What is Obstructive Sleep Apnea?

Whether you share a bed with someone or sleep alone, here’s your chance to learn what obstructive sleep apnea is, how it occurs, signs and symptoms you should look out for and what you can do to get a better night’s sleep.

What is Obstructive Sleep Apnoea (OSA)?

Obstructive sleep apnea is a sleep disorder. In the night while you are sleeping, if somehow your airway is obstructed, you instinctively wake up briefly so that you can reposition your body. Some people wake up so often that their sleep cycles are disturbed. We call this sleep apnea.

How Does Obstructive Sleep Apnea work?

Sleep apnoea is basically caused by interruptions in your breathing while you sleep. These interruptions can last as little as 10 seconds, and in severe cases can happen 30 or more times per hour. The tricky part? You might not even realize it’s occurring because you’re asleep!

Before we get into the details of what obstructive sleep apnea is, we need first to understand what happens when we sleep and how it differs from snoring. When you fall asleep, the muscles in your mouth, tongue and throat relax, which can cause your upper airway to become narrow.¹ As you breathe, the surrounding tissues sometimes vibrate, creating that hoarse or whistley sound we know as snoring.¹ This is fairly common, and many people snore from time to time. 

Obstructive sleep apnoea, on the other hand, occurs when the upper airway repeatedly narrows or collapses, resulting in partial or complete airflow blockage.² Your body keeps trying to breathe but struggles against the blocked airway, resulting in very loud, chronic snoring interrupted by periods of silence when breathing stops or becomes very shallow.² Your brain senses the danger and briefly tries to wake you up just enough to reopen the airway, usually with a gasp, snort or choking sound but not everyone fully wakes up so you might not even realize it’s happening.² The repeated drops in oxygen levels along with fragmented low-quality sleep can explain why many people with obstructive sleep apnea feel terrible the next morning.

What Are the Signs of Sleep Apnea?

Imagine you’re fast asleep and your partner frantically wakes you up asking if you’re OK. You were apparently snoring normally and all of sudden the room went quiet. Moments later you were gasping for air, snorting, rolling over and the cycle started all over again. Now imagine you live alone, unaware of what was happening at night and every morning you wake up feeling exhausted, but you can’t explain why. This could be a sign that you have obstructive sleep apnea (OSA).

If you suspect you might have obstructive sleep apnea, signs to look out for include:

• excessive daytime sleepiness,
•  morning headaches
• sore throat
• reduced alertness
• a lack of motivation for normal daily activities even after spending eight hours in bed.² 

Who is at risk?

Obstructive sleep apnea can happen to anyone from children to the elderly. In fact, a 2025 study of the global burden of OSA estimated that nearly a billion adults between the ages of 30 and 69 have mild to severe obstructive sleep apnea.³ 

Obesity and Other Lifestyle Factors

The biggest risk factor is obesity. Excessive fatty tissue, especially around your neck and upper airway, can cause the airway to narrow or collapse more easily during sleep.⁴ Epidemiologists have noticed that, as global obesity rates have increased, so have the number of cases of sleep apnea.

 For example, a 2025 study looking at 12,860 middle-aged and older adults in the United States and Switzerland found that nearly 3 in 4 participants with obesity had some form of obstructive sleep apnea ranging from mild or severe.⁵ 

Other lifestyle factors that up your risk of developing sleep apnea include smoking, drinking and some drugs. Smoking can irritate and inflame the upper airway, while alcohol consumption and certain medications that cause sedation can relax the throat muscles, increase the risk of airway blockage or make existing obstructive sleep apnea worse.⁹

It’s Just How You Were Made

Another risk factor is the shape and size of your airway. Humans come in all shapes and sizes, and some people just have an airway that is a bit easier to block than would be ideal. 

 For example, people with enlarged tonsils, smaller or cessed lower jaw or naturally narrower airways are more likely to experience breathing problems during sleep.⁶ This explains why people who aren’t overweight can also develop obstructive sleep apnea. 

You might have heard that sleep apnea runs in families. There is some truth to this because your throat shape and jaw structure are influenced by genetics.⁹ 

Age and Sex

One’s age and sex can also play a role. Men generally are more likely to develop this disorder. This is mainly because of the anatomical structure of the upper airway. Men’s tend to be longer than women’s and fat is distributed differently around the neck and upper body. Together this makes the airway more prone to collapsing.⁷

For women, particularly during and after menopause, the changes in estrogen and progesterone levels can reduce the protective effects these hormones have on the upper airway, leading to increased risk of obstructive sleep apnea.⁷

Also, as we get older, we naturally have a reduction in muscle tone of the upper airway and changes in soft tissue elasticity, making the throat like to narrow or collapse during sleep.⁸ 

Why OSA matters for your health

You might be wondering, if someone is still getting several hours of sleep every night, how bad can a bit of breathing interruption really be?

Apart from the signs and symptoms discussed previously, researchers have linked this disorder to several health problems, including cardiovascular disease, type 2 diabetes and mental health problems.

Blood Pressure, Heart Disease and Heart Attack

A major concern is obstructive slope apnea’s effect on your heart and circulatory system. Every time breathing is interrupted, oxygen levels can drop, triggering a stress response that temporarily raises blood pressure and as a result strains the heart and blood vessels.¹⁰ Over time, this repeated stress can contribute to high blood pressure and is associated with an increased risk of heart disease and heart attacks.¹⁰ What’s more, untreated obstructive sleep apnea has also been linked to irregular heart rhythms, heart failure as well as stroke.¹⁰ 

Metabolic Syndrome

There are also metabolic consequences. Research has shown that obstructive sleep apnea is associated with insulin resistance and type 2 diabetes.¹¹ Doctors suspect that the drop in oxygen levels caused by the condition can interfere with your body’s ability to regulate blood sugar. This makes it more difficult for people with diabetes to manage their glucose levels.¹¹ 

Brain Health

Lastly there are also neurological and mental health concerns. The repeated drops in oxygen levels and fragmented sleep can affect your concentration, memory and daytime alertness.¹² Chronic sleep disruption and fatigue are linked to mental health conditions such as depression and anxiety.¹⁹ 

Don’t just brush off your symptoms as poor sleep! It’s very important to speak with a healthcare professional if you have any suspicion that you might be experiencing obstructive sleep apnea.

How Do Doctors Diagnose it?

Diagnosis of obstructive sleep apnea involves a combination of a clinical evaluation with a healthcare professional, symptom screening and a sleep study to measure breathing interruptions and oxygen levels during sleep.¹³ 

During the clinical evaluation, a doctor will review your medical history and physical characteristics such as tonsil size, jaw structure and neck circumference. The doctor might also ask about the symptoms you’re experiencing, such as snoring loudly, waking up gasping for air or feeling exhausted throughout the day. 

They may also ask your partner if they notice any pauses in your nighttime breathing.  This alone is not enough to confirm a diagnosis, so to really find out what’s happening while you’re asleep, doctors typically recommend a sleep study. 

The most common test they use is polysomnography.¹³ This involves spending at night in a sleep laboratory (home sleep apnea test can also be an option) where specialized sensors and electrodes monitor various physiological functions at once. For example, oxygen saturation, respiratory airflow, muscle activity and more.¹³ The measures give a better picture of how frequently your breathing is interrupted during your sleep. 

An important measurement is the apnea-hypopnea index (AHI). To calculate an AHI rating, your doctor will count the average number of complete or partial breathing interruptions per hour of sleep.¹³ For adults the classification is as follows: AHI below 5 events per hour is considered normal, 5 to 14.9 is mild OSA, 15 to 29.9 is moderate OSA, and 30 or more events per hour are considered severe OSA.¹³ In other words, the higher the AHI, the more frequent your breathing is disrupted and the more severe your obstruction. 

Can I Fix It? 

First and foremost, the good news is that obstructive sleep apnea is treatable and there are several options, depending on how severe your case is and the root cause. 

Lifestyle Changes

If your sleep apnea is caused by obesity, smoking or alcohol, the simplest way to manage it is to deal with the root cause. Lose a bit of weight, exercise, stop smoking or drink less. Whether or not it cures your sleep apnea, you will feel more comfortable in your body and sleep better. But let’s be clear: it will probably make a big improvement in your sleep apnea and save you a lot of hassle.

CPAP

The gold standard treatment for sleep apnea is continuous positive airway pressure, also known as CPAP. This involves wearing a mask connected to a machine at bedtime, which gently delivers pressurized air to help keep your airway open so you can breathe normally throughout the night.¹⁴

 In fact, a 2026 review of 55 clinical trials found that CPAP reduced breathing interruptions by an average of 18.1 events per hour compared to the control groups, making it the most effective treatment.¹⁵

Mandibular Advancement Device

 If CPAP is difficult to tolerate, another treatment option is an oral appliance called a mandibular advancement device. This is a custom-made dental mouthpiece fitted by a trained sleep dentist to gently push your lower jaw forward to help keep the airways open, mainly for people with mild to moderate obstructive sleep apnea.¹⁶ 

A 2023 review of 20 studies involving 546 patients found that long-term uses (at least one year) of these devices reduced breathing interrupting by an average of 16.8 events per hour compared with measurements taken before treatment.¹⁷

Surgery

 For people who can’t tolerate CPAP, or whose airway anatomy is the main problem, there are surgical and implant options. These include upper airway surgery to remove or shrink excess tissue, such as enlarged tonsils, nasal surgery to improve airflow and jaw surgery to create more breathing space.² Another option is hypoglossal nerve stimulation, which is an implanted device that stimulates the nerve controlling tongue movement to help keep the airway clear during sleep.¹⁸

Common myths or misconceptions 

Despite being a fairly common condition, there are still a lot of misconceptions surrounding obstructive sleep apnea. So, let’s debunk a few of them!

1. If You Snore, You Have Sleep Apnoea 

This is definitely not true. Snoring is a common occurrence that happens when relaxed tissues vibrate as air passes through the throat. However, snoring becomes more of a warning sign of obstructive sleep apnea when accompanied by pauses in nighttime breathing, gasping or choking as well as symptoms such as waking up already exhausted, and excessive daytime sleepiness.  

2. Only People With Obesity Develop Sleep Apnoea

While obesity is a risk factor, people of all body sizes and ages can develop obstructive sleep apnea. Your airway anatomy, age, family history, and lifestyle factors such as smoking and alcohol consumption can contribute to the development of obstructive sleep apnea or worsen the existing condition. 

3. If you sleep for eight hours, you can’t have sleep apnea

Unfortunately, getting all the sleep in the world does not always mean you’re getting good quality sleep. Someone with obstructive sleep apnea can spend up to eight hours in bed with their eyes closed and still wake up feeling exhausted due to the frequent sleep interruptions. 

4. Sleep apnea only affects old men. 

Obstructive sleep apnea is more common in men and older adults but women, especially those going through menopause or postmenopause, and younger people can also develop it. 

Bottom line:  if you’re regularly waking up tired despite getting enough sleep, waking up choking or gasping or having someone tell you that your breathing stops at night, this is worth speaking to your doctor about. Most of the time, people brush it off as normal snoring or try to fight through the exhaustion. However, over time, untreated obstructive sleep apnea can have significant consequences for the body. The good news is that obstructive sleep apnea can be diagnosed and treated. Whether it’s through CPAP, an oral appliance, lifestyle modifications or other treatments, there are ways to help you breathe and sleep better. 

References 

1. Huyett, P. (2023). What is snoring? JAMA Otolaryngology–Head & Neck Surgery, 149(3). https://doi.org/10.1001/jamaoto.2022.4615
2. Abbasi, A., Gupta, S. S., Sabharwal, N., Meghrajani, V., Sharma, S., Kamholz, S., & Kupfer, Y. (2021). A comprehensive review of obstructive sleep apnea. Sleep Science, 14(2), 142–154. https://doi.org/10.5935/1984-0063.20200056

3. Iannella, G., Pace, A., Bellizzi, M. G., Magliulo, G., Greco, A., Virgilio, De, Croce, E., Gioacchini, F. M., Re, M., Costantino, A., Casale, M., Moffa, A., Lechien, J. R., Cocuzza, S., Vicini, C., Caranti, A., Aragona, M., Lentini, M., & Maniaci, A. (2025). The global burden of obstructive sleep apnea. Diagnostics, 15(9), 1088. https://doi.org/10.3390/diagnostics15091088

4. Mitra, A. K., Bhuiyan, A. R., & Jones, E. A. (2021). Association and risk factors for obstructive sleep apnea and cardiovascular diseases: A systematic review. Diseases, 9(4), 88. https://doi.org/10.3390/diseases9040088

5. Esmaeili, N., Gell, L., Imler, T., Hajipour, M., Taranto-Montemurro, L., Messineo, L., Stone, K. L., Sands, S. A., Ayas, N., Yee, J., Cronin, J., Heinzer, R., Wellman, A., Redline, S., & Azarbarzin, A. (2025). The relationship between obesity and obstructive sleep apnea in four community-based cohorts: An individual participant data meta-analysis of 12,860 adults. eClinicalMedicine, 83, 103221. https://doi.org/10.1016/j.eclinm.2025.103221

6. Sleep apnea – obstructive. (n.d.). Www.Ada.Org. Retrieved November 7, 2026, from https://www.ada.org/resources/ada-library/oral-health-topics/sleep-apnea-obstructive

7. Lin, C. M., Davidson, T. M., & Ancoli-Israel, S. (2008). Gender differences in obstructive sleep apnea and treatment implications. Sleep Medicine Reviews, 12(6), 481–496. https://doi.org/10.1016/j.smrv.2007.11.003

8. Eikermann, M., Jordan, A. S., Chamberlin, N. L., Gautam, S., Wellman, A., Lo, Y.-L., White, D., & Malhotra, A. (2007). The influence of aging on pharyngeal collapsibility during sleep. 131(6), 1702–1709. https://doi.org/10.1378/chest.06-2653

9. Mayo Clinic. (2023, July 14). Obstructive sleep apnea – symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/obstructive-sleep-apnea/symptoms-causes/syc-20352090

10. Yeghiazarians, Y., Jneid, H., Tietjens, J. R., Redline, S., Brown, D. L., El-Sherif, N., Mehra, R., Bozkurt, B., Ndumele, C. E., & Somers, V. K. (2021). Obstructive sleep apnea and cardiovascular disease: A scientific statement from the American heart association. Circulation, 144(3), e56–e67. https://doi.org/10.1161/CIR.0000000000000988

11. Doumit, J., & Prasad, B. (2016). Sleep apnea in type 2 diabetes. Diabetes Spectrum, 29(1), 14–19. https://doi.org/10.2337/diaspect.29.1.14

12. Edwards, K. M., Kamat, R., Tomfohr, L. M., Ancoli-Israel, S., & Dimsdale, J. E. (2014). Obstructive sleep apnea and neurocognitive performance: The role of cortisol. Sleep Medicine, 15(1), 27–32. PubMed Central. https://doi.org/10.1016/j.sleep.2013.08.789

13. Goyal, M., & Johnson, J. (2017). Obstructive sleep apnea diagnosis and management. Missouri Medicine, 114(2), 120. https://pmc.ncbi.nlm.nih.gov/articles/PMC6140019/

14. Noah, W. H. (2025). Using CPAP to treat OSA: Is it time to reverse 30 years of understanding and engineering? Sleep & Breathing = Schlaf & Atmung, 30(1), 16. PubMed Central. https://doi.org/10.1007/s11325-025-03562-2

15. Castellanos, M. F. I., da Costa, J. L., Oliveira, L. M., de Oliveira, J., Zanatta, F. B., & Callegaro, C. C. (2026). Comparative effectiveness of CPAP and isolated or combined non-invasive therapies for obstructive sleep apnea: A network meta-analysis. Sleep Medicine, 141, 108795. https://doi.org/10.1016/j.sleep.2026.108795

16. Manetta, I. P., Ettlin, D., Sanz, P. M., Rocha, I., & Cruz, M. M. (2022). Mandibular advancement devices in obstructive SLEEP APNEA: An updated review. Sleep Science, 15(S 02), 398–405. https://doi.org/10.5935/1984-0063.20210032

17. Yu, M., Ma, Y., Han, F., & Gao, X. (2023). Long-term efficacy of mandibular advancement devices in the treatment of adult obstructive sleep apnea: A systematic review and meta-analysis. PLOS ONE, 18(11), e0292832. https://doi.org/10.1371/journal.pone.0292832

18. Baptista, P. M., Costantino, A., Moffa, A., Rinaldi, V., & Casale, M. (2020). Hypoglossal nerve stimulation in the treatment of obstructive sleep apnea: Patient selection and new perspectives. Nature and Science of Sleep, Volume 12, 151–159. https://doi.org/10.2147/nss.s221542

19. Shah AS, Pant MR, Bommasamudram T, Nayak KR, Roberts SSH, Gallagher C, Vaishali K, Edwards BJ, Tod D, Davis F, Pullinger SA. Effects of Sleep Deprivation on Physical and Mental Health Outcomes: An Umbrella Review. Am J Lifestyle Med. 2025 May 27:15598276251346752. doi: 10.1177/15598276251346752. Epub ahead of print. PMID: 40443808; PMCID: PMC12116485.