Sleep Apnea Symptoms

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Most Common Symptoms of Sleep Apnea

Sleep apnea is associated with a wide variety of symptoms, which can vary based on factors like the condition’s severity and the underlying cause of abnormal breathing. In general, there are two main types of sleep apnea:

• Obstructive sleep apnea (OSA) is the most common form of sleep apnea and occurs when the upper airway narrows or collapses during sleep.
• Central sleep apnea (CSA) is the less common type and happens when there’s an interruption in the signals from the brain that trigger breathing.

People with sleep apnea can be asymptomatic or not recognize their symptoms until told by a doctor, caregiver, or bed partner. When symptoms occur, they may include both nighttime signs of abnormal breathing and disruptions to daily living.

Snoring, Gasping, and Pauses in Breathing During Sleep

Snoring is one of the most recognizable symptoms of sleep apnea. This symptom occurs due to a narrowing or collapse of the upper airway. In OSA, this is due to a combination of an individual’s anatomy Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source and natural changes in the body that happen during sleep, which increase the risk of the tissues collapsing. The sound of snoring occurs when breathing causes these tissues to vibrate.

As many as 90% of people with OSA snore during sleep. Although snoring is a common symptom of OSA, not everyone who snores has sleep apnea. In fact, fewer than half of people who snore meet the criteria for obstructive sleep apnea. Snoring is less common in people with CSA.

As a person with sleep apnea is resting, a bed partner may notice brief lapses in their breathing that last from several seconds to minutes . This pause in respiration causes the sleeper to wake up Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source . As they awaken and resume breathing, they may sound as if they are gasping, snorting, or choking. People with CSA may also wake up with shortness of breath.

Daytime Sleepiness

Daytime sleepiness is frequently reported in people with both obstructive sleep apnea and central sleep apnea. Sleepiness may occur throughout the day or be more noticeable during monotonous activities such as watching TV or driving long distances.

Excessive daytime tiredness affects between 40% and 58% Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source of people with OSA, depending on the severity of their condition. It is also common for people with CSA to feel overly sleepy during the day. Unfortunately, this symptom is commonly overlooked, as daytime sleepiness increases gradually over time, people may mask their tiredness with activity or caffeine, or people may believe that their level of sleepiness is normal.

In people with sleep apnea, excessive daytime sleepiness Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source is believed to be caused by not getting enough sleep and repeatedly waking up to breathe. Experts suggest that repeated drops in the level of oxygen in the blood and co-existing health conditions may also contribute to daytime sleepiness in people with sleep apnea.

Morning Headaches

Headaches after waking up are a frequently reported symptom in people with both obstructive and central sleep apnea. Around 10% to 30% of people with OSA experience headaches, which may last for several hours each morning.

Headaches may feel like both sides of the forehead are being squeezed. Unlike other types of headaches though, morning headaches related to sleep apnea do not usually involve nausea or sensitivity to light or noise.

Researchers are still uncovering the exact cause of morning headaches. Waking up with a headache may be related to the effects of interrupted sleep, pressure building in the skull, or cardiovascular changes caused by breathing disruptions.

Dry Mouth and Sore Throat

People with sleep apnea may also wake up with a dry mouth or throat. Although estimates vary, one-third or more of people Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source with OSA experience symptoms like oral dryness Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source , burning in the mouth, sore throat, difficulty swallowing, or changes in taste.

Dry mouth can be caused by snoring or breathing with an open mouth Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source during sleep. Dry mouth may be an important sign of OSA, as research has found that the severity of morning dry mouth may be linked to the severity of a person’s nighttime breathing disruptions.

Cognitive and Mood Changes

Sleep apnea can affect a person’s mental health. People with sleep apnea may notice changes in their memory as well as their ability to concentrate and maintain attention. Sleep apnea is also associated with mood changes like increased impatience and irritability. People with sleep apnea may also be at an increased risk Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source of certain mental health conditions like depressive disorders, anxiety disorders, and post-traumatic stress disorder.

Although the connection between sleep apnea and mood is not fully understood, cognitive and mood changes may be a side effect of poor quality sleep. Other factors that may contribute to mood changes Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source in sleep apnea include reduced oxygen in the blood, inflammation, and alterations in brain chemicals.

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Other Symptoms of Sleep Apnea

Other symptoms may be caused by complications of sleep apnea or underlying medical conditions that contribute to nighttime breathing disruptions. Other signs or symptoms of sleep apnea include:

• Frequent awakenings and insomnia: Many people with sleep apnea wake repeatedly throughout the night without realizing it. These interruptions can lead to restless sleep, difficulty staying asleep, and feeling unrefreshed in the morning.
• Nighttime urination: Sleep apnea can increase nighttime urine production due to changes in oxygen levels and pressure in the chest during breathing disruptions. Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source As a result, many people wake up multiple times per night to use the bathroom. Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source
• Loss of sex drive and sexual dysfunction: Interrupted sleep and reduced oxygen levels may affect hormones, circulation, and overall energy levels, which can contribute to decreased libido and sexual performance issues in both men and women. Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source
• Nighttime chest pain: Reduced oxygen levels and strain on the cardiovascular system during sleep may cause chest discomfort or pain in some people with sleep apnea.
• Heart palpitations: Sleep apnea can place stress on the heart and may contribute to sensations of a racing, pounding, or irregular heartbeat, especially during the night.
• Shortness of breath during physical activity: Poor sleep quality and reduced oxygen levels may make physical exertion feel more difficult and leave some people feeling winded more easily.
• Breathlessness when lying down: Some people with sleep apnea feel short of breath when lying flat, particularly if they also have underlying heart or lung conditions.

Sleep Apnea Symptoms in Women

Sleep apnea symptoms in women and those assigned female a birth can sometimes look different than the “classic” signs commonly associated with the condition. Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source While loud snoring and gasping during sleep can occur, women are often more likely to report symptoms like fatigue, insomnia, morning headaches, anxiety, depression, mood changes, and difficulty concentrating. Some women may also experience restless sleep or wake up frequently during the night without realizing that breathing disruptions are the cause.

Because these symptoms can overlap with conditions like stress, menopause, anxiety, or insomnia, sleep apnea in women is sometimes overlooked or misdiagnosed. Hormonal changes related to pregnancy, perimenopause, and menopause may also increase the risk of developing sleep apnea. Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source Recognizing these less obvious symptoms can help women seek evaluation and treatment earlier.

Symptoms of Sleep Apnea in Children

Sleep apnea can also affect infants and children and may cause unique symptoms in this age group. Although sleep apnea is less common in younger people, experts estimate that from 1% to 5% of children Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source have obstructive sleep apnea and even fewer have central sleep apnea.

Many symptoms of sleep apnea in children are similar to the symptoms seen in adults, such as snoring or gasping, restless sleep, and visible changes in breathing patterns. Children may also experience daytime sleepiness, morning headaches, and changes in mood.

Given that young children may be limited in their ability to describe their symptoms, some symptoms of sleep apnea may appear differently in children. Caregivers may find it helpful to watch out for symptoms of abnormal nighttime breathing such as:

• Sweating at night
• Sleepwalking
• Night terrors
• Falling asleep at school
• Difficulty paying attention
• Bedwetting
• Overactivity
• Rebellious, aggressive, or impulsive behavior
• Worsening asthma

Obstructive Sleep Apnea vs. Central Sleep Apnea Symptoms

Although obstructive sleep apnea and central sleep apnea are different medical conditions, both are characterized by abnormal nighttime breathing that can interrupt sleep and affect oxygen levels in the blood. Doctors cannot tell the difference between these sleep-related breathing disorders based on a person’s symptoms alone.

Because the symptoms of these conditions are similar, doctors use the results of a sleep study to differentiate between obstructive and central sleep apnea Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source . Also called polysomnography, a sleep study takes various measurements while a person sleeps through the night in a specialized sleep laboratory.

To distinguish between obstructive and central sleep apneas, doctors consider several factors including measurements that assess whether a person is attempting to breathe during a period of reduced or paused respiration.

If tests show that a person is trying to breathe against a closed or obstructed airway, they may be diagnosed with OSA . Conversely, if tests show that they stop trying two breathe during periods of disrupted breathing, they may be diagnosed with CSA. Because many people experience aspects of both obstructive and central sleep apnea, a doctor will consider whether most breathing disruptions are obstructive or central in origin.

When to Talk to Your Doctor

If you experience persistent daytime sleepiness or other symptoms of sleep apnea, it is important to contact your doctor or a sleep specialist. While untreated sleep apnea can contribute to a myriad of complications, sleep apnea treatment may reduce symptoms and improve your sleep.

Several tips may help you figure out the cause of your symptoms and get the most out of working with your doctor.

• Keep a sleep diary: Keeping a daily record can help your doctor get the clearest picture of your symptoms. A sleep diary should include information about your sleep habits as well as both nighttime and daytime symptoms.
• Assess caffeine use: Some people use coffee or energy drinks to cover up daytime sleepiness caused by nighttime breathing disruptions. Be sure to tell your doctor if you find yourself drinking excessive caffeine or using caffeine to prevent yourself from falling asleep during daytime activities.
• Ask your bed partner: Because many of the symptoms of sleep apnea occur during sleep, people who share your room or otherwise see you sleep are important sources of information. If you are concerned about sleep apnea, ask bed partners, caregivers, and loved ones about your nighttime breathing.

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