You might already know what sleep apnea is—a sudden cessation of breathing during sleep, often intermingled with loud snoring. But what causes sleep apnea?

The answer to this depends on the type.

Central Sleep Apnea

In “central sleep apnea” (CSA), the problem lies in the brain. The part of the brain that controls unconscious, automatic breathing, the brainstem, is damaged somehow or affected by some other health problem.

According to The Mayo Clinic, this type of sleep apnea is relatively uncommon, accounting for about 5% of sleep apnea cases. Within central sleep apnea, though, there are many different subtypes.

Types of Central Sleep Apnea

CSA sleep apnea causes can include:

  • medical condition induced apnea: occurs because of general damage in the brainstem
  • substance induced apnea: can occur with medication or opioid abuse
  • Cheyne-Stokes respiration: irregular breathing, occurring due to heart failure
  • high-altitude periodic breathing: irregular breathing, because of very thin air
  • idiopathic central sleep apnea: cause unknown

Obstructive Sleep Apnea

Most sleep apnea causes can be traced to an airway obstruction of some type, hence the name “obstructive sleep apnea” (or OSA).

What Sort of Obstructions?

The word “obstruction” might conjure up images of benign tumors (or freakishly large tonsiloliths, for the hypochondriacs among us) and a conviction that “I must need surgery!”

But this is normally not the case. As this animation at the National Heart Lung and Blood Institute shows, these obstructions are generally caused by healthy tissue—just too much of it.

Fat

A lot of sleep apnea is due to excess weight or a large neck size. Extra weight carried around the neck causes flesh to not only push out, but also in, potentially constricting the airway. Weight loss, in addition to its other benefits, may ease or eliminate OSA.

Large Tonsils, Tongue, or Uvula

The loud snoring of OSA is caused by the vibration of narrowed tissues in the airway, such as the back of the tongue against the soft palate. If the tongue or tonsils are unusually large, your airway may be narrow to begin with, no matter how fit and slender you are.

People who suffer from OSA caused be something like this might be the best candidates for a tonsillectomy, but surgery is generally considered by the National Sleep Foundation to be a second-line defense.

Jaw Angle

If you have an overbite, small jaw, or recessed chin, the way your jawbone is naturally set might also make your airway unusually narrow. Corrective devices that encourage proper alignment of the jaw during sleep might be beneficial.

Smoking and Alcohol Use

Smoking causes the upper airway to swell, and alcohol use causes the same area to unusually relax. Happily, quitting smoking and reducing drinking don’t come with the price tag of a corrective device or surgery, and even better, are likely to free up some of your finances.

Think of that—a cure that will give you money instead of cost money. How can you say no?

But You Still Might Not Have It!

However, none of the conditions listed above necessarily guarantees that you have or will have sleep apnea. If you’re an overweight smoker with a small jaw and monster tonsils, and have always slept silently and soundly, you’re probably off the hook—when it comes to sleep apnea, anyway!