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Obstructive sleep apnea or OSA is a sleeping problem that occurs because your airways are blocked or narrowed during sleep and you have pauses in breathing. Each pause in breathing is known as an apnea episode. It is a common phenomenon but is more severe and recurrent in patients with obstructive sleep apnea. Obstructive sleep apnea is different from central sleep apnea, in which the brain is sending out signals to stop the breathing process during sleep.

The basic cause of obstructive sleep apnea is the relaxation of muscles and tissue of the upper airway during sleep. All muscles relax in sleep and when the upper airway muscles relax, they can block the airway. If the throat is narrower due to obesity or genetics, there is a greater risk of OSA. The relaxation of the throat can happen for up to ten or more seconds, leading to a blockage in breathing. People who have OSA often snore when the tissues vibrate against one another and when air tries to pass through a partially blocked area.

Not everyone who snores suffers from sleep apnea. Getting sleep apnea depends on the shape of the palate, the size of the tonsils and adenoids, the size of the neck (16 inches or more in women and 17 inches or more in men), and having a large tongue or uvula in the back of the throat. If you sleep on your back, you have a higher than average risk of developing OSA.

The symptoms of obstructive sleep apnea are often noted by the person you sleep with and not by you because you are deeply sleeping at the time. Often, there is snoring shortly after falling asleep that increases in intensity. The person then stops breathing for ten seconds or more and then gasps, awakening slightly or rousing, breathing faster for a few minutes to catch up in oxygenation. The pattern repeats itself throughout the night.

When you have OSA, you often don't feel refreshed in the morning and may have daytime drowsiness or sleepiness. You may also be impatient, irritable or grumpy; you can be forgetful; you can fall asleep during the day at work or while watching television; you can feel tired while driving and you can have headaches that are difficult to treat. You can feel depressed or even hyperactive (especially in kids with the disease). Your legs can swell due to right heart failure in severe cases of OSA.

The doctor can do some tests to see if you have sleep apnea. A detailed history and an examination of the head and neck are performed. The doctor will ask about your sleep habits and activities. A sleep study is often done, which involves having you sleep hooked up to monitors that evaluate your breathing and snoring during sleep. Blood gases can be checked during sleep and an electrocardiogram and echocardiogram can look at the effectiveness of the OSA on the heart or to rule out other problems. Thyroid function studies are also done to make sure you aren't low in thyroid.

The treatment of obstructive sleep apnea can be as simple as avoiding sedatives or alcohol before going to bed, stopping the habit of sleeping on your back, and losing weight. Some people need continuous positive airway pressure or CPAP. This involves a device that continuously pushes air or oxygen through the airway in order to keep the airway open. CPAP is fairly easily tolerated and avoids the problem of a collapsed airway. In some patients, there is the need for dental devices to correct airway obstruction. Surgery is used in severe cases, including an uvulopalatopharyngoplasty that removes tissue at the back of the throat. More invasive surgeries might be necessary, including a tracheostomy to open a hole in the trachea and allow breathing during sleep. Surgery can be done in the nasal and sinus area. A tonsillectomy and adenoidectomy can be done in children but tends not to work in adults.

The prognosis of sleep apnea is good when treated. If not treated, a person can suffer from heart disease and low oxygen syndromes in OSA.

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