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7 Warning Signs of Sleep Apnea
This serious health condition has some surprising effects on everything from your blood pressure to your sex life
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Key takeaways
- Sleep apnea is common in older adults, but many cases go undiagnosed because symptoms can be subtle or mimic other health issues.
- Warning signs can include snoring, high blood pressure, morning headaches, dry mouth, exhaustion and difficulty concentrating.
- Treatment options include CPAP therapy, GLP-1s, mouth guards and more.
Sleep apnea, a condition in which breathing during sleep continually stops and starts, becomes increasingly common with age, yet many people don’t realize they have it.
A 2025 report in Sleep found that about 1 in 3 adults over the age of 70 had sleep apnea in 2020 — a number expected to surge to 54 percent by 2050. Other research suggests that more than half of adults 65 and older may be at high risk for the condition.
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“As we age, fat tissue replaces muscular tissue in the throat and neck. This causes our airways to become more collapsible,” explains Dr. Adam Sorscher, a family medicine doctor specializing in sleep medicine at Dartmouth Hitchcock Clinics Heater Road in Lebanon, New Hampshire.
When this happens during sleep, breathing becomes harder and oxygen levels can fall, prompting the brain to briefly wake the body so normal breathing can resume. This cycle not only affects a person’s quality of sleep at night; it can have other health effects too, including an increased risk for high blood pressure, diabetes and stroke.
In fact, research suggests that older adults with sleep apnea are more than twice as likely to die prematurely than those who don’t have it — which is why recognizing the warning signs and getting treated is key.
Snoring is often associated with sleep apnea, but it’s not the only sign of the sleep disorder, Sorscher says. Here are seven additional symptoms that could point to sleep apnea.
1. High blood pressure
Up to half of all people with hypertension (or high blood pressure) also have sleep apnea, according to the American College of Cardiology.
“Every time someone with sleep apnea has a pause in their breathing during sleep, their sympathetic nervous system becomes activated and their blood pressure spikes,” says Dr. Meir Kryger, a professor emeritus of sleep medicine at the Yale School of Medicine in New Haven, Connecticut.
Your body also releases stress hormones, which can raise blood pressure. “A red flag is what we call resistant hypertension, which means that you can’t get your blood pressure under control despite being on at least two high blood pressure medications,” Kryger says.
The good news is that when these patients’ sleep apnea is diagnosed and treated with continuous positive airway pressure, or CPAP — a machine that uses mild air pressure to keep airways open during sleep — their blood pressure usually improves.
2. Morning headache
About 30 percent of people with sleep apnea report having a headache when they wake up in the morning. It’s unclear exactly what causes the headache, though it may simply be due to decreased oxygen in the blood that occurs each time you gasp for breath, as well as dilations of blood vessels in your brain to try to compensate, says Dr. Beth Malow, director of the Vanderbilt Sleep Division at the Vanderbilt University Medical Center in Nashville, Tennessee.
These types of headaches tend to occur frequently, on both sides of the head (rather than on one side, as with a migraine). They generally resolve on their own within a few hours of waking.
3. Impotence
It’s a little-known fact, but one sign of sleep apnea can be trouble getting and maintaining an erection, says Kryger. In fact, a study presented in 2020 at the Sexual Medicine Society of North America found that almost two-thirds of all men seeking treatment for erectile dysfunction also had obstructive sleep apnea.
“Men with sleep apnea usually have lower testosterone levels, which they need for sexual activity,” explains Kryger. “Sleep apnea itself may also cause high blood pressure, which is also linked to impotence. And if you’re sleep-deprived, you are less likely to be in the mood for sex in general.”
4. Restless nights
If you have sleep apnea, you may notice that you wake frequently throughout the night, which can lead you to think you have insomnia when you really don’t, says Kryger.
“We see this a lot, especially in women — they go to their doctor and complain that they have trouble staying asleep, and they’re diagnosed with anxiety and given sleeping pills, which can actually make their apnea worse,” he says.
This is especially true around perimenopause, a time when some women develop sleep apnea, he adds.
Malow says, “Physicians assume their sleep problems are due to hot flashes and don’t look for the underlying cause.”
Another common sign is waking up frequently to urinate. “Some men make an appointment with a urologist because they think they have a bladder problem because they get up to use the bathroom five times a night,” says Sorscher.
“Their bladders are actually fine. Once their apnea is diagnosed and treated and they are sleeping more deeply, they don’t notice these sensations and don’t have any more nocturnal bathroom visits,” he says.
5. Dry mouth
About 30 percent of people with obstructive sleep apnea report having dry mouth when they wake up in the morning. This may simply be because their apnea forces them to breathe through the mouth, which dries it out, says Malow. But it’s also seen more commonly among people with sleep apnea than it is with those who are just habitual snorers.
6. Exhaustion
Let’s face it, many of us are sleep-deprived and feel tired. In fact, an estimated 30 percent of American adults report trouble sleeping, according to the U.S. Centers for Disease Control and Prevention.
But with sleep apnea you’re still wiped out even if you get a full night of sleep, says Malow. Experts say that in such cases, sleep apnea can hurt the quality of your sleep, even if you don’t realize it. You also may find yourself nodding off while doing activities you enjoy, like reading or watching TV.
“If you find yourself falling asleep in situations where you should be alert, during Zoom meetings or even while driving, that’s often a red flag sign,” says Kryger. You also may find yourself more irritable and snapping at others.
7. Difficulty concentrating
Having a hard time focusing? When you’re tired, it can be hard to hold your attention, says Dr. Helena Schotland, a professor of medicine in pulmonary, critical care and sleep medicine at the Icahn School of Medicine at New York City’s Mount Sinai. Some people also experience challenges recalling information or report issues with executive function, or the ability to plan, remember and carry out tasks.
Treating sleep apnea
If you notice any of these signs, Kryger recommends asking your doctor for a referral to a sleep specialist. (You can also take a screening test online, which will give you what’s called the STOP-BANG score for obstructive sleep apnea.) The gold standard treatment for sleep apnea is the CPAP machine, and now, with multiple forms of therapy and masks, most patients can find a comfortable option.
Types of sleep apnea
There are three main forms of sleep apnea:
- Obstructive sleep apnea (OSA) happens when the throat narrows and blocks the flow of air to your lungs.
- Central sleep apnea (CSA) occurs when your brain doesn’t communicate properly with your muscles responsible for breathing.
- Treatment-emergent central apnea syndrome, also called complex sleep apnea, is when OSA converts to CSA during therapy for the condition.
A 2022 study published in the European Respiratory Journal found that while sleep apnea itself accelerates your body’s biological aging, using a CPAP machine for just four hours a night was able to partially reverse it. “The good news is, when people are treated for their sleep apnea, most of their symptoms disappear,” Kryger says.
While a significant share of sleep apnea patients stop using their CPAP machine over time for a variety of reasons, a big one being discomfort, Kryger encourages people with sleep apnea to stay the course.
“There are so many different models of CPAP masks out there that it’s unusual to find a patient who can’t tolerate one at all,” he says. “They are also more convenient — they’re much quieter and smaller than they used to be.”
If you can’t tolerate a CPAP, the Inspire upper airway stimulation system is another option. It’s inserted surgically while you’re under general anesthesia.
“It’s like a pacemaker: It delivers mild stimulation to the hypoglossal nerve, which controls the movement of tongue muscles,” Kryger explains. This allows your airway to remain open during sleep.
Your doctor may suggest wearing an oral appliance over your teeth to keep your throat open. Myofunctional therapy, or exercises to strengthen your upper airway muscles to reduce airway narrowing during sleep, is another treatment option.
Wearable devices like the Oura Ring may seem appealing, but they aren’t approved by the Food and Drug Administration for these purposes, Kryger notes. “At best, they suggest that you may need further testing, like a sleep study,” he says.
Pharmaceutical options, such as tirzepatide (Zepbound), have been approved to treat sleep apnea as well.
Editor’s note: This story, originally published Sept. 14, 2021, has been updated based on new information.
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