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Dr. Stringfellow Answers All Your Questions About Sleep Apnea

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Do you worry that you may have Sleep Apnea? Are you unsure what to ask your doctor? In this article, we asked a Board Certified Sleep Physician, Dr. Amie Stringfellow, some of the most common questions about Sleep Apnea, to help our readers begin their journey to better sleep health.

Most Popular Sleep Apnea Questions

What is Sleep Apnea?

Sleep Apnea is a collapse of the airways that occurs when an individual is sleeping. Sometimes it’s a partial closure and sometimes is a complete obstruction. Both can affect the individual’s ability to breathe while asleep.

Is It Normal To Stop Breathing While Sleeping?

No, it’s NOT normal to stop breathing while sleeping.

Is Snoring the Same As Sleep Apnea?

No. Snoring can be a symptom of Sleep Apnea, but it can also occur on its own. Snoring is the sound that is made when the airflow through the airways becomes turbulent and causes the soft tissue in the airway to vibrate. That’s the noise we hear as snoring, and it can happen without the airway narrowing. With snoring alone, the only side effect may be the irritation of the person’s bed partner.

When the airway is narrowed as with Sleep Apnea, you may hear some of the same vibrations. Having a sleep study is the only way to know for sure if your snoring is due to Sleep Apnea.

A graphic showing a sleep study with electrodes.

What Is a Sleep Study? How Much Does a Sleep Study Cost?

A sleep study is a way for doctors to take a look at what’s going on with an individual during their sleep. There are a few types of sleep studies, and each one looks at different aspects of sleep. One of the most common things we look at is how the individual is breathing while they sleep. This can either be done in a sleep lab, which gives us a much better and more complete picture or at home. The cost of an in-lab study is usually around a $1,000, but what you actually pay out of pocket depends on your insurance.

Home sleep studies are done via a monitor that is worn at home. Home sleep studies (or HSTs for short) are more affordable, typically priced at only $200 to $300 depending on facility. Your insurance may cover most of this cost. The Home Sleep Test can only diagnose Obstructive Sleep Apnea – it doesn’t provide information on brain wave activity or leg movement as an in-lab test will. A Home Sleep Test really only monitors breathing patterns and oxygen levels. It’s a more limited study, but if a patient is only concerned about Sleep Apnea, it’s good for the vast majority of individuals.

What Causes Sleep Apnea?

Many people think that weight is the only underlying cause of Sleep Apnea, but that’s simply not the case. A big part is airway structure, and that comes from our genetics. Added weight makes the problem of having a narrow airway even worse, and can be the precipitating factor in developing Sleep Apnea.

So when folks have a naturally narrow airway, gaining weight makes their Obstructive Sleep Apnea worse. But, if a person is able to lose weight, Sleep Apnea can become less severe. It’s important to note too that losing weight doesn’t “cure” Sleep Apnea. Losing weight can mean fewer apneas and that your blood oxygen doesn’t drop as low, but it’s not the same as a cure for Sleep Apnea.

Is Sleep Apnea Genetic?

Sleep Apnea isn’t an inheritable disease in the sense that there isn’t a “Sleep Apnea gene”. However, in the same way, you may look like a parent or a sibling, you may too inherit a smaller airway which could increase your likelihood of having Sleep Apnea. A smaller airway determines if an individual is more inclined to have a collapsing airway while sleeping. Remember, Sleep Apnea is just the airway closing while an individual sleeps, creating a partial or complete blockage. So, when a patient has a first degree relative with Sleep Apnea; a parent, child, or sibling — the risks of having Sleep Apnea increases by 50%.

What Problems Does Sleep Apnea Cause?

When Sleep Apnea is left untreated, Sleep Apnea can cause a lot of complications for a patient. It significantly disrupts an individual’s sleep and can make them feel very tired in the morning and during the day. It causes fatigue, with not a lot of energy and can make it hard to get going in the morning. It’s a feeling some people describe as “running on fumes”. In some individuals, particularly children, it can cause symptoms similar to ADD. They may notice having a hard time completing tasks, paying attention, or focusing on things they are trying to work on.

In the long run, untreated OSA can contribute to much more significant issues, such as:

  • An increase in blood pressure or blood sugar
  • An increased risk of heart problems, like abnormal heart rhythms or heart attack
  • An increase in the risk of stroke

If we can treat the Sleep Apnea well, then we can better minimize these issues, and then overcome some of the more short-term symptoms. Long-term effects can make other existing conditions worse – like anxiety, depression, and migraines too. It’s important to point out that Sleep Apnea carries with it an increased cardiovascular risk. Successful treatment helps minimize this risk.

Can You Die From Sleep Apnea? How Serious Is Sleep Apnea?

Sleep Apnea is a very serious condition. In the long run it can cause a lot of problems with a patient’s health. There have been a few instances of deaths attributed to Sleep Apnea, but these cases are pretty rare. In most of those cases, the untreated Sleep Apnea caused an abnormal heart rhythm and the actual cause of death is related to heart issues caused by the sleep apnea and not the sleep apnea itself.

What Cures Sleep Apnea?

For most people, there is no one cure for Sleep Apnea. The best thing we can do is treat it and stop the symptoms from being a problem. CPAP therapy is a treatment that lessens the impact of the condition, but it is not going to cure the underlying Sleep Apnea. In some patients, there are cures. For some patients with really large tonsils, removing those and the adenoids can reverse Sleep Apnea. For others, it’s due to weight, and weight loss can cure it — but this is rare. For the vast majority, day-to-day management is the only solution.

How Common is Sleep Apnea?

Sleep Apnea is fairly common. In North America, the prevalence is 20 to 30% in males and 10-15% in females. The other thing I like to point out in regards to this is that Obstructive Sleep Apnea is more common in males. However, research suggests that when women reach menopause, their occurrence of OSA is equal to males. When hormones change, and estrogen thins out, that tends to affect muscle tone and can increase the risk of Sleep Apnea, especially if airways are already on the narrow side. These changes mean the airway is just more likely to collapse, causing Sleep Apnea.

What Your Doctor Should Be Asking You if You Think You Have Sleep Apnea?

In a busy world, it’s not unusual to be a bit sleep deprived. If you’re getting over seven hours of sleep most nights and are still feeling sleepy during the day, consider contacting your doctor. Especially if you’re snoring. Consider reviewing this checklist below and bringing to your doctor, to kickoff the conversation.

Sleep Apnea Symptoms Checklist

  • Snoring: A little snoring is a regular part of sleep, but if your snoring is loud (so loud it can be heard in other rooms) and lasts all night long, it may be a sign you have Sleep Apnea.
  • Daytime Drowsiness: Are you exhausted during the day? Do you experience regular fatigue? Do you sometimes doze off while driving or bored?
  • Gasping or Choking During Sleep: Are there parts of the night in which you stop breathing completely? Do you sometimes wake up gasping and choking for breath?
  • High Blood Pressure: Do you have high blood pressure? Is your high blood pressure hard to control?
  • Sleep Restlessness: Is your sleep restless? Do you toss and turn during the night? Do you wake up during sleep frequently?
  • Family History: Do you have family members that have Sleep Apnea? Any parents or close relatives?

Dr. Amie Stringfellow is board certified in Sleep Medicine, Internal Medicine and Pediatrics. Her practice, Milepost Medical, offers “Direct Primary Care” which means she operates on an affordable direct pay model which doesn’t go through insurance. When it comes to treating Sleep Apnea, Doctor Amie said, “I’m both doctor and patient. I actually have Sleep Apnea, and I know exactly what patients go through.”

  • David Repasky

    David Repasky has been using CPAP treatment since 2017 and has first-hand experience with what it's like to live with Sleep Apnea. He brings the patient's perspective to the CPAP.com blog and has received formal training in CPAP machines, masks, and equipment.

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14 Responses

  1. I’m getting use to being on a CPap and am feeling bloated, especially in the morning. How do i get rid of the bloat? Do you have any suggestions? Will this phenomenon continue or subside after getting use to it?

    1. Hi Dawni, bloating is a sign you are swallowing the CPAP air. There is no real medical solution, but we have found that your sleeping position may be a factor. First, try sleeping as flat as possible, even without a pillow. If the bloating persists, try sleeping on your side or elevated. The position must be different from your current posture.

      If changing your position doesn’t resolve the problem, talk to your doctor about the possibility of lowering your pressure a bit. It may let a few apneas through, but the trade-off might be worth it.

  2. I have just been diagnosed with Sleep Apnea. It is around 50 times a night I stop or have interrupted breathing. I never had any problems before joining the Navy and becoming a welder on submarines. I am trying to find a correlation between developing sleep apnea and welding fumes, lead paint, galvanized steel, stainless steel, or anything like this dealing with the military. Do you know of any studies or literature that may assist me in this. I am trying to use my VA benefits and this is an important part in establishing this correlation. Thank you.

    1. Hey Jade,

      I am not certain if there is any direct correlation between developing sleep apnea and any of the items that you mentioned of dealing with in the military. Please see the link below to gain more information regarding possible connections of sleep apnea and the military. You will also find links in the article to other resources that may be of help.


      Please let us know if we can be of further assistance.

    1. Bonjour Abdi, mes sincères excuses, mais nous n’avons pas les articles en français.

      S’il vous plaît voir le lien ci-dessous et vous pouvez traduire l’article de l’anglais au français.


      J’espère que ça aide. S’il vous plaît laissez-nous savoir s’il y a autre chose que nous pouvons vous aider.

    1. Bonjour Abdi, mes excuses mais nous n’avons pas les articles en français. Vous pouvez utiliser le lien ci-dessous pour traduire de l’anglais vers le français.


      J’espère que cela vous aidera, s’il vous plaît laissez-nous savoir s’il y a quelque chose que nous pouvons vous aider.

  3. Lousy service,I have been trying for four months to get my cpap.I go to the doctor,he says He will order something. for meThey only work 9AM-4 PM Mon-Fri to help me. I am a family doctor.i WORK FOR A LIVING 8 AM-5:30 pm PM Mon-Friday. I have been to the “sleep doctor three times” NOTHING GETS DONE.I have to cancel my patients to get help with this? I get a mask and it vents air out of the top.The seal is fine,the venting system is flawed. It is designed to vent out the front at the top of the mask.I go buy another mask by air touch from a dealer who doesn’t take any insurance so I have to pay cash. I get home and am looking forward to finally being able to use my c pap and the hose doesn’t fit to the mask! Why don’t you make the connections for your masks to fit your hose? The connector to the hose doesn’t work.I am having frequency pvc. No wonder my patients don’t want to use cpap. I know how important it is.The frustrating part is the total lack of service.

    1. Hi Dr. Britton,

      I am sorry to hear that you are having some problems with your sleep doctor providing the excellent service that all patients deserve. We understand how frustrating it is in finding a mask that works well for you. We understand the importance of you maintaining your sleep apnea therapy also.

      We recognize that it is not always feasible for someone with sleep apnea to get to their doctor, or medical supplier Mon-Fri during business hours. For this reason we have extended hours during the week from 8am-8pm central. If you would like assistance with selecting a mask that may work for you, we will be more than happy to assist you. Please make note that we do not accept insurance, but you may be able to request a reimbursement for out of pocket expenses from your insurance company.

      As far as the hose not fitting your mask, that is a little abnormal. Most hoses and masks are interchangeable. The end of the hose should be 22mm which is standard. Please make certain that there is not a piece stuck inside of your hose from the previous mask. To check this you can squeeze the ends of the hose that connects to the mask. If the ends to don’t squeeze together, there is a piece stuck inside that you must remove and then try again to connect the mask.

      If you would like assistance from CPAP.com, we will be glad to help you. Please call 1-800-356-5221.

      I hope this information helps, enjoy your day

  4. I have been using CPAP machines for more than 20 years. The DreamStationAuto.since July 2016. Sleep period usually 6 to 8 hours. In 2016 the AHI varied between 20 to 40 and Periodic Breathing (PB) between 20 to 70. In 2017 AHI 2 to 17 and PB 0 to 50. In 2018 AHI 5 to 30 and PB 0 to 30. In 2019 AHI 7 to 24 and PB 0 to 40. The high numbers appear to be related to mental stress. Big change recently: For the last 4 days HOURS shows far less hours than actually in bed with no obvious change in wakefulness or toilet interruptions. For 7 of the last 8 days AHI averaged 12 and PB was 0.
    On one of these recent days there was a message “inlet blocked” but no obstruction was found. Does this recent info suggest that the machine is malfunctioning? Does the general history suggest (beyond that I should relax more before bedtime) that there needs to be any adjustment of settings?

    1. Hi John, i’m sorry to hear that you are having some problems. I would recommend you speaking with your doctor regarding the changes in your AHI and PB. Have you recently had a sleep study? If not, it could be that your settings need to be changed. For the message that you are receiving “inlet blocked” Check air filter(s) are installed properly and are clean; replace if needed.

      If the problem persists, please feel free to reach us at: 1-800-356-5221 and we will be more than happy to assist you.

      Have a great day!

  5. I usually sleep 3-5 hours before bathroom break. My AHI at this time is usually under 3. After I fall back to sleep and awake with about 7 total hours my AHI is often between 5 and 6. Is this a problem.


    1. Hi Bob,
      The goal is to have an AHI under 5, which is normal. Having an AHI between 5 and 6 means mild apnea. Please speak with your doctor, as he/she may need to review your therapy data in detail to determine what’s causing the increase in your AHI after you return from your bathroom break.

      For further questions, or concerns, please feel free to reach us at: 1-800-356-5221, or you may e-mail us at: cpap@cpap.com.

      Have a great day!

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