Sleep apnea is a common problem where breathing stops and starts again many times during sleep. When breathing pauses, your body may not get enough oxygen.¹

Many people find out only because a partner hears loud snoring or gasping. Left untreated, sleep apnea can wear you down during the day and raise the risk of heart problems, stroke and memory trouble.⁴ The good news is that it can be tested for and treated.

Key points

Loud snoring, gasping in sleep and feeling sleepy during the day are the classic signs. Someone else often notices first.²
Untreated sleep apnea is linked to high blood pressure, heart rhythm problems, stroke, diabetes and problems with memory and thinking.⁴
Many people can be tested at home. Some people need a test in a sleep lab.⁸
CPAP, a machine that blows air through a mask, is the most common treatment. Mouth guards made by a dentist, weight loss, a weekly weight-loss shot (Zepbound) and an implant (Inspire) are other options for the right person.^5,11
Medicare Part B covers sleep tests and CPAP when its rules are met.^14,15

What happens during sleep apnea

There are two main types.

Obstructive sleep apnea (OSA) is by far the most common. The upper airway gets blocked again and again during sleep, so air slows or stops.¹
Central sleep apnea happens when the brain does not send the signal to breathe for a short time. It is less common. It is linked to heart failure, stroke and long-term use of opioid pain medicines.³

This page is mostly about obstructive sleep apnea. Doctors measure how severe it is with the apnea-hypopnea index (AHI). That is the number of times per hour that breathing stops or becomes very shallow. An AHI of 15 or more means moderate to severe sleep apnea.¹²

Signs to watch for

At night, signs include:²

Loud snoring on most nights
Breathing that stops and starts, which a partner may see
Waking up gasping or choking
Getting up often to urinate

During the day, signs include:²

Feeling very sleepy or tired, even after a full night in bed
Morning headaches
Dry mouth on waking
Trouble sleeping (insomnia)
Low sex drive

Loud snoring is more common in men. Tiredness, headaches and insomnia are more common signs in women.² Trouble with focus, decisions and memory can also be a sign.¹

Who is more likely to have it

Risk for obstructive sleep apnea goes up when:³

You are older. Fat can build up in the neck and tongue with age.
You are a man. Men get it more often and tend to have more severe cases.
You carry extra weight. Fat in the neck can press on the airway.
It runs in your family. Genes shape the face, jaw and airway.
You drink alcohol, which relaxes the throat muscles, or smoke, which inflames the airway.
You have certain health problems, such as heart or kidney failure, hormone (endocrine) problems, or large tonsils.

Why it matters for your heart, brain and safety

Heart and blood vessels

Untreated sleep apnea raises the risk of high blood pressure that is hard to control, atrial fibrillation (an irregular heartbeat), heart attack, heart failure and stroke.⁴ An American Heart Association statement found it in about 30 to 50 out of 100 people with high blood pressure, and in up to 80 out of 100 people whose blood pressure stays high despite several medicines.⁶ About 7 in 10 people tested after a stroke have it.⁶

CPAP lowers blood pressure a little, by about 2 to 3 points on average. Large trials have not proven that it prevents heart attacks or strokes.⁶ Treatment does clearly help with daytime sleepiness and quality of life.⁹

Memory and thinking

Poor sleep and low oxygen can make it hard to focus, remember and make decisions. For older adults, untreated sleep apnea is linked to a higher risk of dementia.⁴

One large study looked at Medicare records for about 53,000 people age 65 and older with sleep apnea. Those who used a breathing machine were less likely to be diagnosed with Alzheimer's disease or other dementia over three years.⁷ This shows a link, not proof that treatment prevents dementia. For more, see Sleep, alcohol and smoking.

Driving and surgery

Sleepiness dulls attention and raises the risk of car crashes. Do not drive when you feel drowsy.⁴

If you have sleep apnea, tell every doctor before surgery or a procedure with sedation. Some pain and sedating medicines can make breathing harder, and the care team may take extra steps to protect your airway.⁴

It is also linked to type 2 diabetes, acid reflux and kidney disease.⁴ See Diabetes, weight and dementia risk and Blood pressure, cholesterol and the brain.

How sleep apnea is tested

A questionnaire alone cannot diagnose sleep apnea. You need a sleep test.⁸ There are two main kinds.

Home sleep test

You sleep in your own bed
A small device records breathing, airflow and oxygen
An option for adults with clear signs of moderate to severe sleep apnea and no major heart or lung disease
If the result is negative or unclear, the next step is a lab test, not a second home test

Sleep lab test (polysomnography)

You spend a night in a sleep center
Records brain waves, breathing, oxygen and heart rhythm
Recommended if you have serious heart or lung disease, a past stroke, long-term opioid use, severe insomnia or certain muscle and nerve diseases

Source for the comparison: American Academy of Sleep Medicine guideline.⁸

Medicare Part B covers several types of sleep tests, from full lab studies to simpler devices, if you have signs of sleep apnea and your doctor orders the test. You usually pay 20% after the Part B deductible.¹⁵

Treatment options

Your sleep doctor will match treatment to how severe your sleep apnea is, your health and what you can stick with.

CPAP and other breathing machines

Strong evidence

CPAP (continuous positive airway pressure) gently blows air through a mask to keep the throat open. It is the most common treatment.⁵ Guidelines strongly recommend it for people with sleep apnea who are sleepy in the daytime.⁹ Most healthy adults can start CPAP at home without a night in the lab.⁹

Oral appliances (mouth guards)

Moderate evidence

A dentist fits a custom device that holds your lower jaw or tongue forward while you sleep.⁵ It lowers breathing pauses less than CPAP does, but many people find it easier to wear. It is a good choice if you cannot tolerate CPAP or prefer not to use it. A follow-up sleep test checks that it works.¹⁰

Weight loss and the Zepbound shot

Moderate evidence

Losing weight can ease sleep apnea. In December 2024, the FDA approved Zepbound (tirzepatide) as the first medicine for moderate to severe obstructive sleep apnea in adults with obesity. It is a once-weekly shot used along with healthy eating and more activity.¹¹

Inspire implant (hypoglossal nerve stimulation)

Moderate evidence

A small device is placed under the skin of the chest. It sends gentle pulses to the nerve that moves your tongue, so the tongue does not block your airway during sleep.⁵ It is for certain adults who could not use CPAP or did not get enough benefit from it.¹³

Sleeping on your side and healthy habits

Limited research

Side sleeping may help keep the airway open. Limiting alcohol, quitting smoking and regular activity also help.⁵ Ask your doctor whether these are enough on their own.

Surgery

Limited research

Options include removing large tonsils or extra throat tissue, or moving the jaw forward. Weight-loss surgery may help when obesity is a major cause.⁵ Surgery is usually considered when other treatments have not worked.¹

Getting used to CPAP

CPAP works only if you use it. Many people struggle at first, and that is normal. These steps can help:⁴

Use it for every sleep, including naps, and take it when you travel.
Practice while awake. Wear the mask while watching TV or reading to get used to the feel.
Fit the mask lying down with the machine on. Adjust the straps until air does not leak.
Start with a clean face and a clean mask for a better seal.
Ask about changes if something bothers you. A different mask, a humidifier for dryness, a nasal spray, or a ramp setting that starts with low pressure can make a big difference.
Replace supplies on time. Masks, cushions, tubing and filters wear out.

Common side effects are a stuffy or runny nose, dry mouth or eyes and nosebleeds. If you have stomach bloating or pain, stop using the machine and call your provider.⁵

Your provider, and sometimes your insurer, may check usage data from your machine.⁴ Early teaching and check-ins help people stick with CPAP.⁹

Medicare and CPAP. Medicare Part B covers a 12-week CPAP trial. To keep coverage after that, your doctor must see you in person between day 31 and day 91 and confirm that CPAP is helping. You need to use it at least 4 hours a night on 70% of nights during any 30 days in a row in the first three months.^14,16 The machine is rented for 13 months, and then you own it. You usually pay 20% after the Part B deductible. Use a supplier that accepts Medicare assignment.¹⁴

Zepbound (tirzepatide) for sleep apnea

Zepbound acts on two gut hormones (GLP-1 and GIP) that reduce appetite. Weight loss then eases the airway blockage.¹¹ It is approved for adults with moderate to severe obstructive sleep apnea who also have obesity.^11,12

The FDA based its approval on two year-long studies with 469 adults who did not have type 2 diabetes. One group used CPAP and one did not.¹¹

After 52 weeks	Zepbound	Placebo (look-alike shot)
Fewer breathing pauses per hour (people not using CPAP)	about 25 fewer	about 5 fewer
Fewer breathing pauses per hour (people using CPAP)	about 29 fewer	about 5 to 6 fewer
Sleep apnea became mild or went away, with symptoms resolved	42% to 50%	14% to 16%
Average weight loss	about 18% to 20%	about 2%

Source for the table: AASM fact sheet summarizing the trials.¹²

What this means. About 4 to 5 in 10 people on Zepbound ended up with mild or no sleep apnea, compared with about 1 in 7 on placebo. It is not a replacement for CPAP. It is one more tool within overall sleep apnea care.¹²

Common side effects are nausea, diarrhea, vomiting, constipation, stomach pain and reactions where the shot is given. More serious risks include pancreatitis, gallbladder problems and kidney injury. It carries a warning about thyroid tumors seen in animal studies. People with a personal or family history of medullary thyroid cancer or MEN 2 syndrome should not use it.¹¹ Tell your doctor if you have a history of depression, kidney disease or eye problems from diabetes.⁵

Insurance coverage for Zepbound varies, as of October 2026. Ask your Medicare drug plan or insurer whether it covers the drug for sleep apnea and what you would pay.

The Inspire implant

As of its 2023 FDA update, Inspire is approved for adults with moderate to severe obstructive sleep apnea (an AHI from 15 up to 100) who could not tolerate CPAP or whose sleep apnea stayed too high despite CPAP. The FDA label warns about use in people with a BMI (body mass index) above 40.¹³ Doctors also check how your airway closes during sleep, because one pattern (the airway collapsing all the way around at the soft palate) rules it out.¹³

Sleep apnea in later life

Sleep apnea becomes more common with age.³ Its signs are easy to blame on aging. Frequent trips to the bathroom at night, daytime dozing and trouble with memory are all worth raising with a doctor.^2,4 Changes in how the aging brain controls breathing may also raise the risk of central sleep apnea.³

For a person living with dementia, a mask can be hard to accept. Caregivers can help with a steady bedtime routine and daytime practice, and can ask the sleep team about other masks or treatments. See Sleep in later life.

Sedation and some pain medicines can make breathing harder for people with sleep apnea.⁴ Ask your doctor or pharmacist before taking anything for sleep or changing any medicine. See Sleep medicines: what to know.

When to get help

Talk with your doctor about a sleep test if:

Someone has seen you stop breathing or gasp in your sleep
You snore loudly and feel tired or sleepy during the day
You have high blood pressure that is hard to control, atrial fibrillation, heart failure or a past stroke
You have nodded off while driving or nearly did

Call 911 if someone has chest pain, sudden weakness or numbness on one side, trouble speaking, or cannot be woken up or is struggling to breathe. Do not drive when you are drowsy. If poor sleep has left you feeling hopeless or thinking about suicide, call or text 988 to reach the Suicide and Crisis Lifeline any time.

For other sleep problems, see Insomnia, Restless legs syndrome, Healthy sleep habits and our Sleep and insomnia overview.

Can I stop CPAP if I lose weight?

Possibly, but do not stop on your own. Guidelines advise a new sleep test after a big weight change to see whether treatment should change.¹⁰

Sources

National Heart, Lung, and Blood Institute. What is sleep apnea? NIH, 2025. NHLBI
National Heart, Lung, and Blood Institute. Sleep apnea: symptoms. NIH, 2025. NHLBI
National Heart, Lung, and Blood Institute. Sleep apnea: causes and risk factors. NIH, 2025. NHLBI
National Heart, Lung, and Blood Institute. Living with sleep apnea. NIH, 2025. NHLBI
National Heart, Lung, and Blood Institute. Sleep apnea: treatment. NIH, 2025. NHLBI
Yeghiazarians Y, et al. Obstructive sleep apnea and cardiovascular disease: a scientific statement from the American Heart Association. Circulation, 2021. DOI
Dunietz GL, et al. Obstructive sleep apnea treatment and dementia risk in older adults. Sleep, 2021. Sleep journal
Kapur VK, et al. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med, 2017. DOI
Patil SP, et al. Treatment of adult obstructive sleep apnea with positive airway pressure: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med, 2019. PMC
Ramar K, et al. Clinical practice guideline for the treatment of obstructive sleep apnea and snoring with oral appliance therapy. J Clin Sleep Med, 2015. PMC
U.S. Food and Drug Administration. FDA approves first medication for obstructive sleep apnea. FDA, 2024. FDA
American Academy of Sleep Medicine. Zepbound (tirzepatide) for obstructive sleep apnea: fact sheet for sleep physicians. AASM, 2026. AASM
U.S. Food and Drug Administration. Approval letter, Inspire Upper Airway Stimulation System, PMA P130008/S090. FDA, 2023. FDA
Medicare.gov. Continuous positive airway pressure (CPAP) devices. CMS, 2026. Medicare.gov
Medicare.gov. Sleep studies. CMS, 2026. Medicare.gov
Centers for Medicare & Medicaid Services. Local coverage determination: Positive airway pressure (PAP) devices for the treatment of obstructive sleep apnea (L33718). CMS, 2026. CMS

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.