Obstructive sleep apnea (OSA) - the most common form of sleep apnea - occurs when your airway collapses or fails to open during sleep, causing snoring, interruptions to breathing, and disrupted sleep. People with severe sleep apnea have 30 or more of these interruptions every hour during sleep, which means they wake or stop breathing 240 times on average per eight hours of sleep.¹ 

While sleep apnea is associated with health problems at every level, severe OSA tends to be even more damaging. More severe sleep apnea is associated with a higher risk of heart disease, heart failure, stroke, and other adverse health conditions.¹

In this article, we look at symptoms, risks, and treatment options. 

Signs and symptoms of severe sleep apnea

There are a range of symptoms associated with severe OSA. You don’t need to have all the symptoms to be diagnosed. If you’re affected by just two or three symptoms regularly, it’s advisable that you get checked out by your doctor. 

Daytime tiredness and fatigue

Everyone feels tired sometimes, but if, even after a full night’s sleep, you feel exhausted and sleepy frequently, it could be a sign that OSA is affecting your sleep cycle.²

Loud snoring 

Air moving through a narrow or obstructed airway makes the tissues vibrate, which leads to snoring.³ While most people snore sometimes, people with OSA tend to snore often and more loudly.³  

Breathing interruptions  

Your breathing may stop briefly, multiple times through the night. Your sleep partner or relative may notice this symptom. 

Sudden waking  

Waking suddenly from deep sleep -particularly if you choke or gasp for air as you wake -is a sign of breathing being obstructed.⁴

Mood changes 

Changes in mood, including irritability and anger, can indicate that you’re not getting enough high-quality sleep.^5,6

Decreased libido 

Changes to your normal sex drive may indicate sleep deficit.⁷

Concentration and memory problems 

Struggling to remember names, words, or appointments and finding it challenging to focus can be indicators that you’re not getting enough sleep.⁸ 

Potential risks of severe sleep apnea

Exhaustion, memory problems, headaches, and mood and libido issues are bad enough, but the impacts of severe sleep apnea don’t end there.^5,9 The disorder is associated with some serious long-term health problems. 

Here are some of the most significant health risks: 

High blood pressure

Studies show a strong relationship between sleep apnea and high blood pressure – also called hypertension. Up to half of the people with OSA have hypertension, and people with severe sleep apnea seem more resistant to blood pressure medications, making the problem more challenging to treat.¹⁰

Heart disease 

If you have sleep apnea, you’re at an increased risk of cardiovascular disease and heart failure.¹¹ This seems to result from frequent drops in blood oxygen levels, causing damage to the blood vessels around the heart over time. ¹¹

Stroke 

Because sleep apnea affects cardiovascular health, it’s also a risk factor for strokes; some studies show that having untreated sleep apnea may double your risk.¹²

Severe sleep apnea– risk factors 

While anyone can develop sleep apnea, certain factors increase your risk of developing the disorder. 

These factors include:¹³   

• Age: Sleep apnea is two to three times more common in people over the age of 65.
• Weight: Being overweight or obese increases your risk.
• Gender: OSA is more common in men than in women.
• Medical conditions: Being diagnosed with diabetes, asthma, or high blood pressure.

How severe is your sleep apnea?

OSA can be categorized as one of three levels – mild, moderate, and severe – using the Apnea-Hypopnea Index (AHI). This measures the average number of breathing obstruction episodes per hour during sleep.¹⁴ Put simply, the more often your breathing is interrupted, the more severe your sleep apnea, and the higher your health risk. 

Here’s what your AHI score means:¹⁵ 

5–15: mild sleep apnea 

15–30: moderate sleep apnea 

30+: severe sleep apnea 

How is severe sleep apnea diagnosed?

Usually, diagnosing sleep apnea means undergoing a Sleep Study, which can be done in a sleep clinic or at home. During a sleep study, you wear a range of monitoring devices to measure breathing, oxygen levels, and other indicators while you sleep. 

If you have symptoms of severe sleep apnea, your doctor is likely to recommend an in-lab study, also called a polysomnography test, to make sure they can diagnose your condition accurately and start treatment as soon as possible. 

Treating severe sleep apnea 

There are a range of effective treatment options for sleep apnea – even if it’s severe. Depending on your symptoms, your lifestyle, and other factors, your doctor may recommend a combination of different treatment options, including: 

Continuous positive airway pressure (CPAP) therapy 

CPAP therapy involves wearing a mask connected to a machine that delivers air through the airway while you sleep. 

Lifestyle changes

Because sleep apnea is associated with obesity and can be worsened by smoking and alcohol, doctors often recommend weight loss and other lifestyle changes first.¹⁶ However, if you have severe sleep apnea, lifestyle changes will usually be recommended alongside other treatments, but typically not as a solution on their own. 

Surgery 

There are a few different surgical treatment options for sleep apnea, including tongue, jaw, throat, and nose surgery. While surgery can be effective, it’s generally seen as a last resort if less-invasive CPAP therapy fails.¹ 

Severe sleep apnea and you  

Thanks to the threat of serious health issues, severe sleep apnea can seem scary and overwhelming. The good news? It is treatable, and symptoms can be controlled. Because it’s relatively simple, non-invasive, and effective, CPAP is among the most common treatment options.¹ 

Leaving severe OSA untreated puts you at risk of long-term damage and serious consequences to your health and overall wellbeing, so it’s crucial that you seek professional help if you notice symptoms. 

Frequently Asked Questions

What is considered severe sleep apnea?

Severe sleep apnea is diagnosed when a patient has an AHI score of 30+ - this means that their breathing is disrupted more than 30 times an hour during sleep.¹⁴ 

How serious is severe sleep apnea? 

Severe sleep apnea is a serious disorder that can significantly impact your health and wellbeing. The disorder can cause or worsen a range of health issues, including heart disease, high blood pressure, stroke, diabetes, and depression. It may also impact your day-to-day life, causing memory problems, lack of focus, and exhaustion.¹⁶ 

Can severe sleep apnea be treated? 

Yes. CPAP therapy is among the most common treatment options for severe sleep apnea, but lifestyle changes and surgery are effective in some cases.¹   

The content is for educational purposes only. It should not be used as a substitute for the medical advice of one’s healthcare provider.