“Sleep apnea and death are directly related,” Chad Denman, D.M.D. and Sleep Specialist at Sleep Cycle Center, tells WebMD Connect to Care.
Can You Die From Sleep Apnea?
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If you or a loved one has recently been diagnosed with sleep apnea, you may have a lot of questions. In particular, you may be wondering why doctors emphasize the importance of treatment. You may even be curious about what can happen if sleep apnea goes untreated, or if sleep apnea can cause death.
Sleep apnea can cause health problems, and left unaddressed, can contribute to the risk of sudden death. Fortunately, sleep apnea treatment may reduce the risk of many of these complications. Learn about the signs, symptoms, and consequences of untreated sleep apnea so you can be equipped to handle any sleep apnea concerns that come your way.
Is Sleep Apnea Dangerous?
Untreated sleep apnea is associated with several health conditions, and some of these can become serious enough to lead to death. In people with sleep apnea, breathing is temporarily restricted or stopped during sleep, which can cause the level of oxygen in the blood to go down and the level of carbon dioxide to rise. This usually causes the sleeper to wake up in order to breathe. But these frequent and chronic nighttime breathing disruptions also contribute to the development of health problems. Experts believe that repeated airway obstruction during sleep can contribute to chronic health conditions like diabetes and insulin resistance, changes in blood vessels, stroke, heart failure, abnormal heart rhythms, and even cognitive impairment.
What Are the Risks of Untreated Sleep Apnea?
The risks of untreated sleep apnea depend on the type of sleep apnea diagnosed. Nighttime breathing issues are most often caused by partial or complete collapse of the airway, called obstructive sleep apnea. Breathing issues are less commonly caused by the body’s inability to initiate breathing, which is called central sleep apnea.
Experts believe that untreated obstructive sleep apnea can contribute to or worsen several health issues.
- High blood pressure: Researchers believe that obstructive sleep apnea can worsen high blood pressure. Some reasons behind this include low oxygen levels at night, changes in hormones, and an activated nervous system.
- Diabetes and insulin resistance: People with obstructive sleep apnea are at an increased risk for developing diabetes. This is tied to an increased risk of insulin resistance. Insulin resistance means that the body doesn’t respond normally to insulin, a hormone that helps the body to use blood sugar.
- Pulmonary hypertension: Over time, breathing disruptions can change the structure of the blood vessels in the lungs and contribute to pulmonary hypertension. Pulmonary hypertension is a condition in which blood pressure is too high in the arteries between the heart and lungs.
- Stroke: Untreated obstructive sleep apnea also increases the chances of stroke. This risk may be due to the effects of obstructive sleep apnea on existing risk factors for stroke, like high blood pressure and heart disease, or because of changes in blood pressure to the brain.
- Abnormal heart rhythms: Also known as heart arrhythmias, abnormal heart rhythms can be a result of the low oxygen levels that happen in people with sleep apnea. Experts believe that heart arrhythmias may be one of the main reasons behind sudden death in those with sleep apnea.
Untreated obstructive sleep apnea can also lead to other complications, including problems with concentration and decision making and an increased risk of errors and accidents. Without treatment, sleep apnea can also worsen mood and impair memory.
Can Sleep Apnea Cause Death Suddenly During Sleep?
Obstructive sleep apnea does increase the risk of sudden cardiac death, which describes when a person dies because their heart abruptly stops or isn’t able to support life. Research shows that sudden death is more common in people with obstructive sleep apnea who are also older than age 60, have more severe apnea, or have very low oxygen levels.
Although rare, death can occur because a person’s breathing doesn’t restart after a brief pause due to sleep apnea. More commonly though, researchers believe that sudden cardiac death is linked to shared risk factors between obstructive sleep apnea and sudden cardiac death, like heart disease and high blood pressure, or due to irregular heart rhythms or other factors.
Knowing the signs and symptoms of sleep apnea can help people know when to contact their doctor and get evaluated for this condition. Treatments for obstructive sleep apnea can improve nighttime oxygen levels, lower the risk of chronic disease, and reduce the chances of serious complications.
Signs of Sleep Apnea
The main signs of sleep apnea are disruptions in breathing during sleep. Often, a bed partner is the first to notice abnormal breathing, frequent loud snoring, or gasping for air during the night.
Additional signs and symptoms of obstructive sleep apnea include:
- Waking up gasping for air or choking
- Making unusual sounds while sleeping
- Having frequent daytime fatigue
- Waking up unrefreshed
- Falling asleep during daytime tasks
- Experiencing morning headaches
- Tossing and turning during sleep
- Having mood swings
- Difficulty concentration during the day
- Urinating frequently during the night
The signs and symptoms of central sleep apnea are similar to obstructive sleep apnea symptoms. However, people with central sleep apnea may not report daytime sleepiness as often as those with obstructive sleep apnea.
When to See a Doctor
If you have signs or symptoms of sleep apnea, such as not feeling rested in the morning or having frequent daytime fatigue, then it is important to talk to your doctor about sleep apnea. Prompt treatment for sleep apnea can be an important part of preventing chronic disease and other complications.
To diagnose sleep apnea, your doctor may order a sleep study. Some sleep studies are done at a specialized sleep center in a clinic or hospital, but others can be done at home using portable equipment.
During a sleep study, a health care provider will monitor brain signals as you sleep. In addition, your provider will monitor for any changes in heart rate or breathing, and the test will record if and when your breathing is restricted.
If the sleep study finds that your breathing is frequently disrupted during the test, you may be diagnosed with sleep apnea. Your doctor may then recommend various treatments to help improve your breathing and reduce the risk of complications.
Treatment Options for Sleep Apnea
Treatments for sleep apnea depend on several factors, such as the severity of your symptoms, the type of sleep apnea that you have, and how well you can tolerate each therapy. There are several treatments available for sleep apnea.
- Behavioral changes: Obstructive sleep apnea is commonly related to higher body weight. Thus, sometimes lowering body weight can help reduce symptoms. In addition, doctors may recommend avoiding alcohol and other sedatives, as these can also worsen the severity of sleep apnea.
- Changes in sleep position: During a sleep study, a health care provider may notice that symptoms worsen when you sleep in a certain position, most often on the back. In these cases, doctors may recommend sleeping on your side to help reduce symptoms.
- Positive pressure airway therapy: Positive pressure airway therapy is a common treatment for sleep apnea. This treatment uses a special mask that directs pressurized air into the airway to keep it open during sleep, improve breathing, and normalize nighttime oxygen levels.
- Oral appliances: Removing obstructions to airflow, like the soft palate or tongue, can be done with special oral devices. Therefore, your doctor may recommend trying one if you have obstructive sleep apnea, especially if you are unable to tolerate other therapies.
- Upper airway surgery: Usually, surgery is reserved for people with obstructive sleep apnea who do not respond to other treatments. There are many types of surgeries that can help people with obstructive sleep apnea, so this is something to keep in mind if other treatments are not working as well as desired.
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Can You Die From Sleep Apnea?
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Sleep apnea refers to several sleep disorders in which people have reduced or paused breathing during sleep. These repeated breathing disruptions can reduce sleep quality and contribute to serious health complications. Although treatment often resolves health risks tied to sleep apnea, if left unaddressed sleep apnea can be a life-threatening problem.
Learning about sleep apnea, as well as its potential effects on health and the benefits of treatment, can help people with sleep apnea understand this sleep disorder and how to work with their doctor to treat it most effectively.
Is Obstructive Sleep Apnea Linked to a Higher Risk of Death?
Obstructive sleep apnea (OSA) is the most common type of sleep apnea and affects between 10% and 30% Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. See Full Reference of American adults. Multiple research studies have shown that people with OSA have a higher risk of all-cause mortality, which means that they are more likely to die of any cause when compared to people who do not have OSA. Untreated OSA has also been linked to an increased risk of death Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. See Full Reference from cardiovascular problems.
Research suggests that the risk of mortality in people with sleep apnea may be linked to the severity of their breathing disruptions. Doctors classify the severity of OSA based on a person’s symptoms and their apnea-hypopnea index (AHI), which is calculated based on the number of breathing disruptions that occur during sleep. The risk of all-cause mortality has been found to be higher in people with more severe OSA Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. See Full Reference .
Complications From Untreated Obstructive Sleep Apnea
Obstructive sleep apnea occurs when the upper airway becomes blocked by tissues in the mouth and throat. Obstructions to breathing can negatively affect health by influencing a person’s risk of several complications.
- Accidents: People with OSA get lower quality sleep, leading to daytime sleepiness and lack of concentration that makes them prone to accidents. Drowsy driving is more common in people with OSA, which can make potentially fatal car crashes more likely.
- Cardiovascular disease: The effects of OSA on the body are often seen in the cardiovascular system. For example, people with untreated OSA have been found to be more likely to have an abnormal heart rate, high blood pressure, heart attack, stroke, heart disease, and pulmonary hypertension.
- Type 2 diabetes: OSA can disrupt how the body manages blood sugar levels, raising the risk of type 2 diabetes, a condition that can cause a wide range of further health problems.
- Problems after surgery: People with OSA are more likely to have unintended postoperative side effects, including complications that can be life-threatening.
- Liver disease: Rates of nonalcoholic fatty liver disease are as many as three times as high in people with OSA. While not always linked to complications Trusted SourceMedline Plus MedlinePlus is an online health information resource for patients and their families and friends. See Full Reference , this condition can cause liver damage, liver cancer, and ultimately liver failure.
Can You Die in Your Sleep From Obstructive Sleep Apnea?
Although uncommon, it is possible to die during sleep from untreated obstructive sleep apnea. Observational research has found that OSA increases a person’s risk of sudden death. This risk is believed to be higher in people of older age, in people with a critical illness, and in people with severe OSA.
Most of the time pauses in breathing from obstructive sleep apnea are just temporary. When changes in respiration cause oxygen levels to drop, a person partially awakens in order to restore breathing. However, there are rare reports of people dying because of an inability to properly reinitiate breathing.
When OSA is not treated, it can also interfere with the normal functions of the cardiovascular and nervous systems. This may provoke abnormalities in a person’s heart rhythms and other problems that can cause sudden cardiac death.
Can Treatment Reduce Complications of Obstructive Sleep Apnea?
Treatment can often eliminate or decrease the disruptions to breathing and sleep that are associated with obstructive sleep apnea. As a result, people who are effectively treated for OSA can avoid the heightened risk of complications and death linked to untreated OSA.
As an initial treatment of OSA, doctors often prescribed the use of a continuous positive airway pressure (CPAP) machine. A CPAP device sends pressurized air through a hose and mask to keep the upper airway open during sleep.
A study involving over 88,000 people Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. See Full Reference compared health outcomes in people with OSA who started and continued using a CPAP machine versus people who started with a CPAP device but then stopped using it. Ongoing use of the CPAP device was associated with a significant decrease in the risk of all-cause mortality.
In the same study, the benefits of CPAP therapy were seen at follow-up after one year and after three years. Other research over a period of up to seven years also found a lower risk of death in people with OSA who regularly used a CPAP machine.
In order to effectively treat OSA with CPAP therapy, it is important to use the CPAP regularly. In general, this means wearing the CPAP for at least four hours per night on five or more nights of the week. Doctors and sleep specialists can work with people having difficulties tolerating CPAP by modifying the settings and accessories for CPAP therapy.
Central Sleep Apnea and the Risk of Death
Central sleep apnea (CSA) is much less common than OSA, and there are fewer studies about its effect on the risk of death. CSA involves an inability of the brain and respiratory muscles to properly regulate breathing and is frequently linked to underlying health problems Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. See Full Reference , such as heart failure, that may affect a person’s expected lifespan.
In people with heart failure, having severe CSA has been linked to a higher risk of death Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. See Full Reference . The risk of sudden death may be higher in people with severe CSA and heart failure because of the way that CSA can interfere with cardiovascular function.
For some people, treating the underlying cause of CSA can reduce or resolve breathing problems during sleep. Reestablishing normal breathing patterns may help enhance sleep quality and reduce other symptoms and complications of CSA.
Signs You May Have Sleep Apnea
Recognizing the signs of sleep apnea can help people know when to contact their doctor. Some of the most common signs and symptoms of sleep apnea include:
- Excessive daytime sleepiness, including falling asleep during times when it is normal to be awake
- Frequent snoring that is very loud
- Irregular breathing, including gasping or choking, during sleep
- Morning headaches
- Waking up with a sore throat or dry mouth
- Struggling with concentration or memory during the day
- Feeling unrefreshed despite sleeping for seven hours or more
Symptoms like snoring and restless sleep occur while a person is asleep, so people with sleep apnea may not be aware of their nighttime breathing issues. They may only learn of a potential problem when a bed partner, roommate, or family member tells them.
It is important to remember that it is not possible to diagnose sleep apnea based only on a person’s symptoms. Symptoms of sleep apnea can also be caused by other health issues, so diagnostic testing is required to determine if a person’s symptoms are caused by sleep apnea.
When to Seek Medical Advice
People with symptoms of sleep apnea, such as loud snoring, gasping during sleep, or excessive daytime sleepiness, should talk with their primary care doctor. The doctor can review their symptoms, sleep patterns, and overall health and recommend testing with a sleep study if necessary.
People who have already been diagnosed with sleep apnea should talk with their doctor or a sleep specialist if they have problems sticking with their treatment, have unwanted side effects of treatment, or find that treatment is not reducing their symptoms.
While untreated sleep apnea is associated with potentially life-threatening complications, working with a medical professional and closely following treatment recommendations can resolve many of these health risks.
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Can You Die From Sleep Apnea?
Some symptoms of sleep apnea like snoring and daytime fatigue can seem minor, but it’s important to be aware that the disorder increases your risk of death.
Sleep apnea can cause health problems with your heart, lungs, and even your brain. Any of these problems can be cause for concern, but there is another potential problem that can result from sleep apnea: Death. Here’s what you need to know about the mortality risks associated with sleep apnea.
Can sleep apnea cause death?
“Sleep apnea and death are directly related,” Chad Denman, D.M.D. and Sleep Specialist at Sleep Cycle Center, tells WebMD Connect to Care.
One way sleep apnea can affect mortality is through complications. “People who struggle with obstructive sleep apnea have a 30% higher risk of heart attack or premature death, with the mortality rate peaking around age 55,” Denman says.
Apneic episodes resulting from disorder can also contribute to mortality risk. “Sleep apnea can directly cause death by a person’s breathing being infrequent enough to create immediate tissue ischemia (tissue death from lack of oxygen) in the heart and/or brain, resulting in a fatal heart attack or stroke,” Jenna Liphart Rhoads, R.N., Ph.D., and Nurse Educator at NurseTogether, tells WebMD Connect to Care.
“Sleep apnea is related to a host of other medical conditions, like heart disease, thyroid disease, hypertension, and type 2 diabetes. All of these medical conditions can cause death, so a patient suffering from sleep apnea can die as a direct result of sleep apnea (not breathing) or indirectly through a variety of medical conditions,” Denman explains.
Cleveland Clinic notes that sleep apnea can also cause sudden cardiac arrest: the instantaneous and complete stoppage of your heart. Sudden cardiac arrest results in death within minutes in the absence of intervention—which is unlikely to be administered if you are asleep and no one is aware that your heart has stopped.
Researchers have observed that sleep apnea results in numerous stressors on the heart. They theorize that sudden cardiac death with sleep apnea could be rooted in irregular heart rhythms resulting from these stressors, which include:
- Activation of the fight-or-flight response
- Lowered oxygen levels
- Pressure changes in the chest due to upper airway obstruction
Fortunately, evidence shows that successful treatment of sleep apnea can reduce mortality risks. A 2020 study published by ERJ Open Research tracked a cohort of obstructive sleep apnea patients for 30 years and found that long-term treatment with CPAP (continuous positive airway pressure) therapy reduced mortality while also decreasing the occurrence of type 2 diabetes and cardiovascular disease.
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