What Makes Sleep Apnea Worse? 8 Things to Watch Out For

by | Last updated Mar 29, 2022

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If you or someone you know has sleep apnea, then you know the serious health implications and how hard it can be to get a good night’s sleep when your oxygen supply is impaired and you struggle to breathe.

40 percent of Americans snore and 80 percent of those people have obstructive sleep apnea. Unfortunately, sleep apnea is still a very underdiagnosed sleep disorder. So if you have sleep apnea and you don’t know it, you may inadvertently be doing things that make your sleep apnea symptoms worse!

Some of these factors may even surprise you. We’re sharing eight factors you should be aware of or avoid if you have sleep apnea. 

For those of you who haven’t been diagnosed, but suspect you have sleep apnea you can read more about what it is and how it’s measured. Everyone else can skip ahead to 8 Factors That Can Make Sleep Apnea Worse

What is Sleep Apnea?

If you’re unsure if you have sleep apnea, it’s important to know what it is and seek diagnosis and treatment. If you’re in Tennessee, we offer complimentary consultation and evaluation for in-home testing.

Sleep apnea is a serious sleep disorder characterized by breathing cessation or an obstructed airway during sleep. The most recognized symptoms include loud snoring, gasping, or choking during sleep, as well as daytime sleepiness the following day— even if you think you got a full night’s rest.

There are three main types of sleep apnea:

  • Obstructive sleep apnea: The most common form of sleep apnea, where your airways become partially or fully obstructed.
  • Central sleep apnea: When your brain doesn’t properly signal the muscles that control your breathing, causing breathing cessation.
  • Complex sleep apnea: When you have both obstructive sleep apnea and central sleep apnea. This is the least common form of sleep apnea.

Apneas vs. Hypopneas

Although it’s referred to as sleep apnea, the respiratory events most people suffer from when they have sleep-disordered breathing aren’t apneas. 

An apnea is a nearly complete airway obstruction and isn’t accompanied by any sound. The majority of people with sleep apnea have hypopneas. Hypopneas are partial airway obstructions. The majority of these are accompanied by sound, or a snore.  

This is an important distinction because many people falsely believe that if they don’t stop breathing, and experience a pause in breath, that they don’t have sleep apnea. Nothing could be further from the truth. The partial obstructions associated with obstructive sleep apnea (OSA) are equally as dangerous and detrimental to your physical and mental health.

Measuring Sleep Apnea

To measure sleep apnea, a test is taken to account for a person’s sleep arousals at night. The apnea-hypopnea index, or AHI, is used to determine this, as it records how many times a person has their sleep interrupted each hour. 

  • Mild sleep apnea occurs with 5 to 15 breathing pauses per night. 
  • Moderate sleep apnea occurs with 16 to 30 pauses per night. 
  • Severe sleep apnea is when there are more than 31 breathing pauses per night. 

Any amount of breathing cessation during the night contributes to health problems and conditions, so it’s important to address sleep apnea as soon as possible.

If you’re reading this article, you’ve likely been diagnosed, or know what sleep apnea is and how serious it is. So let’s get right into what lifestyle factors can make the condition worse and how to address them.

8 Factors That Can Make Sleep Apnea Worse

If you have sleep apnea, it’s important to get it treated right away. However, even with treatment, it’s possible to make your symptoms worse if you’re not careful. Consider the following eight lifestyle factors that can make sleep apnea worse, and get started on treating them today for both healthy sleep and your overall health.

1. Weight Gain or Obesity

Your body weight is a major contributing factor to your sleep apnea symptoms— in fact, approximately 70 percent of OSA patients are obese.

Obesity puts you at a higher risk of obstructive sleep apnea, as well as other conditions like hypertension, heart disease, and diabetes. This is because increased fat deposits around your neck can block your upper airway as you rest, and additional pressure on your abdomen can make it difficult to breathe at night.

Sleep apnea can also worsen weight gain because your body regulates your hormones as you sleep. One of these hormones, leptin, helps regulate your body weight as well as your breathing control as you sleep. 

Leptin deficiency may actually disrupt your sleep architecture and impact your upper airway resistance if you have sleep apnea, as well as contribute to weight gain. 

Animal studies have shown a strong correlation between sleep apnea and leptin deficiency, and the correlation appears in humans as well.

Thankfully, losing weight can reduce your sleep apnea severity or even significantly reduce your risk of the disorder. Even 10 to 15 percent weight loss if you’re overweight or obese can reduce severity by 50 percent. 

The healthiest ways to lose extra weight are through a healthy, balanced diet as well as regular moderate exercise.

Related: Does Exercise Help Sleep Apnea? Which Exercises Reduce Risk and Improve Symptoms

2. Certain Medications

Some medications can worsen your sleep apnea symptoms by relaxing the muscles in your throat, which can block your upper airway. This can include:

  • Muscle relaxants
  • Benzodiazepines like Xanax or Valium
  • Painkillers, particularly opioids
  • Sleep aids

If you think your medication may be exacerbating your sleep apnea symptoms, talk to your doctor. They can help you figure out an alternate schedule for taking your medication, or even prescribe you a different medication that won’t impact your sleep.

Note: Do not stop taking your prescription or change your medication schedule without consulting your doctor first.

3. Your Sleep Position

Sleeping on your back can make your sleep apnea worse— this is because your tongue can fall back towards your throat and press against your airway. Any extra weight or pressure, such as body fat, around your airway can block it while you’re on your back also. Instead, try sleeping on your side.

This puts less pressure on your neck and airway, which helps keep things open. If you’re not used to sleeping on your side, try one of these methods to help yourself sleep on your side:

  • Use pillows to help position yourself onto your side, or
  • Position a small object such as a tennis ball or a rolled-up pair of socks on the back of your pajamas. Laying on top of them will make sleeping on your back uncomfortable, and help train you to sleep on your side.

4. Alcohol

Alcohol promotes muscle relaxation, which can include your throat muscles and tongue. Consuming alcohol too close to bed can cause these muscles to relax and your tongue to fall back into your airway, causing snoring or worsening sleep apnea symptoms.

To prevent this, avoid consuming any alcohol within a few hours of your bedtime. This will prevent your throat or tongue from becoming too relaxed and help you breathe better.

Related: Alcohol and Sleep May Not Mix as Well as You Think

5. Age

Older adults may face new sleep problems that they never experienced when they were younger. Unfortunately, older adults are at higher risk of sleep apnea purely because of their age. 

While there is no cure or prevention for aging, there are ways for older adults to reduce their risk for sleep apnea, including:

  • Maintaining a regular sleep schedule and avoiding too many naps
  • Exercising regularly, at least a few hours before bed each night
  • Consulting your doctor about any medications that may be keeping you awake

Related: Why You Should Go to Bed Before Midnight

6. Any Pre-Existing Conditions or Comorbidities You May Have

Although certain pre-existing conditions don’t make sleep apnea worse, it’s the reverse, sleep apnea does make these conditions worse. It’s important to recognize that these conditions are health risks associated with sleep apnea. Among them include:

  • High Blood Pressure (Hypertension)
  • Type II Diabetes
  • Erectile Dysfunction
  • Gastroesophageal Reflux Disease (GERD)
  • Heart Disease
  • Obesity
  • Chronic Pain

Having one or more of these comorbidities can indicate that you have sleep apnea. On top of that, sleep apnea can worsen these disorders. 

For example, fragmented sleep and sleep apnea can cause insulin resistance in your body, which can worsen your type II diabetes symptoms. 

Obstructed airways can also make your heart work harder to pump oxygenated blood throughout your body, which causes your blood pressure to spike and stay elevated.

Treating these conditions can improve your symptoms and help you sleep better, but it’s important to consider how treating sleep apnea can reduce comorbidity symptoms also. More on this shortly.

Related: Sleep Apnea Doubles Risk for Sudden Cardiac Death

7. Smoking

Sleep apnea is one of many breathing problems that smoking can cause. Cigarette smoke is an irritant to not only your upper airway, but also to your throat, tongue, soft palate, et cetera. Over time, the irritation can make this area swell, which can narrow or block your airways.

By far the best way to avoid this is to quit smoking— this can help reduce any symptoms of asthma or COPD as well. Even if you don’t quit cold turkey, reduced smoking helps reduce the swelling and irritation taking place around your airways, which helps you breathe easier day and night.

8. Improper CPAP Usage

CPAP, or continuous positive airway pressure, is the most popular and effective sleep apnea treatment available. It works by gently unblocking your airway with a continuous stream of air, allowing you to breathe fully and sleep easily.

If you use CPAP therapy to treat your sleep apnea, it’s absolutely vital that you use it properly and consistently, including regularly replacing and maintaining your CPAP equipment. 

Using CPAP less than prescribed or not using it at all will prevent your symptoms from improving, and could lead to your symptoms worsening.

The more you use CPAP, the better you will feel. Not just while you’re resting, but when you’re awake too. 

Consistent use of CPAP can not only remove any airway obstruction while you sleep and prevent snoring, but it can help reduce your blood pressure by ensuring your body gets the oxygen it needs. This makes it much easier for your heart to pump blood through your body.

CPAP also helps your body tolerate glucose and use insulin more effectively, which can help improve your diabetes symptoms.

The quality sleep you get with CPAP therapy can also help your body regulate your hormones, such as leptin, which can help you lose weight or maintain a healthy body weight.

Related: How Sleep Affects Your Hormones

The Dangers of Untreated Sleep Apnea

Even with healthy lifestyle changes, sleep apnea won’t go away on its own. Properly treating sleep apnea is the best way to relieve your symptoms and get back to getting a restful night’s sleep. Remember, left untreated sleep apnea can not only ruin your sleep quality, but it can cause or contribute to so many other health problems that can impact your quality of life and your overall health.

So if you think you may have sleep apnea or may be at risk, it’s vital to seek treatment. If you’re still not sure if you’re at risk, take our sleep apnea quiz. It’ll help you make sense of your symptoms so you can discuss them with your doctor or a sleep specialist.

You don’t have to live with the poor sleep and health problems caused by sleep apnea. Contact us at the Sleep Centers of Middle Tennessee today to get started with a treatment that will help you get your sleep, your health, and your quality of life back.


Wolk, Robert, et al. “Obesity, Sleep Apnea, and Hypertension.” Hypertension, 10 Nov. 2003, www.ahajournals.org/doi/full/10.1161/01.hyp.0000101686.98973.a3.

B;, Imayama I;Prasad. “Role of Leptin in Obstructive Sleep Apnea.” Annals of the American Thoracic Society, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/28796527/.

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