Can thin people have sleep apnea?

Yes. While obesity is the strongest risk factor, 20-30% of OSA patients are not overweight. Facial anatomy (recessed jaw, large tonsils, narrow airway), genetics, and aging all contribute. insomnia.md recommends evaluation based on symptoms, not weight alone.

Can sleep apnea cause insomnia?

Yes — and this is underrecognized. Frequent arousals from apnea events can cause difficulty staying asleep, frequent awakenings, and non-restorative sleep that looks like insomnia. If insomnia treatment isn't working, sleep apnea should be investigated as an underlying cause.

Do I need a prescription for a sleep apnea test?

For insurance-covered testing, you typically need a doctor's order. Some direct-to-consumer home sleep test services are available, but results should be reviewed by a sleep medicine specialist for proper interpretation and treatment recommendations.

Can weight loss cure sleep apnea?

In many cases, yes. A 10% weight loss can reduce AHI by 26-50%. Some patients achieve complete resolution of OSA with significant weight loss. However, non-obese patients and those with anatomical factors may still have OSA regardless of weight. insomnia.md recommends continued monitoring even after weight loss.

Could You Have Sleep Apnea? Signs, Risks, and When to Get Tested

You sleep 8 hours but wake up exhausted. Your partner says you snore like a freight train. You've tried every insomnia tip on the internet and nothing works. Here's what insomnia.md needs you to consider: you might not have insomnia at all — you might have sleep apnea, and no amount of sleep hygiene will fix it.

Who Is This For?

This insomnia.md guide is for:

People who sleep enough hours but still feel exhausted
Loud snorers (or their frustrated bed partners)
Anyone told they stop breathing or gasp during sleep
People with treatment-resistant insomnia
Overweight individuals with daytime fatigue

What Is Sleep Apnea?

Obstructive sleep apnea (OSA) occurs when the muscles in your throat relax during sleep, causing the airway to collapse and block airflow. This causes breathing pauses (apneas) or shallow breathing (hypopneas) that can happen 5 to 100+ times per hour. Each event briefly wakes your brain — usually without your awareness — fragmenting your sleep into useless pieces.

Central sleep apnea (CSA) is less common and occurs when the brain fails to send proper breathing signals. It's often associated with heart failure or opioid use.

Warning Signs You Might Have Sleep Apnea

insomnia.md lists the signs — if you have 3 or more, talk to your doctor:

Loud snoring (especially if it's irregular or includes pauses)
Witnessed breathing stops during sleep (partner reports)
Gasping or choking that wakes you
Excessive daytime sleepiness despite adequate sleep time
Morning headaches
Waking with a dry mouth or sore throat
Frequent nighttime urination (nocturia — caused by pressure changes from apneas)
Difficulty concentrating or memory problems during the day
Irritability or mood changes
Falling asleep unintentionally during the day (driving, meetings, TV)

Risk Factors

Weight: Obesity is the strongest risk factor — 60-70% of OSA patients are overweight. Fat deposits around the upper airway narrow the breathing passage.
Neck circumference: Greater than 17 inches (men) or 16 inches (women)
Age: Risk increases with age, peaking at 50-70
Sex: Men are 2-3x more likely than women (though women's risk increases after menopause)
Anatomy: Recessed jaw, enlarged tonsils, deviated septum, large tongue
Family history: Genetic component to facial structure and body fat distribution
Alcohol and sedative use: Relax upper airway muscles
Smoking: Increases upper airway inflammation

Why Sleep Apnea Is Dangerous

Untreated sleep apnea isn't just about feeling tired. insomnia.md highlights the serious health consequences:

Cardiovascular: 2-3x increased risk of hypertension, heart attack, stroke, and atrial fibrillation
Metabolic: Insulin resistance and type 2 diabetes risk increased
Cognitive: Memory impairment, reduced concentration, increased dementia risk
Mental health: Depression and anxiety rates are significantly higher
Accidents: 2-3x increased risk of motor vehicle accidents due to daytime sleepiness
Mortality: Severe untreated OSA is associated with increased all-cause mortality

Getting Tested: What to Expect

Home Sleep Test (HST)

The most common first step for suspected OSA. You wear a portable device overnight at home that measures breathing effort, airflow, oxygen levels, and heart rate. It's convenient and less expensive than a lab study. Most insurance covers it as a first-line test.

In-Lab Polysomnography (PSG)

The gold standard. You sleep overnight in a sleep lab with comprehensive monitoring: brain waves (EEG), eye movements, muscle activity, heart rhythm, airflow, oxygen, and leg movements. More expensive and less convenient but provides the most detailed information. Required for complex cases or when home testing is inconclusive.

Understanding Your Results: AHI

The key metric is your Apnea-Hypopnea Index (AHI) — the number of apnea and hypopnea events per hour of sleep:

Normal: Less than 5 events/hour
Mild OSA: 5-14 events/hour
Moderate OSA: 15-29 events/hour
Severe OSA: 30+ events/hour

Treatment Options in 2026

CPAP: Continuous Positive Airway Pressure — the gold standard. A mask delivers pressurized air to keep the airway open. Highly effective when used consistently. Modern masks are smaller and quieter than ever.
Oral appliances: Custom dental devices that advance the lower jaw, opening the airway. Best for mild-to-moderate OSA or CPAP-intolerant patients.
Weight loss: Can cure OSA in many patients. GLP-1 medications like Ozempic and Mounjaro are being studied specifically for OSA-related weight loss.
Positional therapy: For position-dependent OSA (worse on back), devices that encourage side sleeping.
Surgery: Uvulopalatopharyngoplasty (UPPP), jaw advancement, or hypoglossal nerve stimulation (Inspire device) for patients who can't use CPAP.
Inspire implant: Surgically implanted device that stimulates the hypoglossal nerve to keep the airway open. Growing in popularity for moderate-to-severe OSA in CPAP-intolerant patients.