What Athletes Should Know About Sleep Apnea and Performance

Sleep apnea is often thought of as a condition that primarily affects older adults or people who are overweight. In recognition of Sleep Awareness Week, Christopher Allen, M.D., a sleep physician and adviser for Aeroflow Sleep, is highlighting how sleep disorders like sleep apnea can affect people of all ages and activity levels, including athletes.

According to Allen, anatomical factors such as jaw structure, airway size and neck circumference can increase the risk of obstructive sleep apnea regardless of a person’s fitness level. In athletes who push their bodies to perform at a high level, untreated sleep apnea may quietly interfere with recovery, endurance and reaction time.

Recognizing the warning signs, including loud snoring, persistent daytime fatigue and waking up feeling unrefreshed, can help people seek evaluation and treatment earlier.

Many people think of sleep apnea as something that affects older adults. How can sleep apnea affect athletes, even those who seem very fit and healthy?

Christopher Allen, M.D.: Sleep apnea is commonly associated with older or overweight individuals, but it can absolutely affect athletes as well. Certain anatomical factors, such as jaw structure, airway size, large neck circumference or nasal obstruction, can predispose someone to sleep apnea regardless of fitness level. Athletes may also have increased neck muscle mass, which can contribute to airway narrowing during sleep. Because athletes often push their bodies to the limit, untreated sleep apnea can quietly undermine recovery and performance even in otherwise very healthy individuals.

How does untreated sleep apnea impact reaction time, endurance, muscle recovery and overall performance, both for competitive athletes and everyday people?

CA: Untreated sleep apnea fragments sleep and reduces the amount of restorative deep sleep and REM sleep the body receives. These stages of sleep are critical for muscle repair, hormone regulation and neurological recovery.

As a result, people with untreated sleep apnea may experience slower reaction times, decreased endurance, impaired concentration and delayed muscle recovery. For athletes, even small reductions in reaction time or recovery can affect performance outcomes. For everyday individuals, it can translate into lower energy, reduced exercise capacity and increased injury risk.

What are some warning signs that fatigue or poor performance may be caused by a sleep disorder rather than overtraining or stress?

CA: There are several signs that fatigue may be related to an underlying sleep disorder rather than simply training load or stress. These include loud snoring, witnessed pauses in breathing during sleep, waking up feeling unrefreshed despite adequate time in bed, excessive daytime sleepiness, morning headaches and difficulty concentrating.

Athletes who feel persistently exhausted despite good training habits, nutrition and recovery strategies should consider evaluating their sleep health.

Are certain athletes at higher risk for sleep apnea?

CA: Yes. Athletes in certain sports may be at higher risk. For example, football players, wrestlers, powerlifters and other strength-based athletes often have larger neck circumferences and higher body mass, both of which can increase the likelihood of airway obstruction during sleep. Athletes with craniofacial characteristics such as a recessed jaw or narrow airway may also be predisposed.

However, sleep apnea can affect athletes across many disciplines, including endurance athletes who otherwise appear lean and healthy.

What role does proper sleep play in injury prevention, recovery and long-term health?

CA: Sleep is one of the most powerful recovery tools available to athletes. During deep sleep, the body releases growth hormone, which supports tissue repair, muscle recovery and adaptation to training. Adequate sleep also supports immune function, reaction time, cognitive processing and coordination.

Research consistently shows that athletes who sleep longer and maintain high-quality sleep experience fewer injuries and improved performance outcomes. Over time, proper sleep also supports cardiovascular health, metabolic health and mental resilience.

Why is it important to break the stereotype that this condition only affects inactive or older individuals?

CA: The stereotype that sleep apnea only affects older or sedentary individuals can delay diagnosis in people who would benefit from treatment. When athletes or younger adults assume they are “too healthy” to have sleep apnea, symptoms may go unrecognized for years.

Breaking this stereotype helps encourage earlier screening, diagnosis and treatment. Sleep apnea is a medical condition related to airway physiology, not simply body weight or lifestyle, and recognizing that can help more people access the care they need to optimize both their health and performance.