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Sleep / Guide

What are the signs of sleep apnea?

By: NefeslyLast updated: 2026-10-30

Sleep apnea means that breathing stops again and again, or becomes very shallow, during sleep. Because this happens while you sleep, you often do not notice it; the first person to notice is usually the one sleeping next to you.

Signs you may notice at night

Frequent, loud snoring is one of the most common signs of sleep apnea. A bed partner noticing that your breathing stops is among the most important reasons people see a doctor. Waking up with a choking feeling can also happen. Some people also have night sweats or get up often to use the toilet. Not everyone who snores has sleep apnea, but when these signs come together it is worth paying attention.

Signs you may notice during the day

Waking up tired even after enough sleep, and feeling very sleepy during the day, are important signs. Headaches and a dry mouth, especially in the morning, may also appear. Forgetfulness, poor concentration and irritability can come along with them. Heavy daytime sleepiness can lead to accidents at work and on the road, so it should be taken seriously.

One way to measure sleepiness

Doctors may use the Epworth Sleepiness Scale to assess daytime sleepiness. In this scale you rate your chance of dozing off from zero to three in eight everyday situations, such as watching TV or waiting in traffic. According to the Turkish Thoracic Society report, a total of 10 or more may point to excessive daytime sleepiness. Still, a questionnaire alone is not enough for a diagnosis.

When should you see a doctor?

If you are very sleepy during the day and also have at least two signs such as regular loud snoring, gasping, choking or stopped breathing in sleep, or high blood pressure, your risk may be higher. Your risk may also be higher if you take more than one blood pressure medicine or have heart and blood vessel disease. In these cases it is a good idea to talk to a doctor; only a sleep test ordered by a doctor can confirm a diagnosis.

For expertsdefinitions, thresholds, guidelines

For adult obstructive sleep apnea (OSA), ICSD-3-TR requires at least 5 predominantly obstructive respiratory events per hour on polysomnography (PSG) or a home sleep apnea test (HSAT) together with symptoms or an associated condition (such as sleepiness, unrefreshing sleep, witnessed apnea or choking, hypertension, atrial fibrillation or type 2 diabetes); at 15 or more events per hour no symptom requirement applies.1 Under the recommended rule of the AASM scoring manual, a hypopnea is defined as a reduction in flow of at least 30% lasting at least 10 seconds together with a 3% desaturation or an arousal.2

The AASM diagnostic guideline contains two strong recommendations:3

  • Clinical tools, questionnaires and prediction algorithms should not be used for diagnosis without PSG or HSAT.
  • If excessive daytime sleepiness comes with at least two of habitual loud snoring, witnessed apnea or gasping, and diagnosed hypertension, the risk of moderate to severe OSA is high; in an uncomplicated patient, PSG or a technically adequate HSAT is done.

According to a literature-based model, 936 million (95% CI 903 to 970 million) adults aged 30 to 69 have mild or worse OSA, and 425 million (399 to 450 million) moderate or severe OSA.4 This estimate is an extrapolation of 17 studies from 16 countries; uncertainty is wide for regions without country data.

  1. American Academy of Sleep Medicine. International Classification of Sleep Disorders, Third Edition, Text Revision (ICSD-3-TR). Darien (IL): AASM; 2023. aasm.org/clinical-resources/international-classification-sleep-disorders
  2. American Academy of Sleep Medicine. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications. Version 3. Darien (IL): AASM; 2023. aasm.org/clinical-resources/scoring-manual
  3. Kapur VK, Auckley DH, Chowdhuri S et al. Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. Journal of Clinical Sleep Medicine. 2017;13(3):479-504. doi:10.5664/jcsm.6506
  4. Benjafield AV, Ayas NT, Eastwood PR et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. The Lancet Respiratory Medicine. 2019;7(8):687-698. doi:10.1016/S2213-2600(19)30198-5

Sources

  1. Turkish Thoracic Society. Consensus Report on the Diagnosis and Treatment of Obstructive Sleep Apnea Syndrome. Turkish Thoracic Journal, 2012;13(Suppl 1).
  2. Başkent University Adana Hospital. Obstructive Sleep Apnea Syndrome: patient information leaflet (in Turkish). Undated.
  3. American Academy of Sleep Medicine. A Patient's Guide to Understanding Diagnostic Testing for Obstructive Sleep Apnea in Adults. 2019.

Disclosure: this article has no sponsor.