[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Conditions](https://durgical.com/en/conditions/) › Obstructive sleep apnoea

[Conditions](https://durgical.com/en/conditions/) · [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/)

# Obstructive sleep apnoea

Obstructive sleep apnoea is repeated collapse of the throat during sleep, causing breathing pauses, loud snoring and daytime sleepiness.

Updated 2026-10-30

## Structures involved

Tap one to see what it is and open it in 3D.

- [Pharynx](https://durgical.com/en/anatomy/pharynx/)
- [Soft palate](https://durgical.com/en/anatomy/soft-palate/)
- [Tongue](https://durgical.com/en/anatomy/tongue/)
- [Palatine tonsils](https://durgical.com/en/anatomy/palatine-tonsil/)
- [Genioglossus](https://durgical.com/en/anatomy/genioglossus-muscle/)
- [Mandible](https://durgical.com/en/anatomy/mandible/)
- [Hyoid bone](https://durgical.com/en/anatomy/hyoid-bone/)

## In biochemistry

- [Leptin, appetite and obesity](https://durgical.com/en/biochemistry/topics/leptin-appetite-and-obesity/)

## In embryology

- [First-arch syndromes: Treacher Collins and Pierre Robin sequence](https://durgical.com/en/embryology/first-arch-syndromes-treacher-collins-and-pierre-robin-sequence/)

## In physiology

- [Wakefulness, sleep, the EEG and seizures](https://durgical.com/en/physiology/wakefulness-sleep-the-eeg-and-seizures/)
- [Control of breathing, chemoreceptors and lung reflexes](https://durgical.com/en/physiology/control-of-breathing-chemoreceptors-and-lung-reflexes/)
- [Abnormal breathing patterns and sleep apnea](https://durgical.com/en/physiology/abnormal-breathing-patterns-and-sleep-apnea/)

## Why it happens

- [Obesity: leptin, adipokines and its consequences](https://durgical.com/en/general-pathology/obesity-leptin-adipokines-and-its-consequences/)

## What it is

Repeated partial or complete collapse of the upper airway during sleep, causing pauses in breathing, drops in oxygen and fragmented sleep, with daytime sleepiness and cardiovascular risk.

## Who gets it

Common in adults and rising with obesity; most cases are undiagnosed. More frequent in men and after menopause. In children it is mostly due to enlarged tonsils and adenoids. Among 340 university students in Manizales, Colombia, a screening questionnaire (STOP-BANG) flagged moderate to high risk in 23% of men and 3.1% of women.

## Causes

- Narrow upper airway from fat deposits in the neck and [tongue](https://durgical.com/en/anatomy/tongue/)
- Enlarged tonsils and adenoids (main cause in children)
- Retrognathia or small jaw, craniofacial anomalies
- Reduced dilator muscle tone during sleep

## Risk factors

- Obesity and large neck circumference
- Male sex, older age, menopause
- Alcohol and sedatives before sleep
- Smoking
- Nasal obstruction
- Hypothyroidism, acromegaly
- Family history

## Pathophysiology

During sleep the tone of the pharyngeal dilator muscles, such as the [genioglossus](https://durgical.com/en/anatomy/genioglossus-muscle/), falls. In a narrow airway, the [soft palate](https://durgical.com/en/anatomy/soft-palate/), tongue and pharyngeal walls collapse, causing apnoeas and hypopnoeas. Each event lowers oxygen, raises carbon dioxide and ends in a brief arousal with a sympathetic surge, which fragments sleep and raises blood pressure over time.

## Classification

- Severity by apnoea-hypopnoea index (AHI) per hour of sleep: mild, moderate, severe (widely used cut-offs: 5, 15 and 30 events per hour in adults)

## Symptoms and signs

- Loud habitual snoring
- Witnessed pauses in breathing, gasping or choking at night
- Excessive daytime sleepiness and unrefreshing sleep
- Morning headache
- Poor concentration, irritability
- Night-time urination
- In children: snoring, restless sleep, behaviour and learning problems

## Red flags

- Falling asleep while driving or at work
- Resistant hypertension or new atrial fibrillation
- Daytime hypoventilation or signs of right heart failure
- Severe sleepiness in professional drivers

## Diagnosis

**Clinical**
Suspected from snoring, witnessed apnoeas and sleepiness; questionnaires (STOP-BANG, Epworth sleepiness scale) help screen. Examination looks at BMI, neck circumference, tonsils, palate, jaw and nose.

**Tests**
Overnight polysomnography is the reference test; home sleep apnoea testing in selected adults with high pretest probability. The apnoea-hypopnoea index defines severity.

**Imaging**
Not routinely needed. Drug-induced sleep endoscopy or imaging of the airway in selected patients when surgery is considered.

## Differential diagnosis

- Simple snoring
- Insufficient sleep or shift work
- Narcolepsy
- Central sleep apnoea
- Obesity hypoventilation syndrome
- Depression or hypothyroidism

## Goal of treatment

Keep the airway open during sleep, relieve sleepiness and improve quality of life, and lower cardiovascular and accident risk.

## Treatment

**Lifestyle**
Weight loss, avoiding alcohol and sedatives at night, sleeping on the side when apnoea is positional and treating nasal obstruction.

**Conservative**
Continuous positive airway pressure (CPAP) during sleep is the main treatment for moderate-severe disease; adherence is the main challenge.

**Conservative**
Mandibular advancement oral appliances for mild-moderate disease or CPAP intolerance.

**Medical**
Anti-obesity medicines (incretin-based drug classes) in selected adults with obesity, as part of weight management.

**Surgical**
Adenotonsillectomy is first line in children with enlarged tonsils and adenoids; tonsillectomy or palate surgery in selected adults.

**Surgical**
Maxillomandibular advancement or [hypoglossal nerve](https://durgical.com/en/anatomy/hypoglossal-nerve/) stimulation in selected adults who cannot use CPAP.

## Drugs for this condition

- [Tirzepatide](https://durgical.com/en/pharmacology/tirzepatide/)

## Complications

- Arterial hypertension, often resistant
- Atrial fibrillation and other arrhythmias
- Heart failure, coronary disease and stroke
- Insulin resistance and type 2 diabetes
- Road and work accidents
- Pulmonary hypertension

## Prognosis

Chronic, but treatment improves sleepiness and quality of life and lowers blood pressure; adherence to CPAP determines much of the benefit. In children, adenotonsillectomy often cures it.

## Prevention

- Keeping a healthy weight
- Limiting alcohol and sedatives
- Not smoking

## Test yourself

Think of the answer, then tap the question to see it.

## Which index is used to grade the severity of obstructive sleep apnoea?

The apnoea-hypopnoea index (events per hour of sleep): mild, moderate or severe.

## What is the reference test for diagnosing obstructive sleep apnoea?

Overnight polysomnography; home testing is used in selected adults.

## What is the first-line treatment of moderate to severe obstructive sleep apnoea in adults?

Continuous positive airway pressure (CPAP) during sleep, with weight loss when indicated.

## What is the main cause of obstructive sleep apnoea in children?

Enlarged tonsils and adenoids; adenotonsillectomy is first-line treatment.

## Which cardiovascular conditions are linked to untreated obstructive sleep apnoea?

Resistant hypertension, atrial fibrillation, heart failure, coronary disease and stroke.

[Add to my cards (5)](https://durgical.app/estudiar/?add=/en/conditions/obstructive-sleep-apnoea/)

## Related conditions

- [Obesity](https://durgical.com/en/conditions/obesity/)
- [Arterial hypertension](https://durgical.com/en/conditions/arterial-hypertension/)
- [Atrial fibrillation](https://durgical.com/en/conditions/atrial-fibrillation/)
- [Heart failure](https://durgical.com/en/conditions/heart-failure/)
- [Allergic rhinitis](https://durgical.com/en/conditions/allergic-rhinitis/)
- [Hypothyroidism](https://durgical.com/en/conditions/hypothyroidism/)

Educational information, not medical advice. For any symptom, see a health professional.

Sources: [Obstructive Sleep Apnea](https://www.ncbi.nlm.nih.gov/books/NBK459252/) (StatPearls (NCBI Bookshelf), 2025); [Sex Differences in Predictors of Obstructive Sleep Apnea Risk Among Young Adults: A Cross-Sectional Study in Colombian University Students](https://europepmc.org/article/PMC/PMC12525285) (Journal of clinical medicine, 2025) · adapted, [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/).

[← All conditions](https://durgical.com/en/conditions/)

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/conditions/obstructive-sleep-apnoea/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/obstructive-sleep-apnoea/