Sleep Apnea: Snoring, Gasping and Daytime Sleepiness

What sleep apnea is

Sleep apnea is a common condition in which breathing stops and restarts many times during sleep, which can prevent the body from getting enough oxygen. [1] It needs to be treated because it can lead to more serious problems. [2]

There are two types:

• Obstructive sleep apnea (OSA) happens when the upper airway becomes blocked many times during sleep. It is the most common type. Factors such as obesity, large tonsils or hormone changes can narrow the airway. [1]


• Central sleep apnea happens when the brain does not send the signals needed to breathe. Health conditions that affect how the brain controls the airways and chest muscles can cause it. [1]

Snoring, gasping and daytime sleepiness

During sleep, features can include breathing that starts and stops, frequent loud snoring (more common in men) and gasping for air. [3] You may not know until someone tells you; asking someone to watch you sleep can help. [2] In the day, features include sleepiness and tiredness, trouble concentrating, mood swings, headache on waking and dry mouth. [2][3]

Snoring on its own is very common and is not usually caused by anything serious. [4] Snoring can be a sign of sleep apnea, but not everyone who snores has it. [5] This page cannot tell which applies to you; a clinician can.

How it is checked

A clinician asks about symptoms, risk factors and family history, and may refer you to a sleep specialist or a sleep study. A sleep study helps show which type you have and how serious it is. [6] Tests are often done at home with devices worn overnight, and sometimes in a clinic. [2] Severity is often described with the apnea-hypopnea index (AHI): 5 to 14 is mild, 15 to 30 moderate and over 30 severe (NHS ranges). [2] Consumer sleep trackers are not validated for diagnosis. [7]

Established treatments

Established recommendation (from NHLBI and NHS):

• Healthy lifestyle changes, such as regular physical activity, healthy sleep habits, a healthy weight, limiting alcohol and caffeine, and quitting smoking. Sleeping on your side rather than your back may help keep the airway open. [8]
• Positive airway pressure (CPAP, BPAP or APAP machines) is the most common treatment. Side effects can include congestion, dry eyes or mouth, nosebleeds or a runny nose. [8] The NHS says CPAP can improve breathing, sleep quality and tiredness and reduce the risk of problems linked to sleep apnea, such as high blood pressure; it works best used every night. [2]
• Oral devices fitted by a dentist, if CPAP is not wanted or tolerated. [8]
• Orofacial (mouth and facial muscle) exercises, and surgery or nerve stimulation in selected cases. [8]
• A weight-loss medicine has been approved in the US for people with moderate to severe sleep apnea and obesity; it can cause serious side effects in some cases. [8]

Natural and complementary approaches

No supplement or herb is established as a treatment for sleep apnea. Sleeping pills can make sleep apnea worse. [2] See Sleep safety and Medicine interactions.

Why treatment matters

Without treatment, sleep apnea can lead to high blood pressure, stroke, type 2 diabetes, heart disease, depression and a higher chance of a serious tiredness-related accident such as a car crash. [2] Untreated sleep apnea increases the risk of stroke and heart attack and can affect concentration, decision-making and memory. [1]

Who is more likely to have it

Linked factors include obesity, a large neck, older age (though children and young adults can also have it), a family history, alcohol, smoking, large tonsils or adenoids, sleeping on your back and COPD. [2]

When to get help

See a doctor if your breathing stops and starts in your sleep, you gasp, snort or choke, or you always feel very tired in the day. [2] Do not drive when you feel sleepy; in the UK, people with confirmed sleep apnea with excessive sleepiness must not drive until symptoms are controlled. [2] Rules differ elsewhere, so ask your clinician. Related pages: Sleep safety and drowsy driving, Insomnia and Teeth grinding at night.