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Complications of Sleep Apnea

Last updated: January 2023

Sleep apnea is a sleep disorder causing you to start and stop breathing while you sleep. People with sleep apnea often snore or gasp for air while sleeping. They also have problems staying awake because they do not get restful sleep.1

The most common type of sleep apnea is obstructive sleep apnea (OSA). It occurs when your throat muscles relax. This narrows the airway, which stops your breathing. A less common form is central sleep apnea, which occurs when your brain does not send signals to your body to breathe. Complex sleep apnea syndrome is when you have OSA and central sleep apnea.1

Complications and comorbidities

Sleep apnea has many comorbidities. A comorbidity is when 2 health conditions occur at the same time. Comorbid health conditions can make symptoms worse and cause more complications. Below are some of the comorbidities of sleep apnea.2

Heart problems

OSA can be found in 2 to 4 of every 5 people with the following heart problems:3

The link between OSA and heart problems is so high that the American Heart Association recommends OSA screening for:3

  • High blood pressure that is not under control
  • Pulmonary hypertension
  • Some atrial fibrillation

OSA raises the risk of heart complications. Having both heart failure and OSA raises the risk of worsening symptoms, hospitalization, and death.3

OSA may worsen heart problems due to hypoxia. Hypoxia is when the body does not get enough oxygen.3

OSA causes hypoxia when the airway narrows and you stop breathing. This causes stress and inflammation, which strains the heart and blood vessels (vascular system). Hypoxia also changes your vascular system. This may be why OSA and pulmonary hypertension are linked.3

Stroke

OSA is a risk factor for stroke. It is also linked to worse outcomes after a stroke as well as recurrent strokes. Doctors are still working to understand the link between OSA and stroke.3

Metabolic diseases

OSA and metabolic diseases like metabolic syndrome and type 2 diabetes are often comorbid. Metabolic syndrome is a group of health problems that occur together and worsen your health. Metabolic syndrome and OSA may share a similar root cause. Common health problems of metabolic syndrome are:3,4

  • High blood pressure
  • High blood sugar
  • Body fat on the waist
  • High levels of cholesterol or triglycerides (a type of fat in the body)

Type 2 diabetes occurs when you have too much sugar in your blood. It causes problems with circulation and worsens other health conditions. It also affects your nervous and immune systems. Hypoxia and chronic disrupted sleep may affect metabolism, which could cause diabetes.5,6

Hearing issues

Sleep disturbances like OSA are also comorbid with hearing problems like tinnitus. Tinnitus, or ringing in the ears, impacts as many as 1 in every 5 people. It is also common in older people. It can be caused by hearing loss or an injury to your ears. Circulatory problems are also linked to tinnitus.7,8

The cause of OSA and tinnitus may be similar, which is why they occur together. Doctors are still trying to figure out the reason these conditions are linked.8

Balance issues

People with OSA may have problems with keeping their balance and walking. This may be due to hypoxia. Having problems with your balance raises your risk of falling. Falling can cause broken bones or head injuries. A severe fall can even impact your ability to live alone.9

Severe problems with balance can be seen in people with severe OSA symptoms. It is possible that using a continuous positive airway pressure (CPAP) machine could improve balance issues.9

Mental health

There is a link between sleep apnea and mental health issues such as:10

Abnormal sleep can cause you to be irritable. It can make it hard to stay motivated or control your emotions. And it can make you impulsive. There are likely many reasons sleep apnea and mental health issues are linked. Doctors are still trying to understand these comorbid conditions.10,11

Do you experience complications with sleep apnea? Please share a story or comment below.
Written by: Jessica Gullett Rubino | Last reviewed: October 2022

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