Should You Treat Mild Obstructive Sleep Apnea?

Obstructive sleep apnea (OSA) is typically measured on a scale called the apnea-hypopnea index (AHI), which determines how many times you stop breathing (apnea) and how often your breathing is significantly reduced (hypopnea) during a sleep study.

If you fall on the mild end of that spectrum, you might be wondering if you need treatment at all, especially because the usual treatment — a continuous positive airway pressure (CPAP) machine — can be more than a little cumbersome. Here’s what you need to know, including which treatment may be best for you.

When determining if you need treatment, your doctor will look at more than your AHI score, because it may not accurately reflect the symptoms you have.

“If you have mild sleep apnea, it doesn’t mean you have mild symptoms. And if you have severe sleep apnea, you may not have severe symptoms,” says Shannon Sullivan, MD, a sleep specialist and clinical professor of pulmonary medicine at Stanford University School of Medicine in California.

If you have mild OSA and are regularly waking up feeling tired, experiencing brain fog, or waking up a lot during the night, you’re likely a good candidate for treatment — even if you have a mild AHI score.

“Understanding what the symptoms are and what the patient’s going through is more critical than trying to decide [on treatment] just by a number,” says Monica Mallampalli, PhD, president and CEO of the Alliance of Sleep Apnea Partners in Ellicott City, Maryland.

Whichever treatment approach you end up taking, “You can see great symptomatic benefit from treating mild sleep apnea,” says Dr. Sullivan. It’s also possible that if you don’t treat mild sleep apnea, symptoms could get worse, she adds. If you have only mild sleep apnea now, it’s worth keeping a careful log of symptoms over time, so you’ll be aware if any of them start to worsen, says Dr. Mallampalli.

You may also be able to improve symptoms with some lifestyle tweaks.

Losing weight if you are carrying extra pounds is one of the most effective ways to manage mild sleep apnea and prevent it from getting worse, says Mallampalli. Try eating a healthier diet and exercising more to work toward this goal.

Take stock of your sleep hygiene habits, too. Because sleep apnea is an issue of sleep quality, “You want to make sure that you’re not also layering on top of that a problem with quantity, schedule, or regularity,” says Sullivan. Make sure you’re getting the recommended seven to nine hours of sleep a night, and try to keep your bedtime and wake-up time consistent, even on the weekends, she adds.

Ultimately, you and your healthcare provider might decide you don’t need to treat mild sleep apnea yet if symptoms aren’t disruptive to your daily life. If that’s the case — or even if you’re simply starting with some changes to your sleep and weight-management habits — you should plan to check in with your doctor again in the near future.

“Whenever I’m seeing a patient, I want to have that follow-up plan for when I am going to see them next, what we are going to talk about, and … if it doesn’t go well, what’s our next step,” says Sullivan.

• Even mild obstructive sleep apnea can cause disruptive symptoms, such as brain fog and fatigue, which may benefit from treatment.
• Untreated mild OSA may raise the risk for other health conditions and worsen sleep apnea.
• Treatment for mild OSA can include CPAP therapy, an oral appliance, and other changes, such as improving sleep habits and losing weight.