Can Sleep Apnea Kill You?

Many people wonder if sleep apnea is deadly. Having short pauses in breathing during sleep will probably not be a direct cause of death. But it can increase your chances of dying from other serious conditions. Sleep apnea worsens high blood pressure, heart disease, and diabetes. 

Nearly 30 million people in the U.S. struggle with sleep apnea And this large number doesn’t include those who don’t get diagnosed. Sleep apnea doesn’t just disrupt your sleep (and that of those around you): It’s a serious sleep disorder. And, without treatment, the consequences can be deadly.

What is sleep apnea?

Sleep apnea is a condition where you stop breathing many times throughout the night. It can be caused by something blocking your airflow. Or there may be something wrong with your reflex to breathe. 

There are three types of sleep apnea:

1. Central: The brain fails to send signals to the muscles that control breathing.

2. Obstructive: Soft tissues of the neck or throat block the airway. This is the most common form.

3. Complex: This is a combination of central and obstructive sleep apnea.

With sleep apnea, your breathing stops and starts as many as 400 times a night. This deprives the body of the oxygen it needs to function at its best. Those repeated stops and starts can also take a toll on your personal and work life.

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If you routinely wake up feeling groggy, even after 7 to 9 hours of sleep, sleep apnea may be to blame. Other signs and symptoms to watch for are:

• Excessive daytime tiredness 

• Poor concentration

• Irritability 

• Fogginess or change in memory

• Morning headache

• Loud snoring

• Gasping for air while asleep

• Unrefreshing sleep 

Who is at risk for obstructive sleep apnea?

No one is completely protected from having sleep apnea. It affects people of all ages and sizes. It’s a myth that adults with larger bodies are the only ones it affects. People whose weight is within a comfortable range as well as children can have sleep apnea too. 

Classic risk factors of sleep apnea include:

• Larger body size: Having a larger body size can cause more fat along the upper airway and narrow the opening. This is an issue in about 70% of adults with sleep apnea. 

• Larger neck size: Do your shirts fit snugly around the neck? A larger neck size is associated with increased tissue at the base of the tongue and upper airway. This can block air flow.

• Enlarged tonsils: Large tonsil tissue at the back of the throat can obstruct the windpipe. And large adenoids (at the back of the nose) can narrow the nasal passage. Both can make breathing a chore.

• Chronic nasal congestion: This is often worse at night and may make it harder to breathe.

• Alcohol: This can lead to a loss of tone in the muscles of the tongue and airway, causing them to block air movement.

• Menopause: Once menopause starts, the drop in progesterone may cause the muscles of the tongue to relax. Also, there tends to be an increase in weight in this group.

• Smoking: Irritants in cigarette smoke can cause swelling in the nasal cavity and throat. This can restrict the airway.

• Genetics: Your genetic makeup accounts for nearly 40% of sleep apnea cases. Physical features, like the shape of your jaw and airway, make you more likely to inherit sleep apnea.

• Age: Older age is associated with increased sleep apnea for both men and women. Sleep apnea places an older individual at greater risk of cognitive impairment.

• Low oxygen levels: Low oxygen levels in the blood (hypoxia) can be a result of sleep apnea. Repeat episodes of hypoxia can lead to cardiovascular problems.

What are the dangers of untreated sleep apnea?

Sleep apnea can be dangerous, and you shouldn't take it lightly. Disordered breathing can have multiple effects on the body. The lack of oxygen leads to metabolic changes, frequent awakenings, and sleep deprivation. As a result, you can have complications such as:

• Accidents and injuries: Sleep deprivation can impair thinking, judgment, and safety. Estimates suggest it’s a factor in 100,000 car accidents each year.

• Type 2 diabetes: Sleep apnea increases insulin resistance and changes the breakdown of sugar in the body.

• High blood pressure: The drops in oxygen when your breathing stops can raise your blood pressure. 

• Weight gain: Levels of the hormone ghrelin increase when you don’t get enough sleep. This can make you feel hungry.

• Depression: Chronic sleep deprivation and a lack of oxygen can increase the stress response in the body. This can compromise your mental health. 

• Heart attack: The heart is under constant stress due to the varying oxygen levels. This can damage the lining of the blood vessels and lead to heart rhythm problems. 

• Stroke: Repeat periods of low oxygen can cause increased inflammation and high blood pressure. This leads to decreased blood flow and can harm the brain.

• Weakened immune function: Without adequate sleep and rest, the body has trouble making antibodies and cells to fight infections.

• Respiratory failure: People with sleep apnea are more likely to suffer from respiratory failure (elevated carbon dioxide, low oxygen levels), especially when using alcohol or sedatives. 

How do you diagnose sleep apnea?

The best way to diagnose sleep apnea is through an overnight sleep study. During this test, you're connected to a device that monitors your breathing, vital signs, and movements while you sleep. Sleep studies usually take place in a sleep lab, but you can also do one at home. You and your sleep specialist can decide on the best location.

How do you treat sleep apnea?

Sleep apnea is a lifelong condition. But ongoing therapy can greatly improve symptoms. Nevertheless, in most cases, there isn’t a permanent fix. Treatment for sleep apnea combines lifestyle changes and medical therapies. These can include:

• Weight loss

• Balanced nutrition

• Quitting smoking

• Changes in your sleep position, like sleeping on your side instead of your back

• Continuous positive airway pressure (CPAP) machine (delivers air through a mask to keep your airway open overnight)

• Surgery to remove soft tissue from the palate, the uvula, tonsils, and/or adenoids

• Medications to reduce symptoms

Can sleep apnea cause sudden cardiac death?

Sleep apnea is associated with a greater risk of sudden cardiac death. The longer a person has sleep apnea, and the more severe it is, the greater the risk of sudden death. 

The relationship between sleep apnea and sudden cardiac death is complex. Researchers don’t have evidence that sleep apnea directly causes sudden cardiac death. So it’s not clear how it increases the risk. Experts think it’s related to how sleep apnea causes:

• Low blood oxygen levels

• Metabolic changes

• Electrical changes in the heart (arrhythmias)

• Hemodynamic changes (altered blood flow throughout the body)

Why trust our experts?

Written by:

Bernadette Anderson, MD, MPH

A native of Saginaw, Michigan, Dr. Bernadette earned an undergraduate degree in psychology from the University of Michigan, Ann Arbor. She completed a master's degree in public health at the University of California, Berkeley, and a doctorate of medicine from the Medical College of Ohio.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Frank Schwalbe, MD

Frank Schwalbe, MD, is an assistant professor of anesthesiology at the Yale School of Medicine. He has practiced anesthesiology for 30 years.

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