Living with obstructive sleep apnea (OSA) can mean dull morning headaches, trouble staying awake at your desk, and high blood pressure that’s hard to treat. If these symptoms are getting worse over time, you might not be imagining it.

Sleep apnea progression depends on different health and lifestyle factors. The good news is that many of those factors are habits you can change to slow OSA progression and prevent sleep apnea complications.

In this article, we'll go into detail about the factors that worsen sleep apnea and cover steps you can take to slow sleep apnea progression.

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Risk Factors That Can Worsen Sleep Apnea

Your sleep apnea is more likely to progress if you have certain risk factors. Many behaviors, health conditions, and even your age can contribute to intensifying nighttime breathing problems.

Weight Gain

Gaining weight, especially around the neck, can cause you to experience more pauses in your breathing at night. The extra weight places pressure on your airway, which can cut off the steady flow of air.

You can have sleep apnea at any weight. Neck circumference, jaw positioning, and other anatomy factors can contribute. Still, a high body mass index (BMI) is a major risk factor for worsening sleep apnea.

Sleep apnea can also indirectly cause weight gain by changing your circadian rhythm, which can cause weight-related hormone fluctuations. Talk to your doctor about strategies that can help you manage your weight and sleep apnea at the same time.

Aging

Your sleep apnea may worsen as you get older. Muscle tone around your airway generally declines with age, making your airway more likely to collapse as you sleep.

As you age, you may also be more easily awoken by breathing interruptions. This can worsen sleep apnea symptoms you experience during the day, like morning headaches or trouble concentrating.

People with central sleep apnea may also experience worsening sleep apnea as they age because the part of the nervous system that controls breathing becomes less sensitive to changing air pressure.

Menopause

Johns Hopkins Medicine points out that men are usually more susceptible to OSA than women. However, sleep apnea rates in women spike after menopause. If you already have sleep apnea, you may notice that your symptoms worsen after you enter menopause.

When you enter menopause, your body produces much lower levels of the hormones estrogen and progesterone. The loss of these hormones can change the muscles and fat around your throat and airway, making those muscles weaker and more likely to collapse as you sleep.

Alcohol or Sedative Use

Using drugs that slow down your nervous system, such as sedatives, painkillers, or alcohol, can worsen your sleep apnea because they relax your muscles.

When the muscles around your airway are too relaxed, they can collapse and block airflow. Alcohol also irritates the airway, which further contributes to breathing problems in sleep apnea.

Nasal Congestion

Chronic nasal congestion can make your OSA worse. While something like the common cold only causes nasal congestion for a short time, chronic conditions like allergies, chronic sinusitis, or sinus damage from smoking can all lead to worsening sleep apnea.

Conditions or Procedures That Narrow or Weaken Your Airway

Your sleep apnea might worsen if you have conditions that make your airway narrower or more compressed. Enlarged tonsils, inflammation around the airway, or scar tissue can all make it harder for air to pass through, especially as you sleep or relax.

Some surgeries or medical intubation can leave scar tissue near or in your airway, which can worsen sleep apnea. Be sure to tell your surgical team about your sleep apnea before any surgeries or procedures, especially if they involve your throat or airway.

How To Keep Sleep Apnea From Getting Worse

Even though some risk factors for worsening sleep apnea are things you can’t change, like aging or menopause, there are lifestyle changes and treatments that can support better nighttime breathing and help avoid progression:

• Maintain a healthy weight — Managing your weight doesn’t always cure sleep apnea, but it can help improve symptoms.
• Limit alcohol and sedative use — Avoiding or limiting relaxing substances, including alcohol, can help you breathe better at night.
• Sleep on your side — Sleeping on your back can place more pressure on your airway, so try to sleep on your side when possible.
• Treat nasal blockages — Manage any conditions that cause nasal congestion, including allergies.
• Use prescribed sleep apnea treatments — Stay consistent with using continuous positive airway pressure (CPAP) therapy or other prescribed treatments for sleep apnea.

Talk to Your Doctor

If you think your sleep apnea symptoms are increasing or intensifying, it’s important to tell your doctor or sleep specialist as soon as possible. You and your doctor can work together to identify any behaviors that may be worsening your sleep apnea so you can take steps to change them.

Your doctor might recommend other sleep apnea treatments or change your current treatment plan to help prevent sleep apnea complications.

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On MySleepApneaTeam, people share their experiences with sleep apnea, get advice, and find support from others who understand.

Have you noticed signs of your sleep apnea progressing over time? Let others know in the comments below.