Obstructive Sleep Apnea: Your GoodRx Guide

Definition

Obstructive sleep apnea (OSA) is a very common sleep-related breathing disorder, and it can be quite serious. Experts estimate that it affects 1 billion people in the world. In the U.S., research suggests that OSA affects about 1 in every 4 men and 1 in every 10 women. And these numbers are likely low because many people don’t know they have it and never get tested. 

In OSA, breathing stops for short periods of time while you sleep. These pauses in breathing occur because there’s a physical blockage in the throat or upper airway. These can be complete or partial blockages. This is usually due to the anatomical structures in the back of the throat and the way those structures change shape and position when you sleep. 

These disruptions in breathing reduce how much oxygen you get, so they can have serious effects on your health and quality of life. 

Causes

Many different things can contribute to obstructive sleep apnea. Some are related to physical characteristics, like neck size or jaw shape. Others affect how you breathe or sleep, like smoking or alcohol use. For many people, it’s likely a combination of these factors.

The following risk factors increase the likelihood of OSA:

• Male sex: Men are more likely than women to have OSA — up to a certain age. After menopause, a woman's risk seems to increase similarly to men.

• Older age: The risk of OSA continually increases as you get older, but it’s still a relatively common condition for people in their 30s and younger. And OSA can also affect children.

• Body shape and size: People with a BMI of 30 or above (“obese” category) are at higher risk for OSA. Physical characteristics of the face and neck also play a role, like a shorter lower jaw, enlarged tonsils, or thicker neck.

• Medications and substances: Smoking, alcohol, and sedative medications all increase the risk of OSA.

• Medical conditions: Certain medical conditions are associated with increased risk of OSA, such as Type 2 diabetes, Parkinson’s disease, prior stroke, polycystic ovary syndrome (PCOS), and thyroid conditions.

• Genetics: People with family members who have OSA are also more likely to develop OSA. 

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Symptoms

Many people with obstructive sleep apnea don’t know that they have it. Or their bed partners are the first ones to notice these episodes. But some people may notice that they wake up several times during the night with a choking or gasping sensation. 

OSA isn’t the same as snoring, even though there’s overlap between the two conditions. Many people with OSA snore. But just because you snore doesn’t mean that you have OSA, and vice versa. 

During the day, people may experience many different symptoms related to disrupted sleep or decreased oxygen levels at night, such as:

• Daytime sleepiness

• Morning headaches

• Difficulty concentrating

OSA can have a negative effect on quality of life. Women with OSA commonly report memory loss and mood symptoms. And OSA can increase the risk of a car accident from falling asleep at the wheel. 

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Testing and diagnosis

To diagnose OSA, your sleep specialist will evaluate your symptoms and any sleep disruptions that people who sleep near or next to you have noticed. You’ll also need to do a test to monitor your sleeping patterns. 

The go-to test to help diagnose OSA is a sleep study, or polysomnography (PSG). A PSG takes place overnight in a sleep lab, and it can help diagnose many sleep disorders (not just OSA). While you sleep, healthcare professionals keep track of your: 

• Breathing patterns

• Eye movements

• Body movements

• Vital signs, like heart rate and blood oxygen 

Nowadays, there are also at-home sleep apnea tests. An at-home sleep study can be convenient and reliable, but PSGs are still the gold standard to help diagnose sleep disorders, including sleep apnea. So check with your sleep specialist to find the best test for you. 

The results from your sleep study give your sleep specialist important information about how many episodes of apnea you have per hour. They use these study results along with your medical history to make a diagnosis and determine how severe your OSA is. And this helps figure out which treatment is best for you.

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Treatments

There are a range of treatments for sleep apnea, from self-care and lifestyle changes to surgery and medications. CPAP is the most common treatment for obstructive sleep apnea. CPAP stands for continuous positive airway pressure. A CPAP machine can open your airways so that you get enough oxygen while sleeping. The machine is connected to a mask that you wear at night. 

Small, lightweight CPAP machines are nearly silent, but it usually takes some time for people to get used to wearing them. CPAP is a highly effective treatment for people with moderate-to-severe cases of OSA. 

Other treatment options include: 

• Lifestyle changes: This may mean losing weight or addressing substance use.

• Different sleep positions: You can try to sleep on your side rather than your back, for example.

• Oral devices: This includes things like mouth guards. Dentists usually fit these.

• Surgery: There are a range of surgeries for OSA that may help people with moderate or severe OSA. Usually surgery becomes an option after other treatments haven’t worked. The cost of sleep apnea surgery can be quite high, but it really depends on the type of surgery.

• Medications: Certain medications can help with excessive sleepiness.

Prevention

While you can’t change things like your age or biological sex, there are some changes you can make to lower your risk of obstructive sleep apnea:

• Dietary changes and exercise may help with weight loss, which has a big impact on OSA risk.

• Consider quitting or cutting back on smoking.

• Reduce your consumption of alcohol. 

And remember that just by tending to your other health needs, you’re decreasing your risk of OSA. This includes things like monitoring your blood sugar if you have diabetes, or taking your medications for high blood pressure or other cardiovascular conditions. Most OSA prevention strategies will have a positive effect on other medical conditions and your overall health.