Sleep apnea is a sleep disorder where breathing repeatedly stops and starts during sleep. The most common type happens when the throat muscles relax and block the airway. These pauses can occur dozens or even hundreds of times a night, fragmenting sleep and reducing oxygen levels without the person fully waking up.
About 30 million Americans have sleep apnea. Most of them don’t know it. They might notice they’re tired all the time, or that their partner has mentioned the snoring. What they may not realize is that every time they stop breathing, their brain fires an emergency signal. They rouse just enough to reopen the airway, then fall back asleep. This can happen hundreds of times a night without a single full awakening.
The fragmented sleep adds up. So do the long-term health consequences when the condition goes unrecognized and untreated.
Key Takeaways
- Sleep apnea causes repeated breathing stops during sleep, sometimes hundreds of times a night
- Obstructive sleep apnea (OSA) is the most common type and is caused by the airway collapsing during sleep
- Common signs include loud snoring, gasping during sleep, and daytime fatigue
- Untreated sleep apnea raises the risk of heart disease, high blood pressure, and stroke
The Two Types of Sleep Apnea
There are two main types, and understanding the difference matters for treatment.
Obstructive sleep apnea (OSA) is by far the most common type, estimated to affect 10 to 30 percent of adults in the United States. During sleep, the muscles in the back of the throat relax too much. The airway narrows or collapses. Breathing stops. The brain wakes you just enough to restore it. Repeat, all night.
Central sleep apnea (CSA) is less common, affecting under one percent of people. The problem isn’t a blocked airway. The brain simply fails to send the right signals to the muscles that control breathing. It’s often linked to heart conditions, neurological issues, or certain medications.
Some people have a combination of both, sometimes called complex or mixed sleep apnea.
Common Signs and Symptoms
Many people with sleep apnea don’t recognize they have it. The signs can be subtle, or written off as just being tired. Here’s what to look for:
- Loud, persistent snoring
- Gasping, choking, or pauses in breathing during sleep (often noticed by a bed partner)
- Waking up with a dry mouth or headache
- Excessive daytime sleepiness even after what seemed like a full night of sleep
- Difficulty concentrating, memory problems, or mood changes
- Waking frequently during the night
Not everyone with OSA snores loudly. Women with sleep apnea are less likely to snore and more likely to report insomnia, fatigue, and mood symptoms, which is one reason the condition is underdiagnosed in women.
What Causes Sleep Apnea?
Obstructive sleep apnea is caused by the throat muscles relaxing and blocking the airway during sleep. Risk factors include excess weight, a naturally narrow airway, large tonsils, nasal congestion, smoking, and alcohol use. Central sleep apnea stems from the brain not sending proper breathing signals, often due to underlying health conditions.
Anatomy plays a significant role in OSA. A narrow jaw, large tonsils, or a thick neck can all reduce airway space. Obesity is one of the strongest risk factors because excess tissue around the throat puts direct pressure on the airway.
Age increases risk. Men are more commonly diagnosed before 50. Women’s risk rises after menopause. Family history matters too. If a parent or sibling has sleep apnea, your chance of developing it is higher.
Alcohol and sedatives relax the throat muscles further, which is why symptoms are often worse after drinking, even in people who don’t typically have severe OSA.
How Is Sleep Apnea Diagnosed?
Sleep apnea is diagnosed through a sleep study, either in a lab or at home with a portable monitor. The test records breathing, oxygen levels, and sleep stages. Results are measured by the apnea-hypopnea index (AHI), which counts breathing events per hour. An AHI of 5 to 15 is mild, 15 to 30 is moderate, and above 30 is severe.
In-laboratory polysomnography is the gold standard. Sensors track brain activity, breathing, oxygen levels, heart rate, and body position throughout the night. A sleep specialist reviews the results and determines both the type and severity.
Home sleep tests are now widely available and accurate enough for many straightforward OSA cases. Your doctor will help determine which type of study is appropriate.
Treatment Options
Treatment is matched to the type and severity of sleep apnea.
CPAP therapy is the most common and effective treatment for moderate to severe OSA. A machine delivers pressurized air through a mask worn during sleep, keeping the airway open. It’s highly effective, but some patients find the mask uncomfortable or difficult to sleep with consistently.
Oral appliances are custom devices fitted by a dentist that reposition the jaw or tongue to keep the airway open. They’re a well-supported treatment option for mild to moderate OSA and for patients who can’t tolerate CPAP. They’re quieter and less cumbersome than a CPAP machine.
Lifestyle changes can make a meaningful difference. Weight loss, avoiding alcohol before bed, and sleeping on your side instead of your back all reduce airway obstruction. For some patients with mild OSA, these changes alone are enough.
Surgery is reserved for cases where specific anatomical structures are blocking the airway and other treatments haven’t worked. Multiple surgical approaches exist depending on the location and type of obstruction.
How a Dentist Can Help
Dentists play a real role in sleep apnea care. Custom oral appliances designed to reposition the jaw during sleep are a recognized treatment option, particularly for patients with mild to moderate OSA or those who struggle with CPAP.
An oral appliance is fitted to your specific bite and anatomy. It works by moving the lower jaw forward slightly, which keeps the tongue and soft tissue from collapsing into the airway. Most patients find them significantly more comfortable than a CPAP mask.
Sleep apnea is serious, but it’s manageable with the right treatment. If you’ve already been diagnosed and CPAP hasn’t worked for you, or if you want to explore oral appliance options, we’re happy to have that conversation. Start with your doctor for a diagnosis, and reach out to us if you’re looking for a CPAP alternative that fits your life better.
