While anyone can develop obstructive sleep apnea, certain factors can increase your risk for this condition or mean you may be more likely to already have it.
Obesity
Obesity is the most common risk factor for obstructive sleep apnea. “Fat deposits in the neck and around the tongue and palate make the airway much tighter and smaller,” says sleep medicine specialist Neeraj Kaplish, MD, medical director of sleep labs and clinics and clinical professor of neurology at the University of Michigan in Ann Arbor. “It becomes much more [closed up] during sleep when you’re lying down.” (It should be noted that thin people can also have obstructive sleep apnea and that not all individuals who are overweight have the condition.)
Large Adenoids or Tonsils
Some people have large tonsils or adenoids, or smaller airways, which can contribute to breathing problems during sleep. Large adenoids and tonsils are the most common cause of obstructive sleep apnea in children, says Ronald Chervin, MD, professor of sleep medicine and neurology and section head for sleep disorders at the University of Michigan in Ann Arbor. Adenoids usually shrink by the teen years.
Jaw Misalignment or Size
Some conditions or genetic factors can lead to an imbalance in facial structure that can cause the tongue to sit farther back in the mouth and lead to sleep apnea, says Robson Capasso, MD, chief of sleep surgery and professor of otolaryngology and head and neck surgery at Stanford University School of Medicine in California.
For instance, a lower jaw that’s shorter than the upper jaw, or a palate (the roof of your mouth) that’s shaped a certain way and collapses more easily during sleep can contribute to obstructive sleep apnea.
Family History of Sleep Apnea
If obstructive sleep apnea runs in your family, you may be at increased risk for having the condition. How your airway is shaped and your cranial facial characteristics can be inherited from your relatives, which can all play a role in whether and why you develop sleep apnea.
Chronic Nasal Congestion
People who have persistent nasal congestion at night (regardless of the cause) are more likely to develop obstructive sleep apnea, probably because of the narrowed airways.
Smoking
People who smoke are 3 times more likely to have obstructive sleep apnea than are people who’ve never smoked. Smoking can lead to inflammation and fluid retention in the upper airway, which can affect breathing as well as how well the brain communicates with the muscles that control breathing.
Using Alcohol, Sedatives, or Tranquilizers
Using these substances can increase the relaxation of the muscles in the throat, making obstructive sleep apnea worse.
Asthma
Having asthma is also a risk factor for obstructive sleep apnea. The relationship between the two conditions works both ways, Chervin explains: “Sleep apnea can make asthma worse and asthma can make sleep apnea worse.”
Medication, Such as Opioid Pain Relievers
The neurological communication that happens between the brain and body to regulate breathing can be numbed by benzodiazepines and opioids, says Dr. Capasso. As a result, these drugs reduce airway muscle activation and can contribute to sleep apnea.
Gender and Age
Sleep apnea can occur at any age, but being a male and getting older both put you at increased risk of developing obstructive sleep apnea and central sleep apnea, says Dr. Kaplish. “We don’t really understand why, but it may have to do with fat distribution and hormones.” For instance, as we age, fatty tissue may increase in the neck and around the tongue. Women are also more at risk if they’ve gone through menopause.
High Blood Pressure (Hypertension)
Having hypertension may increase your risk of having obstructive sleep apnea, and untreated sleep apnea can also lead to hypertension.
Diabetes
One study found that people who have type 2 diabetes were 48 percent more likely to have sleep apnea than those without diabetes who were diagnosed with obstructive sleep apnea. Being overweight or having obesity may be the link, but there are people of normal weight who have both sleep apnea and diabetes. Insulin resistance in diabetes may independently increase risk for apnea, too, while inflammation from apnea may increase risk for diabetes, the researchers note.
History of Stroke
Prior stroke is linked to both obstructive sleep apnea and central sleep apnea, but it’s not clear which is causing which, Dr. Chervin says. “As many as three-quarters of stroke patients have sleep apnea, and sleep apnea also raises the risk for stroke,” says Chervin. Sleep apnea leads to low oxygen levels and high blood pressure, both of which can increase one’s risk of a future stroke.
Heart Failure
Congestive heart failure can also increase your risk for obstructive sleep apnea and central sleep apnea. Heart failure can cause retention of sodium and water, and doctors suspect that the excess fluid may enter the lungs at night and lead to obstructive apnea.
