Obstructive sleep apnea (OSA) — recurrent partial or complete collapse of the upper airway during sleep, causing breathing pauses and arousal from sleep — is estimated to affect 26% of adults aged 30–70, with the majority undiagnosed. The consequences of untreated OSA extend far beyond fatigue: it contributes significantly to hypertension, cardiovascular disease, Type 2 diabetes, stroke, and cognitive impairment. Medical and sleep clinics provide the diagnosis and treatment that transforms the health and quality of life of sleep apnea patients.
Recognition and Screening
Screening tools like the STOP-BANG questionnaire (Snoring, Tired, Observed apnea, Pressure/hypertension, BMI, Age, Neck circumference, Gender) identify patients at high risk for OSA in primary care clinics. Bed partner reports of snoring, observed breathing pauses, and gasping are clinically important. Not all OSA patients are overweight — OSA affects lean patients too, particularly those with anatomical airway narrowing.
Diagnostic Testing
Home sleep apnea testing (HSAT) — a simplified monitoring device worn overnight at home — measures airflow, oxygen saturation, respiratory effort, and body position to diagnose OSA without laboratory-based polysomnography. HSAT is appropriate for patients with high pre-test probability of uncomplicated OSA. In-laboratory polysomnography provides more comprehensive assessment for patients with complex presentations, suspected central sleep apnea, or inconclusive HSAT results.
CPAP: First-Line Treatment
Continuous positive airway pressure (CPAP) — a device delivering pressurized air through a mask to keep the airway open during sleep — is the gold standard treatment for moderate-severe OSA. Modern CPAP machines are compact, quiet, data-recording devices that transmit adherence and efficacy data to your clinic for remote monitoring. Proper mask fit is critical — sleep clinics spend significant time on mask fitting and troubleshooting to optimize CPAP adherence.
Conclusion
Sleep apnea is common, diagnosable, and highly treatable — yet the majority of affected adults remain undiagnosed. If you snore loudly, wake unrefreshed, experience excessive daytime sleepiness, have been told you stop breathing during sleep, or have treatment-resistant hypertension or Type 2 diabetes, discuss sleep apnea evaluation with your clinic. Effective treatment typically produces dramatic improvements in energy, mood, cognitive function, and long-term cardiovascular health.
FAQs – Sleep Apnea
Q1. Can sleep apnea be cured without CPAP?
A: For mild OSA, weight loss (if applicable), positional therapy (avoiding supine sleep), and oral appliances provide effective alternatives. Surgical procedures address specific anatomical contributors. For moderate-severe OSA, CPAP remains the most effective treatment for most patients.
Q2. Does everyone with sleep apnea snore?
A: Most OSA patients snore, but not all snorers have OSA, and some OSA patients (particularly those with predominantly central sleep apnea) may not snore audibly. Snoring alone does not confirm or exclude sleep apnea — testing is required.
Q3. Can children have sleep apnea?
A: Yes. Pediatric OSA often presents differently than adult OSA (nighttime mouth breathing, bedwetting, behavioral problems, growth issues, learning difficulties). Enlarged tonsils and adenoids are the most common cause in children; adenotonsillectomy is the primary treatment.
Q4. How quickly does CPAP work?
A: Many patients notice improved energy, daytime alertness, and reduced morning headaches within days to weeks of starting CPAP. Full cardiovascular and metabolic benefits accumulate over months of consistent use.
Q5. What if I cannot tolerate CPAP?
A: CPAP intolerance is common initially but often resolved through mask adjustment, pressure optimization, heated humidification, and gradual acclimatization protocols. If CPAP truly fails, oral appliance therapy, positional therapy, or surgical evaluation are alternatives your sleep specialist can discuss.
