If you constantly feel exhausted despite a full night in bed, you might wonder how to tell if you have sleep apnea. This common but serious sleep disorder involves repeated breathing interruptions during sleep, and knowing the signs is the first step toward better rest and health.
Many people with sleep apnea don’t realize they have it. The symptoms often happen while you’re unconscious, and daytime signs can be mistaken for stress or just being busy. This guide will walk you through the key symptoms, risk factors, and concrete steps you can take to get a proper answer.
How To Tell If You Have Sleep Apnea
Sleep apnea isn’t just loud snoring. It’s a condition where your breathing stops and starts repeatedly through the night. These pauses can last from a few seconds to over a minute and may happen hundreds of times. Your brain briefly wakes you up to restart breathing, fragmenting your sleep even if you don’t remember waking.
There are three main types:
- Obstructive Sleep Apnea (OSA): The most common form. It occurs when throat muscles relax too much, blocking the airway.
- Central Sleep Apnea (CSA): Happens when your brain doesn’t send the proper signals to the muscles that control breathing.
- Complex Sleep Apnea Syndrome: Also called treatment-emergent central sleep apnea, this is a combination of both obstructive and central sleep apnea.
We’ll focus primarily on OSA, as it affects the most people, but the process of identifying any type shares many similarities.
The Most Common Symptoms and Signs
The symptoms fall into two categories: those you might notice at night, and those that affect your daytime life. Often, a bed partner is the first to spot the nighttime signs.
Nighttime Symptoms (What a Partner Might See)
- Loud, Chronic Snoring: Especially snoring that is loud enough to disturb others. Not everyone who snores has apnea, but it’s a major red flag.
- Witnessed Breathing Pauses: This is a classic sign. Your partner may notice you stop breathing for a period, followed by a gasp, choke, or snort as you resume.
- Choking or Gasping Sounds: Sudden awakenings with a sensation of choking or gasping for air are your body’s emergency response to a lack of oxygen.
- Restless Sleep or Frequent Tossing and Turning: The constant micro-awakenings prevent deep, restful sleep, leading to a lot of movement.
- Frequent Trips to the Bathroom: Waking up to urinate multiple times a night (nocturia) can be linked to sleep apnea.
Daytime Symptoms (What You Might Feel)
- Excessive Daytime Sleepiness: This is more than just feeling tired. It’s an overwhelming urge to sleep during quiet moments, like while reading, watching TV, or, dangerously, while driving.
- Morning Headaches: Waking up with a dry mouth or a headache is common due to oxygen drops and poor sleep quality.
- Cognitive Issues: This includes trouble concentrating, memory problems, brain fog, and irritability. You might feel like you can’t focus at work.
- Mood Changes: Increased depression, anxiety, or quick temper can be linked to chronic sleep fragmentation.
- Dry Mouth or Sore Throat Upon Waking: Often caused by sleeping with your mouth open to breathe.
Key Risk Factors to Consider
While sleep apnea can affect anyone, including children, certain factors significantly increase your risk. If you have symptoms and one or more of these risk factors, it’s important to take the next step.
- Excess Weight: Obesity is a leading risk. Fat deposits around the upper airway can obstruct breathing.
- Neck Circumference: A thicker neck (over 17 inches for men, over 16 inches for women) may mean a narrower airway.
- Being Male: Men are 2-3 times more likely to have sleep apnea, though risk for women increases after menopause.
- Age: Sleep apnea occurs more frequently in older adults.
- Family History: Having family members with sleep apnea might increase your risk.
- Use of Alcohol, Sedatives, or Tranquilizers: These substances relax the muscles in your throat, which can worsen obstructive sleep apnea.
- Smoking: Smokers are three times more likely to have OSA. Smoking increases inflammation and fluid retention in the upper airway.
- Nasal Congestion: If you have difficulty breathing through your nose due to anatomy or allergies, you’re more likely to develop OSA.
- Medical Conditions: Congestive heart failure, high blood pressure, type 2 diabetes, and PCOS are all associated with a higher risk.
A Step-by-Step Self-Assessment Guide
If the lists above sound familiar, here’s a structured approach to assess your situation before seeing a doctor.
Step 1: Track Your Symptoms for One Week
Keep a sleep and symptom diary. Note down each morning and evening. Be honest with your entries.
- What time did you go to bed and wake up?
- How many times did you wake up (if you remember)?
- Did you snore, gasp, or choke? (Ask a partner, or use a voice-recording app).
- How did you feel upon waking? (Scale of 1-10 for tiredness, headache, dry mouth).
- How sleepy did you feel during the day? Note any unintended naps.
Step 2: Use a Validated Screening Tool
The STOP-BANG questionnaire is a common clinical tool. Answer yes or no:
- Snoring: Do you snore loudly (louder than talking or heard through a closed door)?
- Tired: Do you often feel tired, fatigued, or sleepy during the daytime?
- Observed: Has anyone observed you stop breathing during your sleep?
- Pressure: Do you have or are you being treated for high blood pressure?
- BMI: Is your BMI more than 35 kg/m²?
- Age: Are you over 50 years old?
- Neck: Is your neck circumference greater than 16 inches (40cm) for women or 17 inches (43cm) for men?
- Gender: Are you male?
Scoring 3 or more “yes” answers indicates a high risk for moderate to severe sleep apnea and warrants a discussion with a doctor.
Step 3: Gather Evidence (If Possible)
If you sleep alone, technology can help. Use a smartphone app designed to record snoring and sounds of breathing pauses (like SnoreLab). While not a diagnosis, it can provide compelling audio evidence to show a physician. Some smartwatches and fitness trackers also estimate blood oxygen levels; repeated dips in oxygen saturation during sleep can be a clue.
Step 4: Schedule a Doctor’s Appointment
Take your symptom diary, STOP-BANG score, and any recordings to your primary care physician. Describe your concerns clearly. They will perform a physical exam, focusing on your mouth, throat, and neck, and review your history.
What to Expect During a Professional Diagnosis
If your doctor suspects sleep apnea, they will refer you for a sleep study. This is the only way to get a definitive diagnosis.
Option 1: Home Sleep Apnea Test (HSAT)
This is a simplified test you can do in your own bed. A technician will give you a portable monitor that typically records:
- Your breathing effort
- Airflow
- Blood oxygen levels
- Heart rate
- Often snoring intensity
You’ll set it up yourself using simple instructions. It’s convenient and less expensive, but it’s usually only for patients with a high probability of moderate to severe OSA and no other major medical conditions.
Option 2: In-Lab Overnight Sleep Study (Polysomnography)
This is the gold standard. You stay overnight at a sleep center. Sensors are attached to your head, face, chest, limbs, and finger to track:
- Brain waves (sleep stages)
- Eye and chin muscle activity
- Heart rhythm
- Breathing effort and airflow
- Blood oxygen levels
- Leg movements
- Body positions
A sleep technologist monitors you all night. This test provides the most comprehensive data and is needed for complex cases, central sleep apnea, or if a home test is inconclusive.
Understanding Your Diagnosis: The AHI
Your sleep study results will give you an Apnea-Hypopnea Index (AHI). This number represents the average number of breathing pauses (apneas) and shallow breathing events (hypopneas) you have per hour of sleep.
- Normal: AHI < 5
- Mild Sleep Apnea: AHI 5-15
- Moderate Sleep Apnea: AHI 15-30
- Severe Sleep Apnea: AHI > 30
This score, along with your symptoms, guides treatment recommendations. Even mild apnea with significant daytime sleepiness needs treatment.
Why You Should Not Ignore the Signs
Untreated sleep apnea is far more than an annoyance. It’s a serious health hazard that strains your entire body. The repeated drops in blood oxygen increase blood pressure and strain the cardiovascular system, raising your risk for:
- High blood pressure (hypertension)
- Stroke
- Heart attack, heart failure, and irregular heartbeats (arrhythmias)
- Type 2 diabetes
- Worsening of ADHD
- Increased risk of work-related or driving accidents due to fatigue
- Complications with surgery and medications
Getting diagnosed and treated can reverse these risks and dramatically improve your quality of life, mood, and energy.
Next Steps After Identifying the Problem
A diagnosis of sleep apnea is the beginning of a solution, not an end point. Effective treatments are available and can be life-changing.
- Lifestyle Changes: For mild cases, weight loss, regular exercise, avoiding alcohol before bed, quitting smoking, and changing sleep position (side-sleeping instead of back-sleeping) can make a significant difference.
- Continuous Positive Airway Pressure (CPAP): The most common and effective treatment for moderate to severe OSA. A machine delivers a steady stream of air through a mask, keeping your airway open.
- Oral Appliances: Dental devices that reposition the jaw or tongue to keep the airway open. These are often used for mild to moderate OSA or for people who cannot tolerate CPAP.
- Surgery: Various procedures aim to remove or shrink tissue in the throat, reposition the jaw, or implant nerve stimulators. Surgery is usually considered when other treatments have failed.
The key is to work closely with your sleep specialist to find the treatment that you can stick with consistently.
Frequently Asked Questions (FAQ)
Can you have sleep apnea without snoring?
Yes, it’s possible, especially with central sleep apnea. While loud snoring is a hallmark of obstructive sleep apnea, not everyone who has apnea snores, and not everyone who snores has apnea. Daytime sleepiness and other symptoms are crucial indicators.
What does a sleep apnea headache feel like?
Sleep apnea headaches typically occur upon waking and are often described as a pressing, non-throbbing pain that feels like a tight band around the head. They usually affect both sides of the head and may last for several hours. They are thought to be caused by low oxygen and high carbon dioxide levels in the blood during the night.
How can I test myself for sleep apnea at home?
You cannot definitively diagnose yourself at home. However, you can use the steps outlined earlier: track symptoms, use the STOP-BANG questionnaire, and consider a FDA-approved home sleep test prescribed by a doctor. Over-the-counter “wellness” devices are not diagnostic tools.
Can weight loss cure sleep apnea?
For many people, significant weight loss can reduce the severity of sleep apnea or even eliminate it, especially if the condition is weight-related. However, it may not cure all cases, particularly if there are anatomical factors involved. Treatment is often still needed during the weight loss journey.
What is the main cause of sleep apnea?
For obstructive sleep apnea, the main cause is the relaxation of the muscles in the back of the throat, which support the soft palate, tonsils, tongue, and side walls of the throat. When these muscles relax too much, the airway narrows or closes as you breathe in. This is influenced by weight, anatomy, and other risk factors.
Is sleep apnea dangerous?
Yes, untreated sleep apnea is a serious medical condition. The chronic sleep deprivation and repeated oxygen deprivation put immense strain on your heart and vascular system, leading to a significantly higher risk of hypertension, heart disease, stroke, and type 2 diabetes. It also greatly increases the risk of accidents.
Listening to your body and your bed partner’s observations is crucial. If the signs point toward sleep apnea, don’t dismiss them as just poor sleep. Taking action by talking to your doctor is a proactive step toward protecting your long-term health and reclaiming restful, refreshing sleep. The process of finding out might seem daunting, but the improvement to your daily energy and long-term wellbeing is well worth it.