Obstructive Sleep Apnea: Symptoms, Diagnosis and Treatment

Obstructive sleep apnea (OSA) occurs when the upper airway repeatedly narrows or closes during sleep, reducing or stopping airflow. It is more than a noise problem. Assessment and treatment aim to improve breathing during sleep and address the condition’s effects on health and daily life.

What symptoms may suggest OSA?

Signs include witnessed breathing pauses, gasping or choking during sleep and loud snoring. Daytime sleepiness, difficulty concentrating and morning headaches may also occur. Symptoms vary, and snoring alone does not establish the diagnosis.

If you recognise concerning symptoms, arrange a medical assessment. Bring notes about your sleep and medicines, and any observations your partner wishes to share. Avoid relying on a self-test to decide that the problem is harmless.

Why does the airway become obstructed?

Several factors can contribute, including airway anatomy, enlarged tonsils, excess weight, age and family history. A clinician considers the whole picture. People without obesity can also have OSA; a weight-management plan should not delay assessment.

How is OSA diagnosed?

A comprehensive sleep evaluation and appropriate testing are used to investigate suspected OSA. Depending on the person and clinical circumstances, testing may take place at home or in a sleep laboratory. A phone recording or questionnaire alone is not a substitute.

Ask what your test measured, what the findings mean and whether further testing is needed if symptoms remain unexplained. Keep a copy of the report and the follow-up plan.

Which treatments may be discussed?

• Positive airway pressure: CPAP provides air pressure through a mask to help keep the airway open. Other PAP modes are selected according to clinical need.
• Oral appliances: a custom-fitted device may be appropriate for some people, including those who cannot tolerate CPAP. Dental fitting and follow-up matter.
• Relevant lifestyle measures: weight management, activity, smoking cessation, alcohol reduction or positional advice may form part of the plan.
• Other selected treatments: a specialist may consider surgery, hypoglossal nerve stimulation or other options. Prescription weight-management treatment is relevant for some patients with obesity; availability and eligibility depend on local approvals and individual assessment.

These options are not interchangeable. Ask why a particular approach is recommended and how its effectiveness will be checked. Do not stop prescribed medicines or alter device settings yourself.

Make follow-up part of treatment

If a mask or appliance is uncomfortable, report the problem and ask for support. Write down when discomfort happens, what equipment you use and any instructions you have already tried. That gives the team a clearer starting point than simply saying the treatment does not work.

Useful follow-up questions include:

• What improvement should we assess, and when?
• Who should I contact about fit, side effects or equipment?
• Will repeat testing be needed?
• What should I do if daytime sleepiness continues?

Our planning checklist can help organise these questions. It does not replace the plan agreed with your sleep team.

Asonor is not a sleep-apnea treatment

Asonor is intended to reduce snoring through local lubrication and hydration of the throat’s mucous membranes. It does not treat OSA and must not replace prescribed sleep-apnea care. A reduction in snoring is not proof that airway obstruction is controlled.

For Asonor product information, consult the current instructions for use. For suspected or diagnosed OSA, seek assessment and follow-up from a healthcare professional.

Sources

• NHS: sleep apnea
• NHLBI: causes and risk factors
• AASM: diagnostic testing guideline for adult OSA
• NHLBI: sleep apnea treatment