If you’ve been diagnosed with obstructive sleep apnea (OSA), you may have questions about what to expect and how to best manage your condition. OSA is the most common type of sleep apnea, and it’s estimated to affect as many as 1 billion people ages 30 to 69 worldwide.

Obstructive sleep apnea is a sleep disorder in which the upper airway is repeatedly blocked during sleep. This happens when muscles in the throat relax and the airway collapses. It’s normal for muscles to relax during sleep, but with OSA, the muscles relax too much and restrict breathing in ways that can be harmful. The airway can also be narrowed by soft tissue, blood vessels, or bony structures. Risk factors for OSA include a large neck circumference, obesity, male sex, and older age.

Untreated OSA can take a toll on quality of life and cause serious health complications. The good news is that OSA is treatable, and many people feel better once they find the right treatment plan. Here are some important facts about obstructive sleep apnea that you can discuss in more detail with your doctor.

1. Sleep Apnea Deprives the Body of Oxygen

In people with obstructive sleep apnea, sleep is broken up by interruptions in breathing throughout the night or during any period of sleep. A diagnosis of OSA means that breathing slows or stops for at least 10 seconds at a time, five or more times per hour of sleep.

When breathing is regularly interrupted due to sleep apnea, oxygen levels in the blood can drop. Over time, repeated drops in oxygen and frequent sleep disruptions can strain the body and raise the risk of health problems involving the heart, brain, and other organs.

The severity of OSA is measured using the apnea-hypopnea index, which reflects how many times breathing is disrupted per hour of sleep:

• Mild — Five to 14 interruptions an hour
• Moderate — 15 to 29 interruptions an hour
• Severe — 30 or more interruptions an hour

In general, the more often breathing is disrupted, the more frequently oxygen levels drop — which can increase health risks if the condition isn’t treated.

2. Sleep Apnea Causes Severe Sleep Disturbance

Frequent interruptions in breathing disturb sleep dozens of times a night in people with obstructive sleep apnea. Their sleeping partners may also be awakened during these disturbances. Common symptoms of sleep apnea include:

• Snoring loudly
• Pausing in breathing
• Choking or gasping for air
• Waking up frequently

When the body recognizes the need for oxygen, it triggers a survival reflex. The reflex to wake up and breathe is often very brief — just long enough for breathing to start again. Many people with OSA aren’t aware that they’ve lost a lot of sleep. The interruptions are often so brief that they may not realize how many times they’ve woken up during the night.

3. Serious Complications Can Develop

Untreated OSA can lead to serious health complications because a lack of oxygen can harm the body. Some complications can be life-threatening over time. Sleep apnea is linked to increased risks of health issues such as:

• High blood pressure
• Heart disease, heart attack, and stroke
• Metabolic disorders such as type 2 diabetes

Untreated sleep apnea also causes symptoms that are directly linked to sleep deprivation and excessive daytime sleepiness. Losing sleep can cause problems that may affect daily life, relationships, and work performance. Sleep loss can lead to cognitive impairment (trouble with thinking and memory), mental health conditions such as depression, and morning headaches. People with OSA may experience mood swings or be irritable from a lack of sleep. Daytime fatigue can lead to lower productivity and a higher risk of accidents at work and while driving.

4. Diagnosis of Sleep Apnea Is Often Delayed

An estimated 80 percent of people with sleep apnea go undiagnosed because they either aren’t aware of their sleep disturbance or don’t realize it could be a serious health problem. Sleep apnea develops over time, and common symptoms such as snoring may not be taken seriously. Daytime drowsiness may be blamed on aging or lifestyle factors.

Often, a bed partner notices signs of sleep apnea, such as loud snoring, gasping for air, or abnormal breathing, and urges their partner to seek healthcare. Even so, research has shown that a sleep apnea diagnosis takes about 10 years from when symptoms first begin.

5. Sleep Evaluations Can Lead to a Diagnosis

Obstructive sleep apnea is identified and diagnosed through sleep studies, in which people are monitored during sleep with sensors. Sleep apnea testing can take place in a sleep lab or at home. The results show how often sleep is disturbed and how heart rate, breathing, and brain activity are affected. Other factors, such as blood oxygen levels and sleep cycles, can also be evaluated. A physical exam of the neck, throat, and mouth can help a doctor determine how soft tissue or the structure around the upper airway may be affecting a person’s sleep apnea.

A thorough diagnosis can help your doctor determine an effective treatment plan based on your individual needs.

6. Treatment Can Often Control Breathing Interruptions

Sleep apnea treatment can often control breathing interruptions during sleep. A continuous positive airway pressure (CPAP) machine is commonly used. This device pumps air through a mask worn during sleep to keep the airways open. An oral appliance — a mouthpiece worn during sleep — can also help.

Other treatment options include:

• Surgery to remove tissue that may be blocking airways
• Removal of tonsils and adenoids
• Nerve stimulators (implanted devices that help strengthen airway muscles)

Your healthcare provider may also advise lifestyle changes to help manage OSA. Exercising regularly, losing weight, avoiding alcohol, and quitting smoking have been shown to help control sleep apnea — along with improving overall health and well-being — in some people.

Early evaluation and treatment are important for preventing complications and protecting long-term health. Be sure to talk with your healthcare provider if you have worsening symptoms due to sleep apnea.

7. Maintaining Sleep Apnea Treatment Is Essential

Sticking with CPAP therapy is a key aspect of effectively treating sleep apnea. Research has shown that about 37 percent of people with OSA whose doctors recommended CPAP don’t adhere to the treatment. People may stop using CPAP because of cost, embarrassment or stigma, or preference for other treatments. Some people find CPAP uncomfortable or have trouble keeping the mask in place during sleep.

If you’re having difficulty adhering to CPAP treatment, talk with your doctor. It’s important to find ways to maintain treatment that can control your sleep apnea and help protect your health.

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