Overview

Diagnosis

Sleep apnea is usually diagnosed through a combination of medical history, symptom review, and specialized testing. Your healthcare professional may ask about your sleep patterns and gather information from someone who shares your bed or household.

Most people are referred to a sleep center, where a sleep specialist can recommend further evaluation.

Tests to detect sleep apnea include:

  • Sleep study (polysomnography): Monitors breathing patterns, heart, lung, and brain activity, arm and leg movements, and blood oxygen levels while you sleep.

  • Home sleep tests: Simplified devices that measure heart rate, airflow, breathing patterns, and blood oxygen. Home tests may sometimes miss sleep apnea, so in-lab studies might still be needed.

For obstructive sleep apnea (OSA), additional evaluations may include seeing an ear, nose, and throat specialist. Cardiologists or neurologists may be consulted to assess central sleep apnea (CSA) causes.

Treatment

Treatment depends on the type and severity of sleep apnea, and may include lifestyle changes, devices, medications, and sometimes surgery.

Lifestyle changes

  • Weight loss, quitting smoking, or adjusting sleep position

  • Treating nasal allergies if present

Therapies for OSA

  • Continuous positive airway pressure (CPAP): Delivers air pressure through a mask to keep airways open. Different mask types may be tried for comfort and fit.

  • Other airway pressure devices: Auto-CPAP or bilevel positive airway pressure (BPAP) adjusts pressure automatically during sleep.

  • Oral appliances: Devices that move the jaw forward to keep the airway open, suitable for mild OSA or if CPAP is not tolerated.

  • Myofunctional therapy: Exercises to strengthen upper airway muscles.

Medications

  • Tirzepatide: FDA-approved weight loss injection for people with obesity and OSA, which can reduce pauses in breathing and improve oxygen levels.

Surgery for OSA
Surgical options are considered when other treatments are ineffective or not tolerated:

  • Tissue removal (uvulopalatopharyngoplasty): Removes tissue at the back of the throat and may include tonsils and adenoids

  • Radiofrequency ablation: Removes throat tissue with energy

  • Jaw repositioning (maxillomandibular advancement): Moves the jaw forward to enlarge the airway

  • Nerve stimulation: Implanted device stimulates the hypoglossal nerve to keep the airway open

  • Tracheostomy: Creates a new airway in the neck for severe, life-threatening sleep apnea

  • Weight-loss surgery: Can help reduce OSA in people with obesity

Therapies for CSA

  • Treat underlying medical conditions like heart or neuromuscular disorders

  • PAP devices such as CPAP, BPAP, or adaptive servo-ventilation (ASV)

  • Supplemental oxygen during sleep

  • Adjusting or changing medications that may worsen CSA

  • Transvenous phrenic nerve stimulation to help trigger breathing

Proper mask fitting is critical for effectiveness and comfort. CPAP masks come in different styles and sizes, and multiple fittings may be necessary to find the best option.

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