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What are the health complications associated with obstructive sleep apnea?

Sleep apnea can make you wake up in the morning feeling tired or unrefreshed even though you had a full night of sleep. During the day, you may feel fatigued, have difficulty concentrating or unintentionally fall asleep. This is because your body is waking up numerous times throughout the night, although you might not be aware of it.

The lack of oxygen your body receives because of sleep apnea can have negative long-term consequences for your health, including high blood pressure, heart disease, stroke, prediabetes and diabetes and depression.

This content originally appeared on the American Academy of Sleep Medicine website.
Carol Ash, DO
Pulmonary Disease

Obstructive sleep apnea is a respiratory problem where you repeatedly stop breathing in your sleep. In this video, internist and sleep expert Carol Ash, DO, discusses the health complications that can result from undiagnosed, untreated sleep apnea.


Sleep apnea is associated with elevated risk for a range of serious and chronic illnesses. Obstructive sleep apnea has been linked to:
  • Cardiovascular problems. In addition to being a risk factor for stroke, sleep apnea is also associated with hypertension, heart disease, and heart failure. Researchers from the University of Alabama, Birmingham and from Germany's University of Technology Dresden found that obstructive sleep apnea increased a person's risk of heart attack by 30% over a 4-5 year period.
  • Diabetes. There's increasing evidence of a link between diabetes and sleep apnea.  Researchers from the University of Alabama, Birmingham and from Germany's University of Technology Dresden found high rates of obstructive sleep apnea among men with Type 2 diabetes. Even worse news: most of these sleep apnea cases were undiagnosed before the study.
  • Sexual dysfunction. Sleep apnea has been shown to cause sexual problems in both men and women. Researchers from the University of Alabama, Birmingham and from Germany's University of Technology Dresden showed women with sleep apnea had significantly higher rates of sexual problems, both with sexual performance and satisfaction. Their research revealed that men with erectile dysfunction were more than twice as likely to also suffer from obstructive sleep apnea.
We've got a great deal more to learn about how sleep apnea may contribute to these conditions, as well as to its role as a risk factor for stroke. What's already clear is that sleep apnea is a red flag for stroke and other serious health problems. Screening for sleep apnea -- and assessing sleep health in general -- needs to be part of the diagnostic and risk assessment process for patients. If sleep apnea and other sleep disorders are ignored, we ignore an opportunity to identify at-risk patients before the worst occurs.
Phil Westbrook
Sleep Medicine

Research studies have shown that obstructive sleep apnea (OSA) is associated with a variety of unpleasant health problems. These include high blood pressure, heart attacks, strokes, heart failure, irregular heart rhythm, diabetes, and early and sudden death. OSA is clearly associated with an increased risk of accidents, both industrial and while driving, so OSA can cause devastating consequences not only for the person with the disorder, but for innocent bystanders as well. Persons with OSA can have problems with learning and memory, as well as decision making. Mood can be altered.

We don't know exactly why all these associated problems happen. OSA has two clear consequences during at night. One is brief arousals from sleep that fragment sleep and another is episodes of low blood oxygen (desaturation or hypoxic events). The frequency of obstructive breathing events during sleep is usually expressed as the Apnea /Hypopnea Index (AHI) or the number of abnormal breathing events per hour of sleep. A clear daytime consequence of OSA is excessive sleepiness, the tendency to fall asleep when you don't intend to. One would expect that the more frequent the breathing problem during sleep, the higher the AHI or the more severe the hypoxic insult to the body, the sleepier the person with OSA would be. Generally this tends to be true, but the relationship between the severity of OSA in terms of AHI or hypoxia and daytime sleepiness is not real strong. While we tend to think of the daytime sleepiness as being due to the sleep disruption or arousal, some research suggests that hypoxia (low oxygen) also plays a role.

Hypoxia is thought to play a major role in causing high blood pressure, and high blood pressure is itself associated with heart attacks, heart failure and strokes. One very large study found that blood pressure went up directly as AHI went up. Another large ongoing study has found 18 years after the initial diagnosis, death from all causes was linked to the severity of sleep apnea as measured by the AHI.

A cofounding factor in many studies of the consequences of OSA is the fact that most people with OSA are fat. Obesity alone is linked to cardiovascular disease and may be linked to sleepiness.

Regardless of the fact that we do not understand all the links between sleep apnea and its consequences, it is clear that treating sleep apnea prevents or lessens the consequences. So if you have OSA, treat it. You will feel better and liv

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.