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What are the symptoms of obstructive sleep apnea (OSA)?

Common symptoms of obstructive sleep apnea (OSA) include snoring and gasping or choking sounds during sleep. Like snoring, sleep apnea is more common in men, but it can occur in women too, especially during and after menopause. Having excess body weight, a narrow airway or misaligned jaw all increase the risk of sleep apnea.

This content originally appeared on the American Academy of Dental Sleep Medicine (AADSM) website.
Many people with obstructive sleep apnea (OSA) do not remember waking up to disruptions in airflow, which can occur hundreds of times every night. In fact, OSA is often first recognized by a sleep partner or roommate, who notices heavy snoring or labored breathing in an attempt to restore normal breathing. Often, people with sleep apnea do not consult their healthcare providers until their significant other complains or expresses concerns about loud snoring that is interrupted by periods of silence followed by gasps for air. Although loud snoring is often considered the hallmark of OSA, not all snorers have OSA. People with OSA often experience excessive sleepiness (ES), which is characterized by an inability to stay awake, even in situations when you want and need to be.

If you have ES, you may feel as though you don't have the energy to complete tasks of daily living, despite getting enough sleep. So, if you or your partner feels unusually sleepy to the point it affects your tasks of daily living, talk with your healthcare provider right away.

Signs and symptoms of OSA include:
  • loud snoring with periods of not breathing (apnea)
  • abrupt awakenings accompanied by shortness of breath and/or choking sensation
  • excessive sleepiness during the day
  • morning headaches or sore/dry throat
  • restless sleep
  • feeling irritable
  • frequent urination at night
The most common symptoms of obstructive sleep apnea (OSA) are loud snoring and daytime drowsiness or fatigue -- but not everyone with OSA has these symptoms. Often a person's bed partner first notices that there might be a problem, based on hearing the person snore or even stop breathing during sleep. In addition to these symptoms, several other factors are commonly associated with OSA and may increase the likelihood of your having, or developing, the syndrome.
Snoring is a key symptom of sleep apnea. Other symptoms of sleep apnea include:
  • waking feeling tired and unrefreshed
  • excessive sleepiness during the day
  • morning headaches
  • difficulty with concentration, memory and focus
  • moodiness
  • chronic congestion
  • someone observes your disrupted breathing
Phil Westbrook
Sleep Medicine

The major symptom of obstructive sleep apnea (OSA) is daytime sleepiness, and when that is a consequence of OSA the diagnosis is the Obstructive Sleep Apnea Syndrome. When you have OSA you have repeated brief arousals from sleep so that you can breathe adequately, and this fragmentation of sleep can decrease your ability to stay alert in the daytime (or night time if you work nights). The fact that OSA can cause frequent episodes of low oxygen levels during sleep may also cause brain damage that contributes to the chronic sleepiness as well as difficulty with memory and impaired judgment. Inadequate sleep can cause irritability and mood changes such as depression. Morning headaches, morning confusion, frequent urination at night, and impotence have also been described as symptoms of OSA.

An observer of someone with OSA may notice two other cardinal features of the disorder. They are what appear to be gasping or choking during sleep, and habitual snoring, often very loud. A close observer may note that a bed-partner with severe OSA has brief periods of loud snoring interspersed with periods of silence when the chest and stomach are heaving, indicating the struggle to get air past an obstructed airway. The struggle ends with a loud gasp, a few loud breaths, and then another period of silence as sleep returns and the airway closes.

A person who is a loud snorer and has daytime sleepiness has the Obstructive Sleep Apnea Syndrome until proven otherwise.

Obstructive sleep apnea can have different symptoms. The most common symptom is disruptive snoring. Your breath might be shallow, or it might stop entirely for ten seconds or more as you sleep. You might snore loudly, snort, or gasp while you sleep. You may awaken abruptly with shortness of breath, or a sore throat. During the day, you may wake up with a headache. You may not feel well-rested, and you may have trouble concentrating.

The most common symptoms of sleep apnea in adults include the following:
- Long breath pauses or struggling to breathe during sleep
- Significant daytime sleepiness and unexpected dozing off while sitting or driving or doing anything monotonous
- Sensation of poor quality sleep, or never getting enough rest
- Frequent awakening
Other symptoms include restlessness or movement during sleep, choking or gagging during sleep, heartburn, increased urination during the night, sweating, morning headaches, poor concentration, poor memory, irritability and depression Many patients with sleep apnea are overweight, however patients can be normal weight and still have significant apnea.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.