Can You Die From Obstructive Sleep Apnea?

Obstructive sleep apnea (OSA) causes repeated pauses in breathing while you sleep. These pauses themselves do not directly cause death; However, OSA is linked to serious health problems such as stroke and heart disease, and people with this condition have a higher mortality risk. Getting treatment for OSA can prevent these complications.

OSA occurs when the throat muscles relax during sleep, blocking airflow. These breathing interruptions usually last more than 10 seconds and occur frequently throughout the night. While these pauses (or apneas) occur, the brain briefly wakes the body to resume breathing.

These repeated interruptions in breathing put stress on your body in several ways:

• Short-term cardiovascular changes: Decreases in oxygen and repeated awakenings trigger the sympathetic nervous system. This increases the heart rate and stiffens the blood vessels, which increases blood pressure.
• Cellular damage and inflammation: Over time, people with OSA develop oxidative stress, a condition in which the body has high levels of cell-damaging molecules called free radicals. Oxidative stress is closely linked to inflammation, which damages blood vessels and puts extra strain on the heart.
• Long-term cardiovascular damage: This stress from low oxygen levels, lack of quality sleep, and restarting breathing contributes to conditions such as high blood pressure, abnormal heart rhythms, and coronary heart disease.

People with OSA are at higher risk of death in general, as well as death specifically from cardiovascular disease. This risk is higher for people with severe OSA, men with OSA, and people whose condition is untreated. Between 1999 and 2019, more than 168,000 cardiac deaths in the United States were linked to OSA.

OSA alone does not usually cause death. On the contrary, this condition increases the risk of serious health problems that can become fatal.

Heart disease

OSA can increase blood pressure and put extra strain on the heart, and repeated drops in oxygen and poor sleep can lead to more inflammation and damage to blood vessels. Over time, this increases the risk of coronary heart disease, a condition in which narrowed arteries prevent the heart from getting enough blood.

Stroke

A stroke occurs when blood flow to the brain is blocked or reduced, which can lead to brain cell death.

Low oxygen levels and inflammation caused by OSA make strokes more likely. In fact, people with OSA have twice the risk of stroke. This link is stronger in people with severe OSA, but treatment can reduce these risk factors.

Heart rhythm problems

People with sleep apnea are up to four times more likely to develop arrhythmias, or abnormal heart rhythms. Experts believe this is likely due to OSA’s effect on the autonomic nervous system, which controls involuntary bodily functions like heart rate.

A common arrhythmia is atrial fibrillation, in which the upper part of your heart beats irregularly, either too slowly or too quickly. If left untreated, some arrhythmias can increase the risk of unexpected death from heart problems.

Accidents caused by severe drowsiness

Many people with OSA feel very sleepy during the day and have difficulty concentrating. Excessive daytime sleepiness can increase the risk of falling asleep at the wheel and car accidents – these accidents can sometimes be fatal.

Obstructive sleep apnea can affect anyone, but some people are at higher risk of serious complications and premature death. Risk factors for premature death in people with OSA include:

• Sex: Men have higher mortality rates than women from OSA-related heart problems.
• Race: Black Americans are more likely to die from OSA-related heart and vascular problems than people in other racial groups.
• Age: For people with mild to moderate OSA, the risk of death from all causes is highest in people younger than 60 years old. But for older people, OSA alone does not significantly increase the risk of death.
• Obesity: Excess weight increases the risk of more severe OSA because fatty tissue in the neck and throat can obstruct the airway. Obesity can also make OSA more difficult to manage. Severe OSA is linked to worse mortality outcomes.
• Underlying cardiovascular disease: OSA is very common in people with heart health problems such as high blood pressure, heart failure, and atrial fibrillation. These conditions worsen your heart health and increase the risk of cardiovascular death.
• Severe OSA: People with severe OSA have the highest risk of death compared to those with mild or no OSA.
• Short sleep duration: Adults with OSA who sleep less than seven hours per night have a higher risk of death than people with OSA who sleep more.

Treating OSA is the best way to protect your health and prevent serious complications.

The most common treatment option is continuous positive airway pressure (CPAP) therapy. CPAP uses a mask to gently blow air into your airways while you sleep, keeping them open. This ends pauses in breathing and lack of oxygen that could otherwise damage your heart and blood vessels.

Regular use of CPAP can improve your oxygen levels, lower your blood pressure, and protect your heart health. The more consistently you use CPAP, the greater the benefits.

Other effective treatments for OSA include:

• Oral appliances: These move your jaw or tongue to keep your airway open.
• Lifestyle changes: Losing weight, exercising regularly, avoiding alcohol before bed, and sleeping on your side can all help keep your airways open.
• Surgery: Sometimes, if other treatments don’t work, your doctor may suggest surgery to remove or move tissue that is blocking your airway, or to move the position of your jaw.

Because treatment can reduce the risk of mortality in patients with OSA, it is important to have a diagnosis and treatment plan in place if you think you may have this condition.

Talk to your doctor if you experience symptoms such as:

• Loud or frequent snoring
• Panting, choking, or pauses in breathing during sleep
• Excessive daytime sleepiness or fatigue
• Morning headaches or difficulty concentrating
• Mood changes, irritability or depression

If you already have a diagnosis of OSA but continue to experience symptoms, talk to your provider. They may recommend that you change your treatment plan to help treat persistent symptoms.