severe OSA [6].

  • Oral appliances: reposition the jaw/tongue to keep the airway open.

  • Surgery (e.g., tonsillectomy, jaw advancement) for selected cases.

  • Adaptive servo-ventilation (ASV) for central sleep apnea.

References:

  1. Young T, et al. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002.

  2. Peppard PE, et al. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013.

  3. Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. Lancet. 2014.

  4. Somers VK, et al. Sleep apnea and cardiovascular disease. J Am Coll Cardiol. 2008.

  5. Kapur VK, et al. Clinical practice guideline for diagnostic testing for adult OSA. J Clin Sleep Med. 2017.

  6. Patil SP, et al. Treatment of adult obstructive sleep apnea with positive airway pressure. Am J Respir Crit Care Med. 2019.