What Is Obstructive Sleep Apnea (OSA)?
Obstructive Sleep Apnea (OSA) is the most common type of sleep-related breathing disorder. It happens when a person’s airflow stops or is greatly reduced during sleep, even though they’re still trying to breathe. This is usually caused by the airway becoming blocked or collapsing temporarily during sleep.
During these episodes, the oxygen level in the blood drops (a condition called “oxygen desaturation”), and the brain briefly wakes the person up to start breathing again. This can happen dozens or even hundreds of times each night, though the person may not remember waking up.
Nighttime Symptoms of OSA:
- Loud, frequent snoring
- Pauses in breathing (witnessed by others), often ending in a gasping or snorting sound
- Difficulty staying asleep (insomnia)
- Restless sleep, with frequent tossing and turning
Daytime Symptoms of OSA:
- Waking up tired despite a full night’s sleep (non-restorative sleep)
- Morning headaches
- Dry or sore throat upon waking
- Feeling unusually sleepy during the day, especially during quiet activities like reading or watching TV
As OSA gets worse, people may feel sleepy during activities that require focus, such as driving or working. Other symptoms can include:
- Fatigue and low energy
- Memory and concentration problems
- Slower thinking and decreased alertness
- Mood changes, including depression or anxiety
- Lower sex drive or sexual dysfunction
- Acid reflux (heartburn)
- High blood pressure (hypertension)
How OSA Develops Over Time:
OSA exists on a spectrum known as the Sleep-Related Breathing Disorder (SRBD) continuum. It often starts with simple snoring, which can worsen gradually, especially when combined with other health conditions like obesity. Over time, the upper airway becomes more resistant to airflow during sleep, leading to increased sleep interruptions and excessive sleepiness.
Types of Sleep Apnea:
- Obstructive Sleep Apnea (OSA): Caused by the airway becoming physically blocked—often by soft tissue in the throat—during sleep.
- Central Sleep Apnea: Happens when the brain doesn’t send the correct signals to the muscles that control breathing. The person may wake up gasping for air but without a physical airway blockage.
- Mixed or Complex Sleep Apnea: A combination of both obstructive and central types.
Although these types are technically different, the term “obstructive sleep apnea” is commonly used in medical practice to refer to all forms. In reality, most cases involve features of both obstructive and central sleep apnea, making nearly all cases “mixed” in nature.
VA Disability Ratings for Sleep Apnea (Code 6847):
| Condition | VA Rating |
| Requires tracheostomy or causes chronic respiratory failure with carbon dioxide retention | 100% |
| Requires use of a breathing device such as a CPAP machine | 50% |
| Persistent daytime sleepiness (hypersomnolence) | 30% |
| Documented sleep-disordered breathing but no current symptoms | 0% |
OSA is listed under ICD-9-CM code 327.23. It is considered a serious but treatable condition. Many people with OSA experience significant improvements with proper treatment, such as using a CPAP (continuous positive airway pressure) machine at night to keep the airway open.