I still remember opening my eyes and seeing my wife’ concerned look. After a long day, I had fallen asleep on the living room couch.

All the way in the kitchen, she heard some snoring and then choking and gasping sounds. When she checked on me, nothing—I had apparently stopped breathing for several seconds. It was time to confirm what we had long suspected: I had sleep apnea.

Prevalence 

After researching the topic and talking to a specialist, I learned that I wasn’t alone in my diagnosis. An estimated six million Americans have been diagnosed with obstructive sleep apnea (OSA), the most common type, and another twenty-four million are thought to be undiagnosed. (Another form, central sleep apnea, happens when the brain fails to signal the body to keep breathing during sleep; it’s far less prevalent, affecting less than 1 percent of adults.)

To get diagnosed, you have to do an overnight sleep study, preferably in the controlled conditions of a sleep lab. There you are hooked up to a polysomnography machine to determine your apnea-hypopnea index (AHI), which measures how many times per hour your airway is partially or completely blocked, known an as apnea, during sleep. There are three classifications of severity: an average of 5–14 events per hour is deemed mild, 15–30 moderate, and over 30 severe. For context, my AHI was 33—meaning that if I slept seven hours on a given night, my breathing was hampered or stopped altogether over two hundred times.

Causes

For those with OSA, apneas occur because the muscles in the back of the throat, when relaxed during slumber, physically block the passageway. There are many factors that can increase your likelihood of getting this condition, including genetics, high blood pressure, type 2 diabetes, smoking, obesity, alcohol use, and even nasal issues. Additionally, depending on age, men are two to four times more likely to experience OSA than women, though it does become a greater risk for both as they get older.

Effects

As you can imagine for a disorder that can literally stop your breathing, the impact ranges from mild to life-threatening depending on the severity. On a small scale, for instance, OSA sufferers may often seem irritable or tired and can experience frequent headaches (especially in the morning), concentration lapses, and dry mouth.

Medically, it can lead to serious long-term conditions. Of first concern is that OSA is linked to high blood pressure and cardiovascular disease, including heart failure and stroke. Just as bad is how it affects the brain. Consistent oxygen deprivation can result in cognitive challenges, memory loss, and, in some cases, brain damage. Other possible outcomes can include increased insulin resistance, weakened immunity, and even liver problems. Certainly the most immediate danger of all, though, is the most obvious: OSA increases the likelihood of nodding off behind the wheel or losing your concentration on the job, potentially putting both yourself and others in harm’s way.

Solutions

The primary way of combating this condition is by utilizing a PAP (positive airway pressure) device. As the name indicates, it works by forcing air via a mask into the back of the throat to keep it open overnight. The most frequently used and recognized type is a CPAP machine, but there are many options out there based on specific needs. A nice convenience of several is that they also measure both the amount of sleep you get and your AHI each night; some, called APAPs, even automatically tweak airflow based on the pattern of your breathing.

PAP devices don’t work for everybody, however. If that’s the case for you, another sleep apnea answer may come from your dentist. Specially made oral appliances can adjust your jaw or tongue to prevent your airway from getting blocked, though they can be uncomfortable and even painful. Several types of surgery are available as well, including one in which an implanted sensor automatically stimulates your throat muscles’ nerves to prevent your airway from being blocked.

And, of course, it may help to make positive lifestyle changes, such as taking steps to prioritize sleep, eat healthier, and limit your smoking and drinking. Experts also recommend trying to sleep on your side to lessen the possibility of airway blockages. (See the next page for some bedtime tips.)

Sleep apnea is an often under-the-radar condition that impacts millions of people, usually without them realizing it. If you suspect that you or a loved one has an apnea issue, don’t delay seeing an expert about it. It’s a lifelong condition, so the sooner you begin addressing it and choose your preferred treatment method, the sooner you can rest easy— both literally and figuratively.