Understanding Sleep Apnea: Types, Symptoms, and Treatment Options

March is Sleep Awareness Month, a time to recognize the critical role sleep plays in our overall health and well-being. While many people struggle with occasional sleep difficulties, some suffer from serious, chronic sleep disorders—one of the most prevalent being sleep apnea.

Sleep apnea is more than just snoring or feeling tired; it is a medical condition that affects millions of Americans, often without them realizing it. Left untreated, it can lead to severe health complications.

What Is Sleep Apnea?

Sleep apnea is a condition where breathing repeatedly stops and starts during sleep. These pauses, called apneas, can last anywhere from a few seconds to over a minute and occur multiple times per hour. This disruption prevents the body from getting enough oxygen, affecting overall health and leading to poor sleep quality.

The condition is classified into three main types:

Obstructive Sleep Apnea

Obstructive Sleep Apnea is the most common form of sleep apnea, caused by a physical blockage of the airway during sleep. It occurs when the muscles in the back of the throat relax too much, causing the airway to collapse. This blockage reduces airflow, leading to oxygen deprivation and prompting the brain to wake the person up momentarily—often without them realizing it.

Risk Factors for Obstructive Sleep Apnea:

• Obesity: Excess weight increases the likelihood of airway obstruction.
• Family history: Genetics play a role in throat structure and airway size.
• Male gender:  Men are more likely to develop OSA than women.
• Age: The risk increases with age, particularly in people over 40.
• Large neck circumference: A thicker neck may have a narrower airway.
• Nasal congestion: Chronic congestion makes breathing more difficult at night.
• Smoking and alcohol use: These can relax airway muscles and increase inflammation.

Central Sleep Apnea

Unlike Obstructive Sleep Apnea, Central Sleep Apnea is a neurological condition where the brain fails to send proper signals to the muscles that control breathing. As a result, the person temporarily stops breathing—not because of an airway blockage but because the brain does not trigger normal respiration.

Causes of Central Sleep Apnea:

• Heart failure: Many cases of Central Sleep Apnea are associated with heart-related conditions.
• Neurological disorders: Stroke, brainstem injuries, and conditions like Parkinson’s disease can contribute.
• Certain medications: Opioids and other sedatives can suppress the brain’s ability to regulate breathing.

Complex Sleep Apnea Syndrome

Complex Sleep Apnea Syndrome occurs when a person initially diagnosed with obstructive sleep apnea begins to develop central sleep apnea after starting continuous positive airway pressure (CPAP) therapy. In other words, while CPAP successfully keeps the airway open and reduces obstruction, the brain intermittently fails to send consistent signals to breathe during sleep.

As a result, individuals experience a combination of both obstructive and central breathing disruptions. These central events are not caused by airway collapse but by instability in the body’s breathing control system, which can lead to ongoing sleep fragmentation and persistent symptoms despite treatment.

Because complex sleep apnea emerges during therapy rather than appearing on the initial sleep study, it often requires additional evaluation and a more specialized treatment approach to ensure effective, restorative sleep.

Common Symptoms of Sleep Apnea

Many people with sleep apnea are unaware of their condition because the symptoms occur during sleep. In many cases, a partner or family member notices the signs first.

Signs of Sleep Apnea:

• Loud, persistent snoring (especially with Obstructive Sleep Apnea)
• Gasping, choking, or snorting during sleep
• Pauses in breathing observed by a partner
• Waking up feeling unrefreshed
• Excessive daytime sleepiness and difficulty staying awake
• Morning headaches
• Difficulty concentrating or memory issues
• Mood changes, including irritability or depression

If you recognize these symptoms in yourself or a loved one, it is crucial to seek a professional evaluation at a sleep center for proper diagnosis.

How Is Sleep Apnea Diagnosed?

The MemorialCare Neuroscience Institute at Long Beach Medical Center brings together the Stroke Center, Division of Interventional Neuroradiology, and Sleep Disorders Center, partnering with the MemorialCare Rehabilitation Institute to offer the full spectrum of neurological care under one roof.

The Sleep Disorders Center provides Home Sleep Tests, a convenient option for diagnosing moderate to severe obstructive sleep apnea without requiring an in-laboratory study. Diagnosis of sleep apnea and other sleep disorders typically begins with a comprehensive evaluation and sleep study. With Home Sleep Tests, patients can undergo overnight monitoring in the comfort of their own home using a small device that tracks heart rate, breathing effort, and oxygen levels to help identify obstructive sleep apnea.

For those experiencing excessive daytime sleepiness that may not be due to untreated sleep apnea, the Multiple Sleep Latency Test is performed the day after an overnight polysomnography to measure how quickly a person falls asleep in a quiet environment, aiding in the diagnosis of narcolepsy and idiopathic hypersomnia. Additionally, the Maintenance of Wakefulness Test assesses a person’s ability to stay awake during the day, helping to evaluate daytime alertness and the impact of sleep disorders on daily functioning.

Why Treating Sleep Apnea Is Critical

Ignoring sleep apnea can have serious long-term consequences, including:

• High blood pressure and increased stroke risk
• Heart disease and irregular heartbeats
• Type 2 diabetes
• Cognitive decline and dementia risk
• Workplace and driving accidents due to excessive sleepiness

By seeking early diagnosis and treatment, patients can dramatically improve their sleep quality, energy levels, and long-term health.

Treatment Options for Sleep Apnea

Thankfully, effective treatments exist to help manage sleep apnea and improve sleep quality. The right approach depends on the severity of the condition and individual needs. Five important preventative and treatment factors to consider are:

Lifestyle Modifications

Mild cases of sleep apnea may be improved with lifestyle changes, such as:

• Weight loss – Losing even 10-15% of body weight can reduce Obstructive Sleep Apnea severity according to Sleep Foundation.
• Changing sleep positions – Sleeping on the side instead of the back may help.
• Avoiding alcohol and sedatives – These substances relax throat muscles and worsen symptoms.
• Quitting smoking – Smoking increases inflammation in the airway.

CPAP Therapy (Continuous Positive Airway Pressure)

CPAP therapy is the gold standard for treating Obstructive Sleep Apnea. It delivers a continuous stream of air through a mask, keeping the airway open. This prevents interruptions in breathing and improves sleep quality.

Some patients struggle with CPAP use due to discomfort, but adjusting to the machine and using a properly fitted mask can greatly enhance compliance and effectiveness.

Recent studies have demonstrated that regular nightly use of CPAP therapy may reduce adverse cardiovascular outcomes in patients with moderate to severe sleep apnea and coexisting cardiac disease.

Oral Appliance Therapy

For mild to moderate cases, a custom-fitted oral appliance (similar to a mouthguard) repositions the jaw to keep the airway open. This is often recommended for patients who cannot tolerate CPAP therapy and is typically fabricated and fitted by a sleep-specialized dentist.

Inspire® Therapy (Hypoglossal Nerve Stimulation)

A newer, FDA-approved treatment, INSPIRE therapy is offered as a treatment option for patients diagnosed with sleep apnea at Long Beach Medical Center. INSPIRE is an implantable device that stimulates airway muscles to prevent obstruction. It is an excellent option for CPAP-intolerant patients with moderate to severe Obstructive Sleep Apnea.

This small device is implanted under the skin near a patient's collarbone during a minimally invasive procedure. It is controlled by a small hand-held remote to turn on therapy when sleeping and a mobile application to track and share sleep data with your care team. While sleeping, Inspire opens the airway, preventing sleep apnea and allowing you to sleep peacefully without the use of a mask or a hose.

Surgical Interventions

Surgery may be considered for severe cases when other treatments fail. Options include:

• Uvulopalatopharyngoplasty: Removes excess tissue from the throat.
• Genioglossus advancement: Moves the tongue forward to prevent airway collapse.
• Maxillomandibular advancement: A more invasive procedure that repositions the jaw.

Getting Help at Long Beach Medical Center

If you or a loved one experiences symptoms of sleep apnea, schedule a consultation at the Sleep Disorder Center at Long Beach Medical Center. Our team offers comprehensive diagnostic services and personalized treatment plans to help you breathe easier and sleep better.

The Sleep Disorders Center has been evaluating patients with sleep-related disorders since 1986. Our centers provide expert evaluation and treatment recommendations utilizing advanced diagnostic equipment for adult and pediatric patients of all ages. The Sleep Disorders Center is an accredited sleep facility with the American Academy of Sleep Medicine. All tests are scored and reviewed by a specialist certified by the Board of Registered Polysomnographic Technologists and interpreted by a physician certified as a Diplomat of the American Academy of Sleep Medicine and a board-certified Pulmonologist.

For more information, visit Sleep Disorder Center and call (562) 933-8645.

About the Author

Sarathi Bhattacharyya, M.D., is a pulmonologist and the medical director of the Sleep Disorders Center at Long Beach Medical Center. He specializes in treating conditions such as pneumonia, sleep apnea, and pulmonary heart disease. Dr. Bhattacharyya earned his medical degree from the David Geffen School of Medicine at UCLA in 2016 and completed both his residency and fellowship at UCLA Medical Center.