When is Sleep Apnea Considered Severe?

More than 28 million Americans have been diagnosed with some form of sleep apnea, and many more cases may go undiagnosed by a physician. The condition is most characterized by pauses in breathing during sleep which may occur due to a physical obstruction or a lack of communication from the brain to the airways. The deprivation of oxygen is a top concern as it often coincides with obesity, diabetes, cardiovascular disease, and a variety of other health conditions.

While sleep apnea should be taken seriously no matter how mild, there more severe your case of sleep apnea is, the more aware you should be about it. Mild sleep apnea might cause a few health problems over time, but a severe case of the condition can be very dangerous if left untreated. Determining if you have severe sleep apnea (and what to do about it if you do) is an important step in the right direction for taking care of your health.

Signs of Severe Sleep Apnea

The signs and symptoms of sleep apnea are similar no matter if your condition is severe or mild, but the more severe the case the more attention should be paid to the condition. And, if left untreated, a mild case of sleep apnea can turn into a more severe form.

These are indicators that you may have a severe form of sleep apnea:

  • At least 30 or more episodes of sleep apnea or reduced air flow every hour
  • Sleepiness or even falling asleep during busy activities (driving, eating, talking, walking)
  • Waking up gasping and choking
  • Significant mood swings
  • Difficulty concentrating
  • Sore throat or dry mouth in the morning
  • Headaches and/or migraines

Severe Sleep Apnea Diagnosis

In order to get a full diagnosis of the severity of your sleep apnea, it is imperative that you visit your primary care physician to start the process. If your doctor thinks that your symptoms may be related to a sleep disorder, he or he will likely refer you to a sleep specialist or a sleep clinic. Be sure to check with your insurance provider to determine what type of coverage you have with regard to accessing sleep clinics or sleep testing facilities.

Before your visit, you will be asked to provide a full medical history with details that may be related to sleep apnea (even if they don’t seem to be). A partner or family member may be able to help you answer these questions better than you might be able to on your own.

You’ll be asked to provide information about:

  • Your sleeping patterns
  • Snoring
  • Breathing at night
  • How often you may be having episodes
  • Fatigue during the day
  • Heart palpitations or problems
  • Other issues that may be related to sleep apnea.

A sleep study is the only way to provide a definitive diagnosis of sleep apnea, whether mild or severe. The process of a sleep study is known as “polysomnography”. You may be asked to visit a sleep lab overnight, or you may be provided with special equipment so that you can perform a sleep study in your own home. The study will need to encompass several hours of sleep—probably six or possibly more. Even if you do stay overnight at a sleep lab, the environment will likely be more like a comfortable hotel room or bedroom, rather than like a hospital room.

The equipment used in the sleep study will generate information related to brain waves, eye and chin movements, heart rate and rhythm, respiration, oxygen levels, carbon dioxide levels, and leg movement. These recordings are all done through passive monitors, without any needles or other painful procedures. If the study shows that you have sleep apnea, you may be awaked in the middle of the study and affixed to a breathing device so that it can be determined how well you respond to this type of therapy. Again, it shouldn’t be at all painful.

Once you’ve had a sleep study, you’ll be given an apnea-hypopnea index (AHI), which determines how mild or severe your sleep apnea is. This represents the number of apnea events happening during each hour that you are sleeping. Events are typically considered to last 10 seconds or longer.

For adults, here is the scale of AHI that determines sleep apnea severity:

Normal: AHI less than 5
Mild Sleep Apnea: AHI between 5 and 15
Moderate Sleep Apnea: AHI between 15 and 30
Severe Sleep Apnea: AHI 30 or above

Once you have a diagnosis, your doctor will help you determine the best cause of action depending on the severity of your sleep apnea.

Do I Need a Sleep Apnea Diagnosis?

If you think you have sleep apnea but aren’t convinced that you need to get a diagnosis, then consider the fact that sleep apnea may even be linked to an increased risk of cancer. Two different studies performed in recent years in the US have suggested that those who suffer from severe sleep apnea (or other severe night time breathing abnormalities) may be up to five times more likely to die of cancer than people who do not have sleeping disorders related to oxygen deprivation. Even people with moderate sleep apnea may be twice as likely to be affected by cancer-related death. Of course these studies are observational and further research is required to come to any final conclusions, but the links are there and the risks should be taken very seriously.

In addition to its links to cancer, severe sleep apnea can cause a person to fall asleep in the middle of activity, even while driving which can obviously cause motor vehicle accidents. The risk of accidents at work for people with sleep apnea is much higher. And the possibility of developing diabetes, cardiovascular disease, obesity, and other health problems is significant.

Sleep apnea, no matter how mild or severe, is not something to be taken lightly and left untreated. If you believe that you or your partner may be exhibiting signs or symptoms of this condition, contact a medical professional right away to get a diagnosis or rule it out.


The good news is that, even severe sleep apnea is a condition that is able to be treated and, when carefully regulated with some lifestyle adjustments, you can go on to live a perfectly normal and healthy life. You may need to lose some weight by eating healthier and exercising, sleep with an adjustable bed to minimize episodes, and possibly make use of a CPAP (Continuous Positive Airway Pressure) machine. But, all in all, the prognosis for people with even the most severe sleep apnea can be very good if they take good care of themselves and follow their physician’s advice.

Special offer for our visitors

Get your Free Sleeping Guide