What is Obstructive Sleep Apnea?
Obstructive sleep apnea (OSA) is the most common type of sleep-disordered breathing, affecting an estimated 22 million Americans. It occurs when the muscles that support the soft tissues in your throat temporarily relax during sleep, causing the airway to narrow or close completely.
When your airway becomes blocked, your brain briefly wakes you to reopen it—often so briefly that you don’t remember waking. These breathing interruptions can occur 5 to 100+ times per hour, severely disrupting sleep quality and reducing blood oxygen levels.
Understanding Apneas and Hypopneas
Apnea
A complete cessation of airflow for at least 10 seconds. During an apnea, you literally stop breathing despite continued effort to breathe.
Hypopnea
A partial reduction in airflow (at least 30%) for 10 seconds or more, associated with either oxygen desaturation or an arousal from sleep.
The Apnea-Hypopnea Index (AHI)
The AHI measures how many apneas and hypopneas occur per hour of sleep:
- Normal: AHI less than 5
- Mild OSA: AHI 5-14
- Moderate OSA: AHI 15-29
- Severe OSA: AHI 30 or higher
Symptoms of Obstructive Sleep Apnea
Nighttime Symptoms
- Loud, chronic snoring (though not everyone who snores has sleep apnea)
- Gasping, choking, or snorting during sleep
- Pauses in breathing witnessed by a bed partner
- Restless sleep with frequent tossing and turning
- Night sweats
- Frequent nighttime urination (nocturia)
- Dry mouth or sore throat upon waking
Daytime Symptoms
- Excessive daytime sleepiness despite adequate time in bed
- Morning headaches
- Difficulty concentrating or memory problems
- Irritability, depression, or mood changes
- Falling asleep during activities (watching TV, meetings, driving)
- Decreased libido
Causes and Risk Factors
Anatomical Factors
- Excess weight: Fat deposits around the upper airway
- Neck circumference: Larger necks have narrower airways
- Narrowed airway: Naturally narrow throat, enlarged tonsils/adenoids
- Jaw structure: Recessed chin or small jaw
- Large tongue: Can fall back and block the airway
Lifestyle Factors
- Alcohol use: Relaxes throat muscles
- Smoking: Increases inflammation and fluid retention in airway
- Sedative medications: Can relax throat muscles
- Sleep position: Worse when sleeping on your back
Other Risk Factors
- Age: Risk increases with age
- Gender: More common in men (though post-menopausal women’s risk increases)
- Family history: Genetic predisposition
- Nasal congestion: Chronic congestion doubles risk
- Medical conditions: Hypertension, diabetes, heart disease
Health Consequences of Untreated OSA
Obstructive sleep apnea isn’t just about poor sleep—it carries serious health risks:
Cardiovascular Effects
- High blood pressure (hypertension)
- Heart disease and heart attacks
- Stroke
- Atrial fibrillation (irregular heartbeat)
- Heart failure
Metabolic Effects
- Type 2 diabetes and insulin resistance
- Metabolic syndrome
- Weight gain (and difficulty losing weight)
Cognitive and Mental Health
- Daytime fatigue and decreased quality of life
- Depression and anxiety
- Cognitive impairment and memory problems
- Increased accident risk due to sleepiness
Other Complications
- Liver problems (non-alcoholic fatty liver disease)
- Complications with medications and surgery
- Relationship problems from snoring and irritability
Diagnosis of Obstructive Sleep Apnea
Important: Sleep apnea must be diagnosed by a physician through a sleep study. We do not diagnose sleep apnea.
Diagnostic Methods
Home Sleep Apnea Test (HSAT)
- Portable device used at home
- Appropriate for most suspected OSA cases
- Measures breathing, oxygen levels, heart rate
- Less expensive than in-lab study
In-Lab Polysomnography
- Overnight stay in a sleep lab
- Comprehensive monitoring including brain waves
- Recommended for complex cases
- Can also diagnose other sleep disorders
We coordinate with physicians who order and interpret sleep studies. Learn more about HSAT coordination →
Treatment Options for OSA
Oral Appliance Therapy
Custom-fitted devices that position your jaw forward to keep your airway open during sleep.
Best for:
- Mild to moderate OSA
- CPAP intolerance
- Patients who prefer a non-invasive option
Learn more about oral appliance therapy →
CPAP Therapy
Continuous positive airway pressure delivered through a mask.
Best for:
- All severities of OSA
- Patients who tolerate CPAP well
- Often first-line for severe OSA
Lifestyle Modifications
- Weight loss (can significantly reduce AHI)
- Positional therapy (avoid sleeping on back)
- Avoiding alcohol before bed
- Treating nasal congestion
- Regular exercise
Surgical Options
Reserved for specific anatomical issues or when other treatments fail.
Why Choose Oral Appliance Therapy?
For patients with mild to moderate OSA, oral appliances offer an effective alternative to CPAP:
- High compliance rates due to comfort and convenience
- Portable and travel-friendly
- Silent operation
- No electricity required
- Effective AHI reduction in appropriately selected patients
Research shows that while CPAP may achieve greater AHI reduction, oral appliances often provide better real-world outcomes because patients actually use them consistently.
Getting Started
If you have been diagnosed with obstructive sleep apnea, or suspect you may have OSA based on symptoms, we can help:
- Consultation: Evaluate your situation and discuss options
- Diagnosis Coordination: Help arrange sleep testing if needed
- Treatment: Provide oral appliance therapy if appropriate
- Follow-Up: Ensure treatment effectiveness with physician-coordinated testing
Note: Home sleep apnea testing (HSAT) is ordered and interpreted by a physician. We coordinate testing and provide oral appliance therapy as a CPAP alternative in collaboration with the patient’s sleep physician.
Schedule a consultation to learn if oral appliance therapy is right for your obstructive sleep apnea.