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Obstructive sleep apnea - adults

Definition

With obstructive sleep apnea your breathing pauses while you are asleep because your airway has become narrowed or partly blocked.

Alternative Names

Sleep apnea - obstructive - adults; Apnea - obstructive sleep apnea syndrome - adults; Sleep-disordered breathing - adults; OSA - adults

Causes

When you sleep, all of the muscles in your body become more relaxed. This includes the muscles that help keep your throat open so air can flow into your lungs.

Normally, your throat remains open enough during sleep to let air pass by. Some people have a narrow throat. When the muscles in their upper throat relax during sleep, the tissues close in and block the airway. This stop in breathing is called apnea.

Loud snoring is a telltale symptom of sleep apnea. Snoring is caused by air squeezing through the narrowed or blocked airway. Not everyone who snores has sleep apnea though.

Other factors also may increase your risk:

Sleeping on your back can also cause your airway to become blocked or narrowed.

Central sleep apnea is another sleep disorder during which breathing can stop. It occurs when the brain temporarily stops sending signals to the muscles that control breathing.

Symptoms

If you have obstructive sleep apnea, you usually begin snoring heavily soon after falling asleep.

Most people with obstructive sleep apnea do not know their breathing starts and stops during the night. Usually, a sleep partner or other family members hear the loud snoring, gasping, and snorting. Snoring can be loud enough to hear through walls.

People with sleep apnea may:

Other problems that may occur include:

Exams and Tests

Your health care provider will take your medical history and do a physical exam.

You may need to have a sleep study to confirm obstructive sleep apnea.

Other tests that may be performed include:

Treatment

Treatment helps keep your airway open while you sleep so your breathing does not stop.

Lifestyle changes may help relieve symptoms in people with mild sleep apnea, such as:

Continuous positive airway pressure (CPAP) devices work best to treat obstructive sleep apnea in most people.

It can take some time to get used to sleeping with CPAP therapy. Good follow-up and support from a sleep center can help you overcome any problems using CPAP.

Dental devices may help some people. You insert them into your mouth while you sleep to keep your jaw forward and the airway open.

Other treatments may be available, but there is little evidence that they work. It is best to talk with a doctor who specializes in sleep problems before trying them.

Surgery may be an option for some people. It is often a last resort if other treatments did not work and you have severe symptoms. Surgery may be used to:

Surgery may not completely cure obstructive sleep apnea and may have long-term side effects.

Outlook (Prognosis)

If not treated, sleep apnea may cause:

Daytime sleepiness because of sleep apnea can increase the risk of:

In most cases, treatment completely relieves symptoms and problems from sleep apnea.

Possible Complications

Untreated obstructive sleep apnea may lead to or worsen heart disease, including:

When to Contact a Medical Professional

Call your health care provider if:

References

Aurora RN, Casey KR, Kristo D, et al. Practice parameters for the surgical modifications of the upper airway for obstructive sleep apnea in adults. Sleep. 2010;33:1408-1413. PMID 21061864 www.ncbi.nlm.nih.gov/pubmed/21061864.

Epstein LJ, Kristo D, Strollo PJ Jr., et al. Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine: Clinical guideline for the evaluation, management, and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med. 2009;5:263-276. PMID 19960649 www.ncbi.nlm.nih.gov/pubmed/19960649.

Kasai T, Bradley TD. Obstructive sleep apnea and heart failure: pathophysiologic and therapeutic implications. J Am Coll Cardiol. 2011;57:119-127. PMID 21211682 www.ncbi.nlm.nih.gov/pubmed/21211682.

McArdle N, Singh B, Murphy M, et al. Continuous positive airway pressure titration for obstructive sleep apnoea: automatic versus manual titration. Thorax. 2010;65:606-611. PMID 20627917 www.ncbi.nlm.nih.gov/pubmed/20627917.

Qaseem A, Holty JE, Owens DK, Dallas P, Starkey M, Shekelle P; for the Clinical Guidelines Committee of the American College of Physicians. Management of Obstructive Sleep Apnea in Adults: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2013;159:471-483. PMID 24061345 www.ncbi.nlm.nih.gov/pubmed/24061345.

Wakefield TL, Lam DJ, Ishman SL. Sleep apnea and sleep disorders. In: Flint PW, Haughey BH, Lund VJ, et al., eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Mosby; 2015:chap 18.


Review Date: 2/2/2015
Reviewed By: Andrew Schriber, MD, FCCP, Specialist in Pulmonary, Critical Care, and Sleep Medicine, Virtua Memorial Hospital, Mount Holly, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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