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Obstructive Sleep Apnea (OSA): Signs, Symptoms, and Treatment Options

Written by Kevin Asp, CRT, RPSGT | Apr 9, 2025 8:24:04 PM

Have you been feeling exhausted despite getting what seems like a full night's sleep? Do you wake up with headaches or experience daytime drowsiness that interferes with your daily activities? If so, you might be one of the estimated 25 million Americans suffering from obstructive sleep apnea (OSA), a potentially serious sleep disorder that remains undiagnosed in about 80% of cases.

What is Obstructive Sleep Apnea?

Obstructive sleep apnea occurs when the muscles in the back of your throat relax too much during sleep, causing your airway to narrow or close completely as you breathe in. When this happens, your brain senses the inability to breathe and briefly wakes you up to reopen your airway. These awakenings are typically so brief that you don't remember them, but they can disrupt your sleep cycle dozens or even hundreds of times each night.

Dr. Jennifer Marquez, a board-certified sleep specialist at the National Sleep Foundation, explains: "Think of your airway as a flexible tube. In people with OSA, this tube collapses during sleep, which is like pinching a straw while trying to drink through it. The body struggles to get air, oxygen levels drop, and the brain triggers a brief arousal to restore normal breathing."

Risk Factors for Developing OSA

Certain factors significantly increase your risk of developing sleep apnea:

  • Excess weight: Fat deposits around the upper airway can obstruct breathing. However, thin people develop OSA too.
  • Neck circumference: People with thicker necks may have narrower airways.
  • Age: OSA occurs significantly more often in adults over 50.
  • Gender: Men are 2-3 times more likely than women to have sleep apnea, though a woman's risk increases after menopause.
  • Family history: Having family members with sleep apnea increases your risk.
  • Anatomical features: Having a small jaw, large tonsils, or a deviated septum can contribute to airway obstruction.
  • Alcohol and sedative use: These substances relax the muscles in your throat.
  • Smoking: Smokers are three times more likely to have OSA than non-smokers.

 

 

Take Action Today

Don't let another night of poor sleep impact your health and quality of life. If you suspect you might have sleep apnea, take the first step toward diagnosis and treatment today.

Schedule a consultation with a sleep specialist or one of our partner clinics in San Antonio to discuss your symptoms and explore testing options. Remember that treating sleep apnea doesn't just improve your sleep—it can enhance your overall health, energy levels, and longevity.

 

 

Common Signs and Symptoms

Sleep apnea symptoms often develop gradually and can be difficult to identify. Many people don't recognize they have a problem until a bed partner points out their loud snoring or breathing interruptions during sleep.

Nighttime Symptoms

  • Loud, chronic snoring: While not everyone who snores has sleep apnea, most people with sleep apnea snore loudly and regularly.
  • Witnessed breathing pauses: Bed partners often report seeing the person stop breathing, followed by a gasp or choking sound.
  • Abrupt awakenings accompanied by shortness of breath: This occurs when your brain briefly wakes you up to restart breathing.
  • Dry mouth or sore throat upon waking: Breathing through your mouth all night due to obstructed nasal passages can cause this.
  • Insomnia or difficulty staying asleep: Frequent disruptions make it hard to maintain deep, restorative sleep.
  • Night sweats: Your body's response to the stress of breathing difficulties.
  • Frequent nighttime urination (nocturia): When sleep apnea causes your body to release stress hormones, it can increase urine production.

Daytime Symptoms

  • Excessive daytime sleepiness (hypersomnia): This is often the most noticeable symptom, causing you to fall asleep at inappropriate times.
  • Morning headaches: These result from oxygen deprivation and carbon dioxide retention during sleep.
  • Difficulty concentrating and memory problems: Sleep fragmentation affects cognitive function.
  • Irritability, mood changes, or depression: Poor sleep quality affects emotional regulation.
  • Decreased libido: Sleep deprivation and hormonal changes can reduce sexual desire.
  • Increased blood pressure: Your body responds to low oxygen levels by increasing blood pressure.

The Hidden Dangers of Untreated OSA

Beyond the immediate symptoms, untreated sleep apnea can lead to serious health complications over time. Sleep apnea affects more than just your sleep quality—repeated drops in oxygen levels and added strain on the cardiovascular system can lead to serious long-term health issues.

The relationship between OSA and metabolic health is particularly significant. Many patients with OSA also have obesity, type 2 diabetes, or metabolic syndrome—conditions that can both contribute to and be worsened by sleep apnea, creating a challenging cycle that requires comprehensive treatment approaches.

Potential complications include:

  1. Cardiovascular problems: High blood pressure, heart attacks, stroke, and abnormal heartbeats (arrhythmias) are all linked to the sudden drops in blood oxygen levels that occur during apnea events.

  2. Type 2 diabetes: OSA is associated with insulin resistance and glucose intolerance, key factors in the development of diabetes.

  3. Metabolic syndrome: This cluster of conditions includes increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels.

  4. Liver problems: People with OSA are more likely to show abnormal liver function tests and signs of fatty liver disease.

  5. Complications with medications and surgery: OSA can make you more susceptible to complications from certain medications and general anesthesia.

  6. Increased risk of accidents: The chronic fatigue associated with sleep apnea significantly increases the risk of workplace and motor vehicle accidents.

Diagnosing OSA: What to Expect

If you suspect you have sleep apnea, the first step is to consult with your primary care physician, who may refer you to a sleep specialist.

Sleep Study (Polysomnography)

The gold standard for diagnosing sleep apnea is an overnight sleep study, or polysomnography. This test records:

  • Brain waves
  • Blood oxygen levels
  • Heart rate and breathing patterns
  • Eye and leg movements
  • Sleep stages

"A comprehensive sleep study provides us with a wealth of information," says Dr. Patricia Watkins, Director of the Regional Sleep Center. "We can determine not only if you have sleep apnea, but also its severity and what happens to your body during these breathing interruptions."

Home Sleep Apnea Testing (HSAT)

For some patients, a simplified home-based test may be an option. While not as comprehensive as a laboratory sleep study, these tests can be conducted in the comfort of your own bed and are often sufficient for diagnosing straightforward cases of moderate to severe OSA.

Treatment Options: Finding What Works for You

The good news is that effective treatments exist for OSA, and finding the right approach can dramatically improve your quality of life and long-term health.

Lifestyle Modifications

For mild cases or as a complement to other treatments, lifestyle changes can be effective:

  • Weight loss: Even a modest weight reduction can significantly improve symptoms. For many patients with obesity, weight loss of 10-15% can lead to meaningful improvements in OSA severity.
  • GLP-1 Medications for Weight Management: For patients with obesity and OSA, GLP-1 receptor agonists (such as semaglutide and tirzepatide) may offer significant benefits. These medications can facilitate substantial weight loss, which often leads to improvement in OSA symptoms.
  • Exercise: Regular physical activity can strengthen the muscles in your airways and improve sleep quality.
  • Positional therapy: For some people, sleep apnea occurs only when sleeping on their back. Training yourself to sleep on your side may help.
  • Avoiding alcohol and sedatives: These substances relax throat muscles and can worsen symptoms.
  • Treating nasal congestion: Using nasal decongestants or addressing allergies can improve airflow.
  • Smoking cessation: Smoking contributes to inflammation and fluid retention in the airway.

Continuous Positive Airway Pressure (CPAP)

CPAP therapy is the most common and effective treatment for moderate to severe OSA. The device delivers a constant stream of pressurized air through a mask, keeping your airway open during sleep.

"CPAP therapy has come a long way," notes Dr. Watkins. "Modern devices are quieter, more comfortable, and more user-friendly than ever before. Many patients report feeling like a different person after just a few nights of effective treatment."

While CPAP is highly effective, some patients struggle with mask discomfort, claustrophobia, or the inconvenience of traveling with the device. Working closely with your sleep specialist to address these challenges is essential for successful treatment.

Oral Appliances

For mild to moderate OSA, or for those who cannot tolerate CPAP, dental devices that reposition the lower jaw and tongue can be effective. These oral appliances, similar to sports mouthguards, are custom-fitted by dentists with specialized training in sleep medicine.

"Oral appliances can be an excellent option for the right patient," says Dr. Sarah Johnson, a dental sleep specialist. "They're portable, don't require electricity, and many patients find them more comfortable than CPAP masks."

Surgical Options

When conservative treatments fail or anatomical issues are clearly responsible for the obstruction, surgery may be considered:

  • Maxillomandibular advancement: Moving the jaw forward to enlarge the space behind the tongue and soft palate.
  • Hypoglossal nerve stimulation: A relatively new procedure involving an implanted device that stimulates the nerve controlling tongue movement to keep the airway open during sleep.
  • Nasal surgery: Correction of nasal obstruction due to polyps, deviated septum, or enlarged turbinates.

 

Emerging Treatments

Research continues to advance our understanding and treatment of sleep apnea:

  • Inspire Upper Airway Stimulation: This FDA-approved implantable device senses breathing patterns and stimulates airway muscles to maintain an open airway during sleep.
  • Combination therapies: Using reduced-pressure CPAP along with an oral appliance may help patients who cannot tolerate full CPAP pressure.
  • GLP-1 Receptor Agonists: Originally developed for type 2 diabetes and more recently for weight management, medications like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro) have shown promising indirect benefits for OSA patients.
  • Pharmacological approaches: Other medications targeting specific aspects of OSA are under investigation, though none are currently approved specifically for OSA treatment.

 

When to Seek Help

If you experience any of the following, consider consulting a healthcare professional:

  • Loud snoring disrupting your or your partner's sleep
  • Waking up gasping or choking
  • Daytime sleepiness affecting your daily activities
  • Morning headaches
  • Difficulty concentrating or remembering things
  • High blood pressure not responding well to medication

Remember that snoring, while common, is not normal—especially when accompanied by gasping or breathing pauses. Early diagnosis and treatment can prevent serious health complications and significantly improve your quality of life.

Conclusion

Obstructive sleep apnea is a common but serious condition that affects millions of Americans. Its impact extends far beyond disruptive snoring, potentially contributing to serious health problems when left untreated. Fortunately, effective diagnostic tools and treatment options are available.

If you recognize the signs and symptoms in yourself or a loved one, don't hesitate to seek medical advice. With proper diagnosis and treatment, the vast majority of people with OSA can enjoy restful sleep and improved overall health.

Local Resources

For residents of San Antonio and surrounding areas, the Sleep Centers of Texas offers comprehensive sleep disorder diagnosis and treatment. Their team of board-certified sleep specialists provides personalized care using state-of-the-art technology.

"At Sleep Centers of Texas, we understand that each patient's sleep apnea is unique," says Kevin Asp, CRT, RPSGT, Chief Operating Officer. "Our multidisciplinary approach ensures that patients receive individualized treatment plans that address their specific needs and concerns."

The center offers complete sleep evaluations, home sleep testing, CPAP therapy, oral appliance therapy, and follow-up care to ensure effective treatment.

Take Action Today

Don't let another night of poor sleep impact your health and quality of life. If you suspect you might have sleep apnea, take the first step toward diagnosis and treatment today.

Schedule a consultation with a sleep specialist to discuss your symptoms and explore testing options. Remember that treating sleep apnea doesn't just improve your sleep—it can enhance your overall health, energy levels, and longevity.

Contact Sleep Centers of Texas at (210) 520-8333 or visit their website at sleepcentersoftexas.com to learn more about their services and to schedule an appointment.

About the Author:

Kevin Asp, CRT, RPSGT, is a respected authority in sleep medicine with over 30 years of experience in the field. Throughout his distinguished career, he has successfully managed multiple sleep centers across Texas, Missouri, and Alaska, helping thousands of patients overcome sleep disorders. As a Certified Respiratory Therapist (CRT) and Registered Polysomnographic Technologist (RPSGT), Kevin combines clinical expertise with practical knowledge to provide comprehensive care for sleep apnea patients. His dedication to advancing sleep medicine education and treatment has made him a valued resource for both patients and healthcare professionals alike.

This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider for diagnosis and treatment of medical conditions.