Introduction
Sleep apnea is a common and serious sleep disorder in which breathing repeatedly stops and starts during sleep, disrupting sleep quality and reducing oxygen delivery to the brain and body. The most prevalent form, obstructive sleep apnea (OSA), occurs when throat muscles relax and block the airway. Untreated sleep apnea is associated with significant health risks including cardiovascular disease, metabolic disorders, and worsening of mental health conditions such as depression, anxiety, and ADHD.
Causes
Obstructive sleep apnea is caused by physical factors that narrow or collapse the upper airway during sleep, including excess weight (particularly around the neck), enlarged tonsils or adenoids, anatomical features such as a recessed jaw, and loss of muscle tone during deep sleep. Risk factors include obesity, male sex, older age, family history, alcohol use, and smoking. Central sleep apnea, a less common form, results from the brain failing to send proper signals to breathing muscles.
Symptoms
Common symptoms include loud snoring, gasping or choking during sleep (often reported by a bed partner), abrupt awakenings, morning headaches, dry mouth, excessive daytime sleepiness, difficulty concentrating, irritability, and mood disturbances. Many people with sleep apnea are unaware of nighttime breathing disruptions and present primarily with daytime fatigue, cognitive problems, or mood symptoms that may initially suggest a psychiatric cause.
Diagnosis
Diagnosis typically involves an overnight sleep study, either in a sleep laboratory (polysomnography) or at home using a portable monitoring device. The severity of sleep apnea is measured by the Apnea-Hypopnea Index (AHI), which counts the number of breathing disruptions per hour of sleep. A primary care physician or sleep specialist typically coordinates the evaluation, though referral from a mental health provider is common when sleep apnea is suspected as a contributor to psychiatric symptoms.
Treatment
Continuous positive airway pressure (CPAP) therapy is the most effective and widely used treatment for moderate to severe OSA, delivering a steady stream of air to keep the airway open during sleep. Alternatives include oral appliances that reposition the jaw, positional therapy, weight loss, and in some cases surgical interventions. Treatment of sleep apnea often results in significant improvements in mood, cognition, energy, and quality of life, and may reduce the severity of co-occurring psychiatric conditions.
This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.