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Obstructive sleep apnea (OSA) is a sleep disorder in which the soft tissues at the back of the throat repeatedly relax and collapse during sleep, partially or completely blocking the upper airway. Each blockage briefly interrupts breathing (an apnea) or reduces airflow (a hypopnea), causing oxygen levels to dip and the brain to rouse the body enough to reopen the airway. These events can recur many times an hour, fragmenting sleep without the person fully waking.
OSA is the most common type of sleep apnea. It differs from central sleep apnea, in which the brain fails to send proper signals to the breathing muscles. OSA is highly prevalent: a 2025 analysis published in *Respiratory Medicine* estimated that roughly 83.7 million U.S. adults — about 32% of the adult population — were living with OSA in 2024, though the large majority of cases remain undiagnosed.
Doctors grade severity using the apnea-hypopnea index (AHI), the average number of apnea and hypopnea events per hour of sleep:
OSA occurs when anatomical and physiological factors make the upper airway prone to collapse during sleep. Key risk factors identified by the National Heart, Lung, and Blood Institute (NHLBI) and other authorities include:
OSA symptoms occur both at night and during the day. Because the person is asleep, a bed partner often notices the nighttime signs first. Common symptoms include:
Not everyone with OSA snores, and not all snorers have OSA. Persistent daytime sleepiness warrants medical evaluation.
A diagnosis of OSA requires an objective sleep study, not symptoms alone. The American Academy of Sleep Medicine (AASM) recognizes two validated approaches:
AASM guidance recommends in-lab polysomnography rather than home testing for people with significant cardiorespiratory disease, neuromuscular weakness, suspected hypoventilation, chronic opioid use, a history of stroke, or severe insomnia. A clinician evaluates the results alongside symptoms to confirm the diagnosis and severity.
Treatment goals are to keep the airway open, restore restful sleep, and reduce long-term health risks. AASM-recognized, evidence-based options include:
Lifestyle steps support medical treatment but rarely replace it for moderate-to-severe disease:
See a doctor if you have loud habitual snoring, witnessed pauses in breathing, gasping or choking during sleep, or persistent daytime sleepiness — especially alongside high blood pressure, heart disease, or diabetes. Untreated OSA is associated with hypertension, heart attack, atrial fibrillation, stroke, heart failure, and type 2 diabetes, and daytime drowsiness raises the risk of motor-vehicle and workplace accidents. Seek emergency care for sudden chest pain, severe shortness of breath, or symptoms of stroke.
*This article is for informational and educational purposes only and is not a substitute for professional medical advice. Talk with a qualified clinician about diagnosis and treatment.*
CPAP (continuous positive airway pressure) is the first-line, evidence-based therapy for moderate-to-severe OSA. Other FDA-cleared/approved options include custom oral appliances (mandibular advancement devices) for mild-to-moderate disease or CPAP intolerance, and hypoglossal nerve stimulation (Inspire), first FDA-approved in 2014, for select adults who cannot tolerate CPAP; a 2017 expansion broadened the eligible AHI range to 15 to 65. In December 2024 the FDA approved tirzepatide (Zepbound) as the first prescription medication for moderate-to-severe OSA in adults with obesity, used alongside a reduced-calorie diet and increased physical activity; in the SURMOUNT-OSA trials it reduced breathing events by about 25 to 29 per hour, with roughly 43% and 51.5% of participants meeting disease-resolution criteria at the highest dose. Treatment choice should be individualized with a qualified clinician; this is informational only and not medical advice.
This page is for general information and is not medical advice. Always consult a qualified clinician about diagnosis and treatment. Individual results vary.