Obstructive sleep apnea happens when something blocks the airway during sleep. NHLBI says it is caused by conditions that block airflow through the upper airway while you sleep, for example when the tongue falls backward (NHLBI). Several things raise the chance of this: age, being male, extra weight and fat around the neck, family history, the shape of your jaw and airway, alcohol and smoking. Some of these you can change, and some you cannot. This guide explains the causes, how common sleep apnea is and what you can do to lower your risk. It is for education only and does not replace a doctor.
Worried about your own risk? Try the sleep apnea risk calculator, or read sleep apnea screening tests.
What Causes Sleep Apnea?
When you fall asleep, the muscles in the back of your throat relax, which leaves less space for air to pass through. Snoring can result, and in sleep apnea the airway narrows or closes so far that breathing stops and starts (Sleep Foundation). The NHS says the airways become too narrow while you sleep (NHS), and MedlinePlus describes the airway as collapsing or becoming blocked (MedlinePlus). Obstructive sleep apnea is the most common type (NHLBI). For the full picture of symptoms and treatment, see sleep apnea.
Sleep Apnea Risk Factors
Risk factors are things that make sleep apnea more likely. They are not a diagnosis, and having one does not mean you have it. The NHS links sleep apnoea to obesity, a large neck, older age, family members with the condition, alcohol, smoking, large tonsils or adenoids, sleeping on your back and COPD (NHS). The table below sorts the main ones by whether you can change them.
| Risk Factor | What Sources Say | Can You Change It? |
|---|---|---|
| Age | Risk rises with age, as fatty tissue may build up in the neck and tongue (NHLBI). It rises until the 60s and 70s (Sleep Foundation). | No |
| Sex | More common in men. Men also tend to have more serious cases and be diagnosed younger (NHLBI). | No |
| Family history and genes | Genes shape the skull, face and airway. Close relatives with sleep apnea raise your risk a lot (NHLBI, Sleep Foundation). | No |
| Airway shape | Large tonsils, a large neck or tongue, or a shorter lower jaw can narrow the airway (NHLBI, Sleep Foundation). | Sometimes, by medical treatment |
| Extra weight | Fat deposits in the neck can block the airway (NHLBI). | Often |
| Alcohol | It relaxes the muscles of the mouth and throat (NHLBI). | Yes |
| Smoking | It causes inflammation in the upper airway (NHLBI). | Yes |
| Some health conditions | Low thyroid hormone, polycystic ovary syndrome, and heart or kidney failure are linked to higher risk (NHLBI). COPD is also listed (NHS). | Managed with a doctor |
Risk Factors You Cannot Change
NHLBI says age and family history cannot be changed (NHLBI). The Sleep Foundation adds sex, genetics and anatomy (Sleep Foundation). If several of these apply to you, it does not mean you will get sleep apnea. It means you should pay closer attention to symptoms such as loud snoring, gasping and daytime sleepiness. Read obstructive sleep apnea symptoms for what to look for.
Is Sleep Apnea Genetic?
Partly. NHLBI says genes can shape the skull, face and airway, and the Sleep Foundation says having close relatives with obstructive sleep apnea raises your risk significantly (NHLBI, Sleep Foundation). The Cleveland Clinic adds that a family history of heart conditions, stroke or high blood pressure also matters (Cleveland Clinic).
Risk Factors You Can Change
Weight, alcohol, smoking and managing medical conditions are the main ones (NHLBI). The Sleep Foundation says weight loss can sometimes eliminate obstructive sleep apnea symptoms, and that cutting back on alcohol may help. It also says avoiding sleeping on your back may help some people, but that this has not been rigorously studied (Sleep Foundation). The NHS warns against taking sleeping pills unless a doctor recommends them, because they can make sleep apnoea worse (NHS). The link with weight is explained in sleep apnea and weight gain, and alcohol is covered in alcohol and sleep.
How Common Is Sleep Apnea?
A long-running Wisconsin study estimated how many adults have moderate to severe sleep-disordered breathing, defined as 15 or more breathing events an hour. Among men, about 10 percent of those aged 30 to 49 and 17 percent of those aged 50 to 70 were affected. Among women, it was about 3 percent and 9 percent (Peppard et al. 2013). The Sleep Foundation estimates 30 million adults in the United States have sleep apnea (Sleep Foundation). Cleveland Clinic says about 1 billion people aged 30 to 69 worldwide have obstructive sleep apnea, and that central sleep apnea is less common but not rare (Cleveland Clinic). Many people have it and do not know, which is why screening matters. See sleep apnea screening tests.
Can Thin People Get Sleep Apnea?
Yes. Cleveland Clinic says anyone of any body size can develop sleep apnea (Cleveland Clinic). Jaw shape, tonsils, genes and age all play a part, so do not rule it out because you are slim.
What Causes Central Sleep Apnea?
This type is different. NHLBI says central sleep apnea is caused by problems with the way the brain controls breathing during sleep. Heart failure, stroke, ALS, myasthenia gravis, opioid use and genetic conditions can cause it, and premature babies have a higher risk that usually falls as they grow (NHLBI). The Sleep Foundation adds high altitude (Sleep Foundation). It needs a doctor’s diagnosis.
What About Children?
Children can have it too. MedlinePlus says children with enlarged tonsils or adenoids may get sleep apnea (MedlinePlus), and the Sleep Foundation says about 1 to 5 percent of children have obstructive sleep apnea (Sleep Foundation). Talk to your child’s doctor about loud snoring or breathing pauses.
How To Lower Your Risk Of Sleep Apnea
You cannot prevent every cause, and there is no guarantee. Cleveland Clinic says you can lower your risk by keeping a healthy weight, eating well, staying active, keeping good sleep habits, managing cholesterol, blood pressure and type 2 diabetes, and avoiding smoking and alcohol (Cleveland Clinic). NHLBI says maintaining a healthy weight can help prevent or treat sleep apnea caused by obesity (NHLBI). The NHS also suggests exercising, sleeping on your side and limiting alcohol, especially near bedtime (NHS). Good habits are covered in sleep hygiene 101.
When To See A Doctor
The NHS says to see a GP if your breathing stops and starts in your sleep, you gasp, snort or choke, or you are very tired in the day. Ask someone who has seen your symptoms to come with you, because sleep apnoea can be serious if it is not diagnosed and treated (NHS). NHLBI gives similar advice (NHLBI). A doctor may suggest a home sleep apnea test or a sleep study. Learn more in when to see a sleep specialist and sleep apnea health risks.
Quick Takeaways
- Sleep apnea is usually caused by the airway narrowing or closing during sleep.
- Age, sex, family history and airway shape cannot be changed.
- Weight, alcohol, smoking and other health conditions can be managed.
- Any body size can have sleep apnea.
- You can lower your risk, but you cannot guarantee you will avoid it.
FAQs About Sleep Apnea Causes
Does Drinking Alcohol Make Sleep Apnea Worse?
Does Smoking Cause Sleep Apnea?
Why Is Sleep Apnea More Common In Men?
Sources agree that it is, and that men tend to have more serious cases and be diagnosed younger (NHLBI). The sources I could open do not give a single reason. Risk in women also rises with age.
Can Losing Weight Cure Sleep Apnea?
For some people, yes. The Sleep Foundation says weight loss can sometimes eliminate obstructive sleep apnea symptoms, but results vary, so ask your doctor (Sleep Foundation).
Can Sleeping Pills Make Sleep Apnea Worse?
The NHS says not to take sleeping pills unless a doctor recommends them, because they can make sleep apnoea worse (NHS).