In this article: What Is the Classic Sign of OSA? What Are the Symptoms of OSA? What Is the Cycle of OSA? What Happens if OSA Is Not Treated? How Is OSA treated? Diagnosis and Treatment If You Are Already Receiving Therapy...

Each of us expects a good night's sleep, but for many people sleep is a problem. Approximately 18 million Americans suffer from a common, but often undiagnosed, sleep disorder known as obstructive sleep apnea (OSA).

Obstructive sleep apnea is a life-threatening and life-altering condition that causes a person to stop breathing repeatedly during sleep. This interrupted breathing pattern interferes with restful sleep and places a strain on the cardiovascular system. The lack of sleep affects daytime alertness and one's ability to function well throughout the day. Ultimately, OSA takes its toll on a person's quality of life.

The good news is that OSA is easily diagnosed, and effective treatment is available.

The classic sign of OSA is snoring interrupted by pauses in breathing.

A significant other or family members may often know that there is a problem before the person with OSA does. They witness the snoring, pauses in breathing or gasping for breath while the sufferer is sleeping.

With OSA, a sufferer falls asleep and begins snoring. The snoring is typically loud and occurs on most nights. Periodically there will be pauses in breathing -- apnea -- during sleep. The pauses in breathing can last 10 seconds or longer.

If you observe the OSA sufferer's chest area at this time, you can see that he or she is trying to breathe. However, the effort to breathe doesn't generate airflow because the airway is obstructed (obstructive apnea). At the end of the apnea, you can hear one of three sounds: a loud snore, gasping or choking. This is the sound of the airway opening and letting air into the lungs. The pauses in breathing can occur more than 20 times an hour.

Related article: Sleep Apnea and Nutrition

What Are the Symptoms of OSA?

There are some easy-to-identify signs and symptoms associated with OSA. Do you have any of them?

• Do you snore? Do you choke or gasp for breath while you sleep?
• Do you stop breathing during sleep?
• Do you feel tired after a usual night of sleep?
• Has your weight increased by 10 percent or greater in the last five years?
• Have you ever nodded off or fallen asleep while driving?

If you answered yes to two or more of these questions, you may suffer from OSA.

Additional symptoms include morning headaches, difficulty concentrating, depression, irritability, memory loss and sexual dysfunction.

What Is the Cycle of OSA?

The cycle of obstructive sleep apnea starts with snoring. The airway collapses, or closes off. The person tries to breathe but is unable to get air into his or her lungs through the collapsed airway, and an apnea episode (cessation of breathing) occurs. The brain realizes that it is not getting enough oxygen and fresh air and wakes the person from a deep level of sleep to a lighter level. The airway opens and normal breathing occurs. The person falls back into a deeper sleep, begins snoring again and the cycle repeats.

Sleep is disrupted each time an apnea and change in the level of sleep occur. This may happen many times during the night; often more than 20 times an hour. People with OSA never feel rested because they don' t have normal sleep. The low oxygen levels, and the effort required to breathe during the night, put a strain on the cardiovascular system.

How Many People Suffer From OSA? 18 million people in the U.S. suffer from OSA. 4 out of 100 men 30 to 60 years of age. 2 out of 100 women 30 to 60 years of age. The majority of OSA sufferers remain undiagnosed and untreated.

What Happens if OSA Is Not Treated?

Continuous positive airway pressure (CPAP) is the most common and effective treatment for OSA. CPAP provides airflow to the patient via a nasal mask.

The airflow holds, or "splints," the airway open so air flows freely to the lungs. With CPAP therapy:

• Breathing becomes regular and snoring stops.
• Oxygen level in the blood becomes normal.
• Restful sleep is restored.
• Quality of life is improved.
• Risk for high blood pressure, heart disease, heart attack, stroke, and vehicular or work-related accidents is reduced.

Thousands of people with OSA are using CPAP therapy and experiencing relief of signs and symptoms.

Less common treatments include surgery and oral appliances. These treatments may be effective in certain individuals.

All treatments should include lifestyle modifications such as weight loss, if needed, and exercise, sufficient hours of sleep and avoidance of alcohol, sedatives, hypnotic drugs and tobacco.

If you suspect you have obstructive sleep apnea, seek medical advice. Tell your primary care physician about your symptoms and why you are concerned. If your doctor suspects OSA, he or she may perform a physical exam, and ask you questions about your sleep patterns and daytime activities. Your doctor may also order a sleep study.

The sleep study may be done as an outpatient test in the hospital (the person stays in the hospital sleep lab for only as long as the study takes), in an outpatient setting such as a clinic or under certain circumstances in the home. The results of the study will give your physician the information needed to determine whether you have OSA.

You may be asked to fill out a lengthy questionnaire before your sleep study. The doctor who evaluates your sleep study needs to know what medications you are taking, your medical history, regular sleep habits and details about what kinds of medical and sleep-related problems you may be experiencing. Tell the doctor about any medications, tobacco products, alcohol and caffeine products you use because they may affect your sleep.

To answer some of the questions about your sleep habits, you may need help from a spouse or family member, because some incidents occur while you are asleep. Examples of typical questions are: "Do you snore?" "Do you kick your legs while sleeping?"

Various sensors and monitoring devices are applied to you to evaluate your sleep and breathing during the night. There may be a set of electrodes (wires with small metal cups) attached to your head. They are similar to the patches used for EKGs and show the brain-wave patterns that tell the doctor what stage of sleep you are in during the night. These electrodes record only small electrical signals. They cannot read dreams or thoughts and do not deliver shocks.

Additional electrodes may be taped to a muscle group right below your knees to detect any leg movements and twitches. Belts or electrodes will be placed on or around your chest and abdomen to measure your breathing. A soft wire will be taped between your nose and upper lip to measure airflow as you breathe. A sensor will be taped to one of your fingertips to monitor the oxygen level in your blood. The sleep lab conducting your study may use all of the sensors described or just a few. These sensors do not use needles and are painless.

If this process sounds uncomfortable, in reality it is not. The purpose of a sleep study is to get you to sleep as normally as possible so that accurate results can be obtained. In most cases, people fall asleep in the same amount of time they normally do, and usually sleep for the entire night.

You may be asked to wear a mask, which delivers air pressure to your airway to hold it open, over your nose for part of the sleep study or to return and try the mask on another night. Information that is recorded while you wear the mask will help the physician determine the best therapy for you and whether you will benefit from therapy.

The next morning, the sensors and electrodes are removed. The study is analyzed and a report is generated. A doctor will review your report to determine if you have OSA, and if you need to be evaluated to determine if you would benefit from therapy (if this has not already been done). Before leaving the sleep lab, you will be informed of the follow-up process and of who will discuss your test results with you.

Thousands of people with OSA are using CPAP. They are experiencing relief of signs and symptoms and are leading more active and productive lives.

To receive the maximum benefit from your prescribed CPAP therapy, you should carefully follow your physician's instructions. Typically he or she will tell you to use your CPAP equipment every time you go to sleep for as long as you sleep.

You will frequently be asked by healthcare professionals how many hours per night you use your CPAP and if you are experiencing any side effects or any of the signs and symptoms you had before you were diagnosed with OSA. This information is used to determine your overall compliance with therapy. If your compliance does not meet your physician's expectations, he or she will want to know if that is caused by difficulties tolerating the therapy or whether you do not feel any difference in your overall health by using CPAP. Your physician and your Apria healthcare professional can work with you to address either circumstance and help you improve your compliance.

Intolerance of the mask is often the reason people underutilize or abandon therapy. Therefore, it is vitally important to find a mask that fits properly and is comfortable to wear. You must maintain the mask and replace it when clinically necessary to ensure fit, comfort, and optimal compliance with therapy.