10 Warning Signs of Untreated Sleep Apnea

Obstructive sleep apnea may exhibit some surprising signs and symptoms. While it’s often associated with older adult males carrying extra weight, it can actually affect anyone, depending on the shape of their jaw and airway. Consider some of these alternative signs and whether the underlying cause might be due to untreated sleep apnea.

1. Depression

Sleep apnea can impact mood, often contributing to depression.

Common signs include persistent sadness, low energy, poor concentration, loss of interest in activities, changes in appetite or weight, and feelings of guilt or worthlessness.

In addition to depression, anxiety, panic attacks at night, and irritability may also occur. Severe cases may involve thoughts of self-harm.

Treating sleep apnea can improve mood and energy, but some people may also need therapy and/or antidepressant medication for complete relief.

Be sure to discuss any mental health concerns with your healthcare provider.

If you are having suicidal thoughts, dial 988 to contact the 988 Suicide & Crisis Lifeline and connect with a trained counselor. If you or a loved one is in immediate danger, call 911.

2. Impaired Thinking

Sleep apnea can cause daytime brain fog and difficulty thinking clearly. Repeated nighttime airway collapses disrupt deep sleep, fragmenting rest and reducing its quality.

Poor sleep prevents the brain from clearing debris and regulating special brain chemicals (neurotransmitters), leading to hazy thinking, poor concentration, attention issues, and short-term memory problems.

Treating sleep apnea can improve focus, mental clarity, and overall cognitive function.

3. Impotence

Sleep apnea may cause erectile dysfunction due to reduced blood flow and nervous system changes. It also impacts cardiovascular health, contributing to high blood pressure, heart failure, and high cholesterol.

Repeated nighttime breathing disruptions lower oxygen levels and trigger inflammation, which in turn affects blood flow and your nervous system.

Treating sleep apnea may improve sexual function and reduce the risk of heart-related issues.

4. High Blood Pressure

Sleep apnea increases your risk of high blood pressure (hypertension), which can lead to a heart attack or stroke. Nighttime breathing disruptions lower oxygen levels, raise heart rate, and trigger inflammation.

If your blood pressure is high and hard to control, sleep apnea should be evaluated with a sleep study.

Fortunately, treatment with continuous positive airway pressure (CPAP) can be as effective as medication in lowering high blood pressure and reducing cardiovascular risks.

5. Waking to Urinate

Frequent nighttime urination, or nocturia, can be a sign of sleep apnea. Disrupted sleep may reduce the release of anti-diuretic hormone (ADH), leading to increased trips to the bathroom.

Lighter sleep can increase bladder awareness, and heart strain from breathing disruptions may impact urine production.

Other causes include excess fluid intake, diuretics, or prostate issues. Treating sleep apnea may reduce nighttime urination and improve overall sleep quality.

6. Teeth Grinding

Nighttime teeth grinding (bruxism) may be a sign of sleep apnea and affects up to 10% of people.

Grinding may tighten your airway muscles and limit jaw movement, helping keep your tongue from blocking your airway. While it may reduce sleep apnea-related awakenings, bruxism can also cause tooth damage, temporomandibular joint (TMJ) problems, and headaches.

7. Unrefreshing Sleep

Even if you get adequate sleep, sleep apnea can leave you feeling tired and unrefreshed, causing symptoms similar to sleep deprivation.

Sleep apnea often causes excessive daytime sleepiness, making it easy to nap or fall asleep within seconds or minutes, even during the day. This drowsiness can be dangerous, especially when driving.

8. Heartburn

Airway collapse during sleep apnea can create negative pressure that pulls your stomach contents up into your esophagus, causing:

• Nighttime heartburn or acid reflux

• Coughing

• Choking

• Daytime gastroesophageal reflux disease (GERD)

A weak lower esophageal sphincter, which usually prevents stomach acid from entering your esophagus, can lead to reflux and heartburn.

Treating sleep apnea may help some heartburn symptoms.

9. Sleepwalking, Sleeptalking, or Sleep Eating

Sleepwalking, sleeptalking (somniloquy), or sleep eating can be hidden signs of sleep apnea. These parasomnias occur when the brain is partly awake and partly asleep.

During these mixed states, movement centers in your brain remain active, leading to actions such as walking without conscious memory of it. Because sleep apnea disrupts regular sleep, it can trigger these abnormal behaviors.

Treating apnea often reduces limb movements and improves overall sleep quality.

10. Dry Mouth, Drooling, and Bad Breath

Both dry mouth and drooling can be signs of sleep apnea.

Dry mouth often results from blocked nasal passages and mouth breathing, which can cause snoring, airway collapse, and even bad breath.

Drooling may occur for the same reason: an open mouth during sleep. Therefore, dry mouth and drooling may both indicate an increased risk of sleep apnea.