Sleep Apnea Isn’t Just About Snoring

Sleep apnea is often missed because its symptoms don’t always look like a classic sleep disorder, according to Dionne Morgan, M.D., a sleep medicine physician with Miami Cardiac & Vascular Institute at Baptist Health South Florida. Many patients assume feeling tired, waking up frequently at night, having morning headaches or struggling with insomnia are just part of everyday life. Even symptoms like waking up multiple times to use the bathroom or feeling unrefreshed after a full night in bed may not immediately raise red flags for patients or clinicians. While snoring is common in people with obstructive sleep apnea, it’s not specific enough on its own to make a diagnosis.

When sleep apnea goes untreated, its effects often spill into daytime life. Poor sleep quality caused by repeated breathing interruptions can lead to brain fog, memory lapses, trouble concentrating and excessive daytime sleepiness. Morgan explains that these disruptions also raise safety concerns, including drowsy driving and reduced attention. Over time, untreated sleep apnea can make it harder to maintain a healthy weight, as chronic fatigue affects energy levels, food choices and motivation to exercise.

More concerning are the long-term effects on the heart and metabolism. Each time breathing pauses during sleep, oxygen levels drop and the body responds with a surge of adrenaline to restart breathing. These repeated stress responses cause nighttime spikes in blood pressure and increase inflammation. Over time, this can contribute to chronic high blood pressure, heart disease, stroke and abnormal heart rhythms like atrial fibrillation. Fluctuating oxygen levels and fragmented sleep may also contribute to cognitive decline, particularly issues with attention and memory, even if sleep apnea is not directly linked to dementia.

Lifestyle factors play a major role in both the severity and treatment of sleep apnea. Weight gain, especially obesity, significantly increases risk, while weight loss can improve symptoms and, in some cases, resolve mild sleep apnea. Morgan notes that newer weight loss medications, along with diet, exercise and bariatric surgery, may play an important role for some patients. Alcohol and sedating medications, such as benzodiazepines and opioids, can worsen sleep apnea by relaxing airway muscles and suppressing breathing, and should be avoided or used cautiously in untreated patients.

When it comes to mild sleep apnea, treatment decisions are individualized. While long-term outcome data are limited, treating symptomatic mild sleep apnea can significantly improve quality of life and sleep quality, especially in people with existing heart disease. Ultimately, Morgan emphasizes that treatment should focus on the patient, not just the severity of the diagnosis.