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Does Sleep Apnea Get Worse Over Time & What Sleep Position is Best for Sleep Apnea?

Sleep apnea is a common sleep disorder, affecting many people across the globe. It is estimated that more than 18 million adults in the U.S suffer from obstructive sleep apnea.1 In this article, we will discuss the factors that make sleep apnea get worse with time. Also, as there is a possibility that your sleep position plays a role in determining the severity of sleep apnea, knowing what sleep position is best for sleep apnea can help.

Does Sleep Apnea Get Worse Over Time?

Sleep is very essential for good health. Getting inadequate sleep can negatively affect your attention, learning, memory and your overall health. Sleep apnea is one of the sleep disorders that not only affects your sleep and performance but also puts you at greater risk of other health problems. However, the majority of people experiencing sleep apnea remain undiagnosed. To evaluate the risk of health problems associated with sleep apnea, it is necessary to understand if sleep apnea gets worse over time and what sleep position is best for sleep apnea.

Sleep apnea can be caused due to physical structure or medical conditions. Some of the causes and risk factors of sleep apnea include craniofacial abnormalities, enlarged tonsils, obesity, endocrine disorders, kidney or heart failure, genetic disorders, and premature birth.2 Additionally, some factors increase the risk of sleep apnea in some cases. These include age, family history, genetics, faulty dietary and lifestyle habits, weight gain and underlying medical conditions.

A commonly asked question is does sleep apnea get worse with time? The answer is yes, sleep apnea can worsen with time if left untreated or unattended. While some milder cases of sleep apnea may not need any treatment, most cases need attention to prevent other complications. Mild cases of sleep apnea may be managed by dietary and lifestyle changes, however, severe cases need appropriate treatment to prevent complications. Experts suggest that if sleep apnea gets worse over time, it may result in long term effects if left untreated. Long term sleep apnea and sleep deprivation can increase the risk of attention and memory problems, high blood pressure, heart diseases, stroke, metabolic disorders, type 2 diabetes, and some cancers. Just as there are risk factors for the occurrence of sleep apnea, there are certain conditions that can cause sleep apnea to worsen with time, if left untreated.

Studies conducted to determine the major factors affecting the severity of obstructive sleep apnea revealed certain important findings.

Here are some of the common risk factors that can cause sleep apnea to get worse over time, if not attended or treated appropriately.

  • Structure – Structural formations and anatomy of the orofacial region play an important role. Craniofacial deformities, enlarged tonsils, adenoids, deviated nasal septum, or other problems in the nasal, oral or pharyngeal region can worsen sleep apnea in some cases. While these problems are commonly seen in children, they can occur in adults as well.

  • Medical Conditions –The presence of co-existing ailments determines the severity of sleep apnea. People having diabetes, hypertension, heart diseases, and metabolic disorders must get treatment for the underlying conditions. Poor glucose control, poorly controlled blood pressure is considered to worsen sleep apnea and the same can be managed by controlling these conditions. Thus, managing underlying medical conditions effectively can prevent sleep apnea from getting worse with time.

  • Weight Gain – As obesity is one of the risk factors of sleep apnea, if it continues to exist, it can make the situation worse. Weight gain, particularly in and around the neck and upper body can cause more problems for a person experiencing sleep apnea. Excess weight makes the tissues bulkier and the muscles around the airways can collapse more easily, thus worsening sleep apnea.

  • Aging – With increasing age, the muscles of the body lose their tone and elasticity. Tissues that lack proper tone and strength can easily cause obstruction of the airways, during sleep. Thus, the risk of sleep apnea getting worse with age is high, if not treated in time. Aging also increases the risk of metabolic disorders, weight gain, and chronic problems, which too can influence an existing sleep apnea.

  • Alcohol Intake – Alcohol intake results in relaxation of muscles, which can result in increased relaxation of muscles of the throat and the oral cavity. Sleep apnea occurs when the muscles of the throat collapse, which can be more if the muscles are relaxed. Thus alcohol intake can cause obstruction of airways due to relaxed throat muscles. Hence, if alcohol intake continues, sleep apnea can get worse with time.

  • Smoking – Cigarette smoking is harmful to the airways and acts as an irritating for the respiratory tract and oral cavity. Long term smoking can result in inflammation and swelling of the airways and the structures in the oral cavity, throat and surrounding structures. This can add to the airway obstruction and result in the worsening of sleep apnea over time if smoking is not curbed. Smoking can also worsen respiratory illness that causes pulmonary obstructive disorders, which too are great risk factors of sleep apnea.

  • Medications – Medications to influence the severity of sleep apnea. Certain medicines that result in the relaxation of muscles or affect the muscle tone can cause the throat muscles to drop down when you sleep. As this causes airway obstruction when sleeping, it can make sleep apnea get worse with time, if the medications continue.

  • Menopause in Women – While sleep apnea is considered to be common in men, the risk in women increases after menopause. There are chances that sleep apnea may get worse in post-menopausal women due to various reasons. The changing hormones, increasing weight, and aging can result in sagging of the tissues, lowering of muscle tone and deposition of fat around the throat and neck. This can easily obstruct the airways and affect breathing while sleeping thus worsening sleep apnea.

  • REM Sleep – You need good quality sleep at night for proper healing of your body and mind. Sleep apnea deprives you of the sleep you need the most and leaves you fatigued. Ironically, the phase that demands good quality sleep the most, is the biggest risk factor for worsening of sleep apnea. As the muscles get relaxed during the rapid eye movement (REM) sleep, it can cause collapse and obstruct the upper air passages, thus, can make your sleep apnea get worse.

  • Sleep Position – As sleep apnea often occurs when the rear side of the throat muscles and tongue collapses to obstruct the air passages, it is more common when you lie on your back. This is possible because your weight falls on the airways and the tongue tends to relax more when you are sleeping on your back. Studies do suggest that supine sleep posture or sleeping on the back is associated with severe obstructive sleep apnea.3 Hence, sleep apnea is more when sleeping on the back, while this can be prevented when sleeping on the sides or on your tummy. The way you sleep can influence the severity of sleep apnea and determine if it gets worse with time or is controlled.

It is known that obesity and age are the major factors influencing the occurrence and severity of sleep apnea. Aging is a natural process that will continue its course. Considering increasing cases of obesity, which is a growing concern in most modern countries, the risk of sleep apnea getting worse with time is high. Hence, the best approach is to identify the symptoms and get the condition diagnosed in time, for appropriate treatment and lifestyle changes.

What Sleep Position Is Best For Sleep Apnea?

As we have seen that your sleep position is one of the factors that can influence the severity of sleep apnea. Your sleep position or the way you sleep is one of the aspects that determine if your sleep apnea gets worse over time or you are able to manage it. So, what sleep position is best for sleep apnea?

Let us understand some of the sleep positions consider best for sleep apnea.

  • Sleep on your sides – Sleeping on your sides, eight left or right is one of the best sleep positions for sleep apnea. This prevents the tongue from falling backward ad thus does not block the airways. Take a thick pillow to support your head and neck for better comfort.

  • Sleep on your tummy – Sleep on your tummy too is good for sleep apnea as it helps maintain airways for breathing. However, some people may find it difficult to sleep on tummy with a pillow, as it can cause strain on the neck. It is better to use a thin pillow or completely avoid using one when sleeping on your belly. People with abdominal problems, acid reflux may find it difficult to adjust to this posture though.

  • Sleep on your back with head raised – To avoid blocking of airways with tongue and throat muscles, You can also sleep on your back but with your head raised. This posture prevents blocking of airways and acid reflux too. Sleeping with your head elevated with the help of pillows or on a recliner can help. This too is one of the best sleep positions for sleep apnea.

These are some of the comfortable sleep positions that can help you manage sleep apnea. However, you may have to try different sleep positions for a while until you find comfort and experience less sleep apnea.

Treatment of sleep apnea includes the use of various techniques to reduce snoring and sleep apnea related mechanisms. Dental appliances and other prostheses may be needed to prevent the dropping of the tongue and throat muscles that obstruct the air passage when sleeping. As the oxygen supply may be affected, doctors may suggest CPAP treatment, which helps to maintain airway pressure for proper breathing. Other treatment options include reducing weight, following a healthy diet and lifestyle and maintaining proper sleep posture. We can thus conclude that sleep apnea can get worse over time if left untreated and if certain factors influence it negatively. Now you know that some factors can cause sleep apnea to get worse over time, you can take the necessary action and protect your health. Some sleep positions considered best for sleep apnea can help, so make it a part of your lifestyle changes.


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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:April 9, 2020

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