Sleep apnea is a common, yet often undiagnosed, sleep disorder characterized by repeated interruptions in breathing during sleep. These pauses, which can occur dozens or even hundreds of times each night, prevent the body from achieving restorative, deep sleep. This persistent lack of quality rest significantly impacts daily function and overall physical health. If left unaddressed, the condition is associated with serious long-term consequences, including increased risk of cardiovascular problems and metabolic disorders. Understanding its observable signs is the first step toward seeking a formal diagnosis and appropriate management.
Recognizing the Symptoms
The initial signs of a possible breathing disorder during sleep are often first noticed by a partner or family member. Loud, habitual snoring is a common indicator, though not everyone who snores has the condition, and not all people with the condition snore. A more specific sign is the observation of distinct pauses in breathing, followed by a sudden, sometimes loud, snort, gasp, or choking sound as the body forces air back into the lungs.
These events cause the person to wake up briefly, leading to fragmented rest. A dry mouth or sore throat upon waking is a frequent complaint, as is the experience of morning headaches. The fragmented sleep cycle results in excessive daytime sleepiness, which can manifest as an inability to stay awake while driving or sitting quietly.
The chronic sleep deprivation from apnea affects cognitive and emotional well-being. Individuals may experience difficulty concentrating, memory problems, or mental fogginess throughout the day. Behavioral changes, such as increased irritability, mood swings, or depression, are commonly reported symptoms stemming from the continuous stress placed on the body and brain.
Understanding the Different Types
The way breathing stops while sleeping determines the type of disorder. The most prevalent form is Obstructive Sleep Apnea (OSA), which involves a physical blockage of the upper airway. In OSA, throat muscles relax excessively during sleep, causing soft tissue to collapse and obstruct the passage of air despite the body’s continued effort to breathe.
A less common type is Central Sleep Apnea (CSA), where the airway remains open, but the brain fails to send the proper signals to the muscles that control breathing. CSA is often associated with underlying medical conditions, such as heart failure or neurological disorders.
A third category, known as Mixed or Complex Sleep Apnea, involves features of both OSA and CSA. This form typically begins with obstructive events but transitions to central events during the night or in response to initial therapy. The primary cause of the breathing disruption guides the diagnostic and treatment approach.
The Diagnostic Process
Formal diagnosis requires a consultation with a healthcare provider, who will begin by taking a medical and sleep history. This initial assessment may involve a screening questionnaire, such as the Epworth Sleepiness Scale (ESS), which measures the likelihood of falling asleep in various daily situations. While the ESS indicates daytime sleepiness, it is not a diagnostic tool and must be followed by objective testing.
The definitive procedure for diagnosis is a sleep study, known as polysomnography (PSG), typically conducted overnight in a specialized sleep center. During a PSG, various physiological parameters are monitored, including brain activity, heart rate, oxygen saturation levels, leg movements, and breathing patterns. Alternatively, Home Sleep Apnea Testing (HST) uses simplified monitoring equipment in the patient’s own bed, suitable for diagnosing uncomplicated OSA.
The results of the sleep study determine the Apnea-Hypopnea Index (AHI), which is the average number of apneas (complete breathing cessation) and hypopneas (partial airflow reduction) that occur per hour of sleep. An AHI score classifies the severity of the condition: 5 to 15 events per hour is considered mild, 15 to 30 events per hour is moderate, and greater than 30 events per hour is classified as severe.
Next Steps After Self-Assessment
If symptoms suggest sleep apnea, the next step is to schedule an appointment with a primary care physician. It is beneficial to keep a brief sleep diary for one to two weeks before the appointment, documenting bedtimes, wake times, and how rested you feel upon waking.
If possible, ask a partner to note the frequency and nature of any loud snoring, gasping, or pauses in your breathing during the night. The physician will also need to know about relevant lifestyle factors that may contribute to the condition, such as recent weight changes, alcohol consumption before bed, or the position in which you tend to sleep.
Discussing any history of high blood pressure or other relevant medical diagnoses provides important context for the physician. This comprehensive information allows the doctor to make an informed decision about whether a referral for formal sleep testing is warranted.