Sleep Apnea is Becoming More Common: 10 Warning Signs to Know

Sleep apnea is an increasingly common but often overlooked condition that can severely impact overall health. Characterized by repeated pauses in breathing during sleep, sleep apnea is linked to serious complications such as high blood pressure, heart disease, diabetes, and cognitive decline. Alarmingly, many individuals are unaware they have the condition. Research suggests that up to 30 million people in the United States suffer from obstructive sleep apnea (OSA), yet an estimated 80% of cases remain undiagnosed. Knowing this, and recognizing the warning signs of sleep apnea can not only help bring awareness, but is also crucial for early intervention.

In this article, learn the different types of sleep apnea, what causes it, the top warning signs to watch for, and why getting tested is essential for long-term health.

What is Sleep Apnea?

Sleep apnea is a sleep disorder in which breathing repeatedly stops and starts during sleep. These interruptions, known as apneas, can last from a few seconds to over a minute and occur multiple times per hour, preventing the brain and body from receiving sufficient oxygen.

There are three primary types of sleep apnea:

Obstructive Sleep Apnea (OSA)

The most common form, Obstructive Sleep Apnea (OSA), occurs when the muscles in the throat relax excessively during sleep, causing a temporary blockage of the airway. This leads to repeated drops in oxygen levels, triggering the brain to wake the body just enough to resume breathing — often without the person being aware. Over time, these disruptions contribute to poor sleep quality and increase the risk of serious health complications like hypertension and heart disease.

Central Sleep Apnea (CSA)

A less common condition, Central Sleep Apnea (CSA), differs from OSA in that it is not caused by a physical airway blockage but rather a failure in the brain’s respiratory control system. This disruption leads to inconsistent breathing patterns, often resulting in frequent awakenings and poor sleep quality. CSA is commonly associated with underlying conditions such as heart failure, stroke, or the use of certain medications like opioids.

Complex Sleep Apnea Syndrome

Also called treatment-emergent central sleep apnea, this condition is a combination of OSA and CSA, which starts as OSA and develops into CSA. This type of sleep apnea is often discovered during CPAP therapy. Patients with Complex Sleep Apnea Syndrome may initially respond to CPAP therapy, but over time, their breathing irregularities persist or worsen due to the emergence of central sleep apnea events.

What Causes Sleep Apnea?

According to research, several factors increase the risk of developing sleep apnea, including:

Excess Weight: Fat deposits around the neck can obstruct breathing pathways, increasing the risk of OSA.
Aging: Older adults are more likely to experience reduced muscle tone in the throat, increasing the risk of both OSA and CSA.
Gender: Men are at a higher risk for both OSA and CSA, but overweight or postmenopausal women have an increased likelihood (unless receiving hormone therapy).
Family History: Genetic predisposition of sleep apnea can increase the risk of OSA.
Alcohol and Sedatives: These substances relax throat muscles, increasing the risk for and worsening symptoms of OSA.
Smoking: Smokers have three times the risk of developing OSA sleep apnea compared to non-smokers.
Nasal Congestion: Chronic nasal congestion from allergies or structural issues can contribute to breathing problems during sleep and increase the risk of OSA.
Medical Conditions: Chronic conditions such as heart disease, stroke, type 2 diabetes, chronic asthma, and endocrine disorders (like hypothyroidism and PCOS) are linked to an increased risk of sleep apnea.

10 Sleep Apnea Warning Signs

Identifying sleep apnea can be life-saving. The following are the most common symptoms and warning signs to look out for:

#1 Loud, Persistent Snoring

Snoring is one of the most recognizable signs of sleep apnea, especially when it is loud and chronic. While occasional snoring is common, persistent snoring — particularly when accompanied by choking or gasping sounds — may indicate airway obstruction. This occurs when the soft tissues in the throat relax too much, partially blocking airflow.

#2 Gasping or Choking During Sleep

People with sleep apnea often wake up suddenly, gasping for air or choking due to a blocked airway. These episodes occur when breathing stops momentarily, triggering the brain to wake the person just enough to restore airflow. Although the individual may not always remember these awakenings, they can happen multiple times per night, severely disrupting sleep quality. If left untreated, these frequent interruptions can lead to chronic fatigue and increased health risks.

#3 Pauses in Breathing Witnessed by a Bed Partner

Since sleep apnea occurs while sleeping, many individuals are unaware they stop breathing throughout the night. Often, a bed partner notices repeated pauses in breathing, sometimes lasting 10 seconds or longer, followed by gasping or snorting sounds as normal breathing resumes. These episodes can happen dozens or even hundreds of times per night, significantly reducing oxygen levels. If a loved one has observed these breathing interruptions, it is a strong indicator of sleep apnea and should be evaluated by a healthcare professional.

#4 Excessive Daytime Sleepiness (Hypersomnia)

People with sleep apnea often wake up feeling unrefreshed, even after a full night’s sleep. This is because the repeated breathing interruptions prevent the body from reaching deep, restorative sleep, leading to chronic daytime drowsiness. This excessive sleepiness can not only lead to dozing off and frequent reliance on caffeine, but it can also impact concentration, productivity, and reaction time.

#5 Morning Headaches

Frequent morning headaches are a common symptom of sleep apnea, caused by oxygen deprivation and disrupted sleep. When breathing repeatedly stops during the night, carbon dioxide levels rise in the bloodstream, leading to blood vessel dilation and headache pain. These headaches typically feel dull or throbbing and often resolve within a few hours after waking. If you frequently wake up with headaches, especially in combination with snoring or daytime fatigue, it may indicate an underlying sleep disorder that requires medical attention.

#6 Difficulty Concentrating and Memory Issues

Sleep apnea can disrupt the brain’s ability to function properly, leading to difficulty concentrating and memory problems. This is due to the frequent drops in oxygen levels during apneas, which can impair cognitive functions. In fact, studies have shown that individuals with untreated sleep apnea may experience memory lapses, poor focus, and reduced mental clarity, making it harder to complete tasks or retain information. Over time, these cognitive impairments can contribute to more serious issues like decreased work performance and overall mental fatigue.

#7 Mood Changes and Irritability

Sleep apnea can significantly affect mood, leading to irritability, anxiety, and even depression. The lack of quality sleep disrupts the balance of mood-regulating hormones, like serotonin and cortisol, which can cause emotional instability (such as increased mood swings and heightened emotional responses).

#8 Frequent Nighttime Urination (Nocturia)

Nocturia, or waking up multiple times during the night to urinate, is a common issue among individuals with sleep apnea. The frequent interruptions in sleep caused by breathing pauses and oxygen fluctuations can trigger the body’s need to urinate more often. Additionally, sleep apnea can stimulate the production of atrial natriuretic peptide (ANP), a hormone that increases urination. As a result, many people with sleep apnea find themselves waking up several times during the night, disrupting their ability to get restorative sleep.

#9 High Blood Pressure

The intermittent drops in oxygen levels during apnea episodes cause the body to release stress hormones, such as adrenaline, which can increase heart rate, constrict blood vessels, and lead to elevated blood pressure. If left untreated, sleep apnea can significantly increase the risk of developing hypertension or worsen existing high blood pressure. However, proper management of sleep apnea, through lifestyle changes or treatments like CPAP therapy, can help control blood pressure levels, reducing the risk of serious conditions such as heart disease and stroke.

#10 Dry Mouth or Sore Throat in the Morning

One of the more common symptoms of sleep apnea is waking up with a dry mouth or sore throat. This can occur due to mouth breathing, which often happens when the airway is obstructed during sleep. As you struggle to breathe through the blocked airway, your mouth tends to stay open, causing it to dry out. Additionally, the airway blockage can lead to throat irritation, making it sore when you wake up. If these symptoms persist, it’s important to consult with a healthcare provider, as they can be indicative of sleep apnea or other underlying conditions affecting the airway.

Diagnosis & The Importance of Getting Tested

Because sleep apnea is often undiagnosed, seeking medical evaluation is crucial if you experience symptoms. A healthcare provider may recommend:

Home Sleep Apnea Test (HSAT): A portable device that monitors breathing, oxygen levels, and airflow at home. However, portable monitoring doesn’t always diagnose sleep apnea—a polysomnography is the best option.
Polysomnography (PSG): Conducted in a sleep lab, this comprehensive study—and “gold standard” for diagnosing sleep apnea—tracks brain activity, eye movement, heart rate, and respiratory effort.

Sleep Apnea Treatment

There are several effective treatments for sleep apnea:

Continuous Positive Airway Pressure (CPAP) Therapy: The gold standard treatment for OSA, CPAP delivers pressurized air through a mask to keep the airway open, preventing apnea and snoring.
Oral Appliances: While less effective than CPAP therapy, many find that wearing custom-fitted devices that reposition the jaw and tongue to prevent airway obstruction to be more comfortable. These devices may help to alleviate snoring and apnea, and are most often available from your dentist.
Surgery: In severe cases, when other treatments have failed, procedures such as uvulopalatopharyngoplasty (UPPP) or Inspire therapy (a nerve stimulator) may be recommended for those with OSA.
Adaptive servo-ventilation (ASV): For those with CSA, this treatment uses a machine that adjusts airway pressure in real time, responding to changes in breathing patterns to prevent apneas and hypopneas.
Medication: While not a primary treatment, certain drugs may help manage symptoms in CSA.

However, for milder cases of sleep apnea, lifestyle changes (such as weight loss, regular exercise, avoiding alcohol and sedatives before bed, and sleeping on your side) can often help reduce symptoms and improve sleep quality. Here’s what you need to know:

The Importance of a Healthy Lifestyle in Managing Sleep Apnea: 5 Tips to Consider

#1 Maintain a Healthy Weight

Excess weight, particularly around the neck, increases the risk of airway obstruction. The good news is that studies show that losing just 10% of body weight can significantly reduce the severity of OSA. In fact, for some individuals, weight loss alone can eliminate symptoms entirely.

#2 Get Regular Exercise

Physical activity, including both resistance and aerobic training, has been shown to be beneficial for patients with obstructive sleep apnea, regardless of their obesity status, and even for those who are already utilizing CPAP therapy. Just be sure to avoid vigorous activity too close to bedtime, as it may interfere with your ability to fall asleep.

#3 Avoid Alcohol and Sedatives

Alcohol and sedatives relax throat muscles, increasing airway collapse risk. Studies indicate that alcohol consumption before bed can increase apnea episodes by 25%, worsening symptoms and oxygen deprivation. If you’re looking to wind down, consider reaching for a mocktail or calming herbal tea instead — it can help relax your body and promote deeper sleep without the negative side effects.

#4 Improve Sleep Posture

Improving sleep posture is a simple yet effective way to reduce the severity of sleep apnea. Sleeping on your back can cause the tongue and soft tissues in the throat to collapse backward, obstructing the airway. To combat this, try sleeping on your side, which helps keep the airway open. If you struggle to get comfortable, try using a body pillow or a special sleep positioner to prevent rolling onto your back during the night. And if side-sleeping isn’t working, elevating the head of the bed slightly can also reduce apnea episodes by promoting better airflow.

#5 Quit Smoking

Quitting smoking is essential for effectively managing sleep apnea, as smoking irritates and inflames the upper airways, hindering proper airflow during sleep. It also increases mucus production and swelling, while weakening the muscles around the throat, all of which contribute to airway obstruction and worsen sleep apnea. Research shows that smokers are three times more likely to develop obstructive sleep apnea than non-smokers, making smoking cessation a key step in alleviating symptoms and improving overall sleep quality.

The Takeaway

Sleep apnea is a widespread and underdiagnosed condition with serious health consequences. Identifying the warning signs and seeking early treatment can significantly improve your quality of life and reduce the risk of associated health complications. If you or a loved one exhibits symptoms, consulting a healthcare professional is essential for proper diagnosis and management. With the right treatment and lifestyle adjustments, sleep apnea can be effectively controlled, leading to better sleep, improved health, and enhanced well-being.