If you’re living with sleep apnea, or you’re concerned that a loved one may have it, knowing which signs to watch for and what they can mean can help you get medical care sooner. Early help matters, especially if symptoms start or get worse.

Here’s what you need to know about sleep apnea and how it usually shows up. If you or a loved one has any of these symptoms, talk to a healthcare professional or a sleep specialist about getting a sleep study and a diagnosis. They can help figure out what’s causing the sleep problems and recommend a treatment option that fits your needs.

What’s Sleep Apnea?

Sleep apnea is a sleep disorder that happens when your breathing repeatedly stops and starts while you sleep. There are several types, but the most common one is called obstructive sleep apnea (OSA). This happens when your airway collapses at night, creating a physical blockage in the upper part of your respiratory tract. This reduces your airflow, causing breathing pauses. Unless noted otherwise, this is the type of sleep apnea discussed in this article.

This blockage in OSA happens because the airway relaxes during sleep. OSA can cause you to wake up, partially or fully, all night long because your body is trying to get the oxygen that it needs. This means that not only are you not getting enough oxygen, but you’re also not getting restful sleep. OSA is connected to heart and blood pressure problems, liver problems, type 2 diabetes, and more, so it’s important to get it diagnosed and treated right away.

Symptoms of Obstructive Sleep Apnea During Sleep

Many common signs and symptoms of OSA happen while you’re asleep. You might not even know they’re happening until a bed partner or loved one notices them.

1. Snoring

Snoring that’s significant and often loud is a key sign of sleep apnea. This kind of snoring is often louder than your normal speaking voice and can be heard through thin walls or closed doors. Loud snoring happens during sleep apnea because the air doesn’t flow easily through the airway. The rough air movement makes the snoring noise.

2. Restless Sleep

Restless sleep is also a symptom of sleep apnea. You might feel like you toss and turn all night or even wake up thrashing, kicking, or with your body jerking. This happens because your body is trying to get the air it needs. It may jolt you awake so you can start breathing again.

3. Gasping

Some people diagnosed with OSA report waking up gasping for air. This may be something that you experience or only something your partner hears. Either way, it means that your body is trying to get the oxygen it needs by taking in air quickly.

4. Choking

Similarly, some people with sleep apnea choke while they’re asleep or as they wake up. This can happen when your airway briefly collapses and then reopens as you start breathing again.

5. Other People Seeing You Not Breathing During Sleep

One major sign of sleep apnea is when someone notices that you stop breathing while you sleep. A bed partner may realize you aren’t breathing for a moment, then hear you gasp or choke as you start again. These pauses are called breathing events. During a breathing event, your airway partly or fully collapses, which can lower oxygen levels.

Other Symptoms of Obstructive Sleep Apnea

There are symptoms of sleep apnea that you can see during the day, too.

1. Trouble Focusing

Sometimes, people living with OSA will have trouble focusing while they’re awake. Some may also notice memory problems because they aren’t getting enough restful sleep at night. In more severe cases, low oxygen levels during sleep may affect brain health over time.

2. Headaches in the Morning

Sleep apnea can cause headaches in the morning. These headaches may be linked to disrupted sleep and changes in oxygen or carbon dioxide levels during the night. Morning headaches may go away once you’re up, about, and breathing normally. Sleep apnea may lead to headaches later in the day, too, but these are usually tied to being very tired.

3. Feeling Tired or Fatigued

Extreme or significant tiredness, fatigue, or daytime sleepiness is one of the most common symptoms of sleep apnea. It may be the only symptom that someone with sleep apnea knows about or reports to their healthcare provider. It happens because you aren’t getting the oxygen your body needs at night, so it’s waking you up regularly. This keeps you from getting deep, restorative sleep and puts you in a state of sleep deprivation. Your doctor may give you a questionnaire to assess how tired you are as part of your evaluation for OSA.

4. Mental Health Problems

Depression and anxiety are common in people living with OSA. On their own, they aren’t always signs of sleep apnea. But if they happen along with other symptoms on this list, it may be time to talk to a healthcare professional about an evaluation. Researchers don’t know for sure if OSA directly causes depression or anxiety, but poor sleep and low oxygen levels during the night may play a role.

Symptoms That Often Coexist With Sleep Apnea

There are some symptoms of related conditions that often go along with sleep apnea. These are noted here because they’re so closely related to OSA that a sleep specialist may ask you about these medical conditions when they’re working to diagnose you.

1. Obesity

Obesity is very common in people living with OSA. It’s believed that deposits of fat in and around the upper airway may put pressure on the airway, leading to its collapse and to sleep apnea. OSA may make weight management harder for some people because poor sleep can affect hunger hormones.

2. High Blood Pressure

High blood pressure, or hypertension, is often included on questionnaires used to figure out whether a person should be evaluated for sleep apnea. They tend to occur together, and OSA may put a person at a higher risk of developing hypertension. Additionally, treating OSA may modestly lower blood pressure in some people. Higher blood pressure in people with OSA may be caused by not having enough oxygen or by waking up a lot, though more research is needed to establish these causes.

Talk to Your Doctor

If you have any of these symptoms, alone or together, and they keep happening or get worse over time, it’s important to talk with a healthcare professional. OSA is different from other types of sleep apnea and is often very treatable once you get the right diagnosis. For example, a machine providing continuous positive airway pressure (a CPAP machine) can help keep your airway open while you sleep. With the right treatment, many people start sleeping better and feeling better over time.

Join the Conversation

On MySleepApneaTeam, people share their experiences with obstructive sleep apnea, get advice, and find support from others who understand.

What sleep apnea symptoms alerted you to get tested for the condition? Let others know in the comments below.