The Severity of Sleep Apnea: An Essential Guide for Patients and Caregivers

Whether you are caring for someone suffering from obstructive sleep apnea or you wish to learn more about its severity, it’s important to learn the severity of sleep apnea. 
We will begin with a brief overview of sleep apnea before moving on to discuss how its stages can differ between individuals (and what this signifies in terms of possible treatment options). 

Sleep apnea, breathing and oxygen

Obstructive sleep apnea is often defined by broken sleeping patterns due to the inability of the body to receive adequate levels of oxygen. This primarily results from a narrowing (or a complete closure) of the airways at sporadic times while you are asleep.

As a result, individuals who have been diagnosed with sleep apnea will often experience symptoms including:

  • Excessive snoring
  • Waking up in the middle of the night gasping for breath
  • Feelings of tiredness and irritability throughout the day
  • Difficulty concentrating 
  • drowsy driving

It is also important to mention that not everyone will experience the same problems. One of the ways to determine the severity of sleep apnea involves determining what is known as the apnea-hypopnea index (AHI). 

AHI measurements are used to determine the severity of sleep apnea normally characterized as mild, moderate or severe. The AHI is the total number of apneas and hypopneas divided by the total number of hours while sleeping.  An AHI range between 5 to 15 is considered mild.  An AHI range between 15 to 30 is considered moderate.  An AHI greater than 30 is considered severe.

To quantify an apnea or hypopnea, it is determined by the amount of cessation of breathing in comparison to a normal breath. When a patient has an 80% or greater reduction in their breathing lasting for a minimum of 10 seconds it is an apnea. 

A hypopnea is a partial reduction of breathing at greater than 30% compared to a normal breath lasting for a minimum of 10 seconds.  Thus a patient can still be snoring when they have hypopnea since the airway is only minimally obstructed.

The main takeaway point here is that clinicians will employ an AHI score in order to better understand the type of sleep apnea that you may be suffering from. It is then much easier to find an effective solution so you can finally enjoy a sound night of rest. 

The Severity of Sleep Apnea Explained

Now that we have taken a quick look at how the AHI score can be used within clinical settings, what about the severity of sleep apnea? These are generally broken down into three categories and each will be described in detail immediately below.

Mild Sleep Apnea

A mild case of sleep apnea will be diagnosed in the event that you experience between 5 and 15 AHI events per hour. It is also interesting to note that in certain cases, these events might not produce any symptoms. Therefore, some individuals may not require any form of targeted treatment after the test. Sleep apnea can occur in the future so subsequent testing may be recommended should symptoms occur. However, this will vary from person to person and a consultation with a physician is suggested. 

Moderate Sleep Apnea

Moderate sleep apnea is said to occur when a patient suffers from between 15 and 30 AHI events each hour. If we extrapolate this to eight hours of sleep, he or she might actually be enduring up to 240 partial or complete closures of the airway per night. Symptoms may or may not be present.  In general, men tend to underestimate their symptoms and women tend to overestimate their symptoms.  A consultation with a physician is recommended to help you determine next steps.

Severe Sleep Apnea

Severe sleep apnea is defined as anyone who experiences more than 240 AHI events while sleeping(30+ per hour). As you can imagine, this will normally cause noticeable disruptions to their overall sleep cycles and the symptoms outlined earlier will often be present. In this case, some type of medical intervention is often recommended. 

Why are Some Individuals Unaware of Their Sleep Apnea?

Considering the severity of sleep apnea highlighted above, it is understandable to assume we would be aware of their presence. However, it should be noted that up to 25% of AHI events occur during REM sleep (when we are dreaming and cessation of breathing is the most severe).  We also have cessation of breathing in non-REM sleep but these events are less severe. 

The issue here is that the mind is generally not aware of physical stimuli while sleeping. This could make it difficult to remember that an AHI event actually occurred. Assuming that the symptoms are not overly severe, the individual might not even believe that a problem exists.

What Treatments are Available for the Different Severity of Sleep Apnea?

Treating sleep apnea will generally revolve around the symptoms themselves. As mentioned earlier, those with mild sleep apnea might not require any type of intervention at this time but sleep apnea is progressive with age. 

At-home remedies such as changing one's sleeping position and adjusting humidity levels could be sufficient. However, those who have been diagnosed with moderate to severe sleep apnea (awakening more than 15 times each hour) will often benefit from the use of a continuous positive airway pressure (CPAP) device. 

A CPAP is a device consisting of an electrical pump, a flexible hose and a nasal interface. Its main intention is to provide the user with air at an appropriate pressure to keep the airway open and your AHI below 5 events per hour of sleep. An Auto CPAP adjusts the pressure throughout the night to prevent snoring and to normalize your AHI.

As a result, the airways will be less likely to narrow and cause breathing problems while sleeping. There are many types of CPAPs on the market and some of these offer personalized options such as heated air and built-in humidifiers. A sleep specialist will be able to provide recommendations based on  the symptoms that you have been experiencing. 

Does a Problem Exist?

If you have been told you snore loudly – and have other symptoms of obstructive sleep apnea -- it is prudent to speak with your doctor. A home sleep study may be advised to determine the severity of your condition. Thankfully, there are many proven treatment options at your disposal.

Learn more about SleepQuest’s home sleep study