Sleep Apnea 101: A Comprehensive Guide

Let's talk about sleep apnea — because it's far more common than you think.

If you’ve ever been told you snore like a chainsaw or find yourself gasping for air in the middle of the night, take comfort in knowing you're one of many who struggle with it daily.

Nearly 39 million American adults have reported sleep apnea or nighttime breathing problems. Even our own customer survey points to a similar trend — 33.7% of those surveyed shared that they experience sleep apnea or interrupted breathing during the night.

Here's an in-depth look at sleep apnea and why it's a bigger deal than you may realize.

Sleep apnea is a sleep disorder that disrupts your normal breathing and starves you of oxygen while you're asleep. 

When you stop breathing, your body's internal alarm system kicks into high gear — either fully waking you up or interrupting your deep sleep — so you can start breathing again and get much-needed oxygen. 

This disordered breathing can lead to symptoms such as:

• Lack of deep REM sleep
• Loud snoring 
• Choking and gasping while asleep
• Daytime exhaustion

A fundamental problem with these symptoms is that they aren't always easy to detect. That is until someone — like a bed partner — brings them to your attention.

There are three distinct types of sleep apnea:

1. Obstructive sleep apnea (OSA): OSA is the most common type of apnea. It occurs when a blockage or disruption in airflow causes the respiratory system to stop working for a moment, often due to the soft tissue in the throat obstructing the airways.
2. Central sleep apnea (CSA): CSA occurs when there's a momentary disconnect between your brain and the muscles responsible for breathing. It's often linked to broader issues in the central nervous system and brain activity.
3. Complex (mixed) sleep apnea: This refers to a combination of both obstructive and central sleep apnea.

"Sure, it makes me snore all night long, but it can't be that bad, right?"

You'd be forgiven for thinking this. After all, persistent snoring is often what leads people to discovering they have sleep apnea in the first place.

But the truth is not quite that easy to swallow.

In reality, sleep apnea often occurs alongside other health issues, and if left unattended, it can lead to serious health complications — both in the short and long term.

Sleep apnea has been linked to several physical health concerns that can affect your body in meaningful ways:

• Cardiovascular health complications: Regularly disrupted breathing patterns can cause your blood's oxygen levels to drop. This raises your risk for heart disease, hypertension, and other cardiovascular problems.
• Diabetes: Research shows that sleep apnea can increase your chances of developing insulin resistance and type 2 diabetes.
• Stroke: Sleep apnea has also been associated with a higher risk of suffering a stroke.
• Diminished motor function and daytime fatigue: Frequent disruptions in your sleep cycle can leave you tired, groggy, and less coordinated during the day.

Sleep apnea doesn't only affect your physical health; it can also take a toll on your mental well-being and day-to-day functioning:

• Disrupted sleep schedule: You might not realize how critical a full night's sleep is until you're missing it. Sleep apnea interrupts your rest, leaving your body unable to recharge properly.
• Mood swings: Lack of quality sleep often makes it harder for you to regulate emotions, leading to more frequent irritability or emotional sensitivity.
• Daytime fatigue: Because sleep apnea cuts short the deeper stages of sleep, you may struggle with daytime drowsiness, reduced focus, and lower cognitive functioning. This can impact your relationships, your work performance, and even your ability to drive safely.

Numerous risk factors are associated with OSA. Some of these, like certain lifestyle habits, can be changed. Others, like aging or your family medical history, aren’t within your control. 

Here’s what could raise your chances:

• Excess weight: Being overweight can lead to additional fatty tissue in the neck area, obstructing your airway while you sleep. Maintaining a healthy weight could help prevent or lessen this type of sleep apnea.
• Physical traits: Larger tonsils and a bigger tongue can raise your chances of sleep apnea. But the real culprit is neck circumference. Specifically, a neck circumference of 15.7 in (40 cm) or greater may better predict the possibility of OSA.
• Age: Although sleep apnea can occur at any stage of life, getting older tends to increase your risk. As the years go by, extra fatty tissue can accumulate around your neck and tongue, potentially restricting airflow.
• Hormone levels: Changes in certain hormones affect your face, tongue, and airway. Conditions like polycystic ovary syndrome (PCOS),  hypothyroidism, or high levels of growth hormone or insulin can make sleep apnea more likely.
• Sex: Statistically, men are more prone to OSA  than women.
• Genetics and family history:  Believe it or not, you can inherit sleep apnea. This is because genes play a role in shaping your skull, face, and airway. 
• Heart or kidney issues: If you’re dealing with heart or kidney failure, fluid can build up around your neck, making it harder to breathe comfortably at night.
• Lifestyle factors: Smoking can inflame the throat, narrowing your airway. Alcohol also makes the muscles in your mouth and throat relax more than usual, which can lead to blockages during sleep.

Central sleep apnea stems from how the brain regulates your breathing. Several factors might raise your chances of encountering this condition:

• Genetics and family history: Certain inherited conditions, such as congenital central hypoventilation syndrome (CCHS), can boost your chances of developing central sleep apnea.
• Medical conditions: Health conditions like heart failure, stroke, amyotrophic lateral sclerosis (ALS), myasthenia gravis, and even your hormone levels can compromise your brain's ability to manage the breathing process.
• Age: As you age, so does your brain. This can affect how your brain manages breathing while you're asleep.
• Opioid use: Relying on opioid-based pain relievers — whether prescribed long-term or used in other ways — can disrupt the part of your brain that controls breathing and sleep.
• Lifestyle habits: Smoking and alcohol use can interfere with your brain’s sleep and breathing controls or affect the muscles that help you breathe.
• Sex: Central sleep apnea affects men more frequently than women.

If you suspect you might be affected by these risk factors, consider talking to your doctor about possible next steps. 

Part of what makes sleep apnea so harmful is that it comes with a host of disruptive symptoms  — we can break these down into primary and secondary symptoms. 

The first signs of sleep apnea — which aren't always noticeable unless you have a bed partner — come into play while you're snoozing. These sleep-induced symptoms include:

• Choking and/or gasping
• Frequent pauses in breathing
• Restlessness
• Loud snoring
• A lack of deep REM sleep
• Waking up regularly

Over time — sometimes even as little as two days — your sleep will deteriorate to the point where you'll begin to experience secondary symptoms that affect your day-to-day life. These symptoms include:

• Extreme fatigue
• Mood swings
• Difficulty concentrating
• Morning headaches
• Decreased interest in sex
• Waking up with a dry or sore throat

It's safe to say that sleep apnea presents its fair share of challenges, ones that even the most resilient person may struggle to cope with.

If you notice these symptoms and suspect you have sleep apnea, please do yourself a favor and speak to a medical doctor about your concerns.

Diagnosing sleep apnea is a bit more involved than simply jotting down how many hours you snooze.

Below is a snapshot of what doctors usually do to separate run-of-the-mill snoring from a full-blown sleep disorder—so you can finally get some answers and (hopefully) a better night’s rest.

The first step is often a simple conversation — though it can feel pretty personal. Your doctor will likely ask about:

• Smoking or drinking habits
• Medications that could relax throat muscles or lead to nasal congestion
• Whether you ever wake up gasping or choking
• If your bed partner notices any loud, persistent snoring
• Excessive daytime fatigue, even after a full night’s rest
• Morning headaches or dry mouth

If you share a bed, your partner’s observations can be a game-changer. Pauses in breathing or loud snorts mid-sleep are often spotted by someone watching (or listening) from a few inches away.

Next comes a hands-on examination. Your doctor examines your throat, nose, and mouth for anything out of the ordinary — like enlarged tonsils or a crooked septum.

They may also take note of your neck circumference and body mass index (BMI) measurements to determine if extra weight around your airway is causing trouble.

A quick look at your jaw alignment can also reveal whether structural quirks are making it tougher for air to flow freely when you drift off.

The gold standard diagnostic tool for sleep apnea is a polysomnography (PSG). 

This sleep study is the first of four types of sleep apnea testing that the American Academy of Sleep Medicine (ASSM) introduced as part of their sleep apnea testing program.

During this study, you’ll spend the night at a sleep center linked up to various monitors that track your: 

• Brain waves
• Heart rate
• Breathing patterns 
• Eye movement
• Blood oxygen levels
• Musculoskeletal activity

Once your sleep study is complete, a specialist will analyze the data, focusing on your stages of sleep, wakefulness, and the number of times your breathing stopped (apneas) or became shallow (hypopnea) per hour — this is known as the  Apnea-Hypopnea Index (AHI).

• Mild sleep apnea: 5–15 interruptions per hour
• Moderate sleep apnea: 15–30 interruptions per hour
• Severe sleep apnea: 30+ interruptions per hour

If sleep apnea is confirmed, your doctor will discuss treatment solutions, which can range from lifestyle changes to continuous positive airway pressure (CPAP) therapy or other medical interventions.

Home sleep apnea tests make up the remaining three types of testing.

• Type 2: Think of these as portable PSG tests. They can monitor the same data as a PSG but without the supervision of a trained professional. For this reason, they aren't a very popular choice.
• Type 3: This level of testing uses portable monitoring devices that measure several respiratory, blood oxygen, and cardiac measures.
• Type 4: Typically, type 4 testing only monitors your airflow and blood oxygen levels.

As the name suggests, these tests can be carried out in the comfort of your own home, making them a more convenient (and affordable) method of diagnosing sleep apnea.

So, we’ve walked through the risk factors, signs, and diagnostic procedures for sleep apnea. Now we're going to talk solutions.

Fortunately, there are several treatment options that can help you breathe easily — literally. From lifestyle tweaks to state-of-the-art therapies, here’s what you need to know.

Sometimes, small changes in your daily routine can work wonders to reduce sleep apnea. 

Try and work towards:

• Shedding extra weight: Diet and exercise help lessen fatty tissue around your neck and throat, which can block airflow.
• Avoiding alcohol and smoking: Alcohol relaxes throat muscles, and smoking inflames your airways — both can worsen apnea symptoms.
• Improving your sleep hygiene: Try setting a consistent bedtime, dimming the lights before sleep, and limiting screen time to encourage a healthier sleep cycle.
  
  

While none of these steps alone will “cure” sleep apnea, they can significantly improve your odds of a better night’s rest.

For many individuals, Positive Airway Pressure (PAP) therapy is a game-changer. PAP machines deliver a constant or varying flow of pressurized air through a mask, keeping the airway open throughout the night. 

Three primary types exist:

1. CPAP (Continuous Positive Airway Pressure): Often considered the gold standard for managing obstructive sleep apnea (OSA). It provides a steady, single level of air pressure.
2. BiPAP (Bi-Level Positive Airway Pressure): Delivers two levels of pressure (a higher one during inhalation and a lower one during exhalation). It’s commonly used for patients who find it difficult to exhale against CPAP pressure or have additional respiratory issues.
3. APAP (Automatic Positive Airway Pressure): Adjusts airflow in real-time, responding to changes in your breathing pattern to deliver just the right level of support.
   
   

A systematic review and meta-analysis from the American Academy of Sleep Medicine found that CPAP therapy significantly improves disease severity, reduces daytime sleepiness, and lowers blood pressure.

It also helps prevent motor vehicle accidents and boosts the quality of life for people with OSA. 

How you sleep can make a world of difference, particularly if you have positional sleep apnea — which is exactly what it sounds like: sleep apnea triggered or worsened by certain sleeping positions, especially lying on your back.

You can reduce the effects of positional sleep apnea by:

• Sleeping on your side: Shifting to your side can help keep your tongue and soft tissues from collapsing into your airway.
• Adjusting your pillow: Rolling up a towel or adding extra pillows can encourage a side-sleeping position. 

If you really want to take the guesswork out of fixing your sleeping posture, a positional pillow like our very own  Posiform Anti-Snore Pillow is your best bet.

The Posiform Anti-Snore Pillow combines ergonomic features like a no-roll central ridge, tailored comfort cutouts, and a downward tilt that gently encourages you to sleep on your side while keeping your airway open. 

We break down the science behind the Posiform and the study that demonstrates its effectiveness.

If you struggle to tolerate PAP therapy or are exploring alternative options, oral appliances might right up your alley.

There are two primary types:

1. Tongue stabilizing devices (TSDs): These oral devices hold your tongue in a forward position, preventing it from blocking the back of your throat.
2. Mandibular advancement devices (MADs): MADs reposition your lower jaw slightly forward, which helps widen your airway. 

MADs are, without a doubt, the more popular of the two because of their comfortability and effectiveness.

A 2022 study evaluated the effects of mandibular advancement devices on sleep apnea and found that they are highly effective at treating snoring and mild to moderate OSA. 

There is a wide range of these devices on the market, from budget-friendly over-the-counter options to high-end, custom-fitted mouthguards supplied by dental professionals. 

But very few MADs (if any) match our clinically proven Somnofit-S Anti-Snore Mouth Guard+.

Our best-selling Swiss Somnofit-S Anti-Snore Mouth Guard+ combines a customizable fit, sleek design, and high-quality finish to create a mouth guard that is more comfortable, flexible, and discreet than similar anti-snoring devices on the market. 

Much like our Posiform Pillow, the Somnofit-S was put to the test in a clinical trial and yielded very positive results. 

Surgery may be necessary when all else fails — or if your doctor identifies a structural issue that can’t be corrected non-invasively.

Some commonly used procedures include:

• Uvulopalatopharyngoplasty (UPPP):  A surgery that removes excess tissue from the throat to widen the airway.
• Genioglossus advancement (GA):  This procedure repositions the tongue muscle to prevent airway obstruction.
• Hypoglossal nerve stimulation (HGNS):  A small device is implanted to stimulate the hypoglossal nerve, preventing airway collapse during sleep.
• Maxillomandibular advancement (MMA):  A more complex procedure that repositions the upper and lower jaw to enlarge the airway.

Surgery can be helpful, but it’s not a universal fix — recovery periods, potential complications, and overall success rates vary. 

Discuss these options at length with a specialized ENT (ear, nose, and throat) doctor or surgeon to figure out what’s right for your situation.

Getting your sleep apnea under control often involves trial and error. One therapy may not fit every scenario, which is why working closely with a healthcare professional is key. 

If there's one thing we want you to take away from this, it's that sleep apnea is serious but manageable. 

While it can lead to high blood pressure, poor sleep quality, and daily exhaustion, there are real solutions that can help you breathe easier (literally) and improve your sleep.

The key is awareness and action. Identifying your symptoms and understanding whether you have obstructive, central, or complex sleep apnea is the first step toward better sleep and better health. 

Once you know what's happening, you can start making changes that actually work.

Here are some simple steps you can take today:

• Start with small lifestyle changes:  Regular exercise, quitting smoking, and keeping a consistent sleep routine can   help reduce symptoms, especially obstructive sleep apnea.
• Try affordable sleep aids: Positional pillows, oral devices, and CPAP machines can make a big difference in keeping your airway open and improving sleep quality.
• Consult a doctor or sleep specialist: If you suspect you have sleep apnea,   don't ignore it. A sleep study can confirm your diagnosis and help you find the best treatment options.
• You're not alone: It can happen to anyone at any age, and   taking action now can prevent serious health issues later.

The bottom line? You don't have to suffer through restless nights and exhausting days. There are solutions that work, and with the right approach, you can start getting the deep, restful sleep your body needs.

The content in this article is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a licensed healthcare provider with any questions you may have regarding a medical condition or treatment options. Please consult a qualified healthcare professional for personalized medical advice or concerns about snoring, sleep disorders, or related health issues.