Sleep Apnea Causes and Risk Factors

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Central sleep apnea is caused by problems with the way your brain controls your breathing while you sleep.

Obstructive sleep apnea is caused by conditions that block airflow through your upper airways during sleep. For example, your tongue may fall backward and block your airway.

Your age, family history, lifestyle habits, other medical conditions, and some features of your body can raise your risk of sleep apnea. Healthy lifestyle changes can help lower your risk.

Many conditions can cause sleep apnea. Some factors, such as unhealthy lifestyle habits, can be changed. Other factors, such as age, family history, race and ethnicity, and sex, cannot be changed.

• Age: Sleep apnea can occur at any age, but your risk increases as you get older. As you age, fatty tissue can build up in your neck and the tongue and raise your risk of sleep apnea.
• Endocrine disorders, or changes in your hormone levels: Your hormone levels can affect the size and shape of your face, tongue, and airway. People who have low levels of thyroid hormones or high levels of insulin or growth hormone have a higher risk of sleep apnea.
• Family history and genetics: Sleep apnea can be inherited. Your genes help determine the size and shape of your skull, face, and upper airway. Also, your genes can raise your risk of other health conditions that can lead to sleep apnea, such as cleft lip and cleft palate and Down syndrome.
• Heart or kidney failure: These conditions can cause fluid to build up in your neck, which can block your upper airway.
• Large tonsils and a thick neck: These features may cause sleep apnea because they narrow your upper airway. Also, having a large tongue and your tongue’s position in your mouth can make it easier for your tongue to block your airway while you sleep.
• Lifestyle habits: Drinking alcohol and smoking can raise your risk of sleep apnea. Alcohol can make the muscles of your mouth and throat relax, which may close your upper airway. Smoking can cause inflammation in your upper airway, which affects breathing.
• Obesity: This condition is a common cause of sleep apnea. People with this condition can have increased fat deposits in their necks that can block the upper airway. Maintaining a healthy weight can help prevent or treat sleep apnea caused by obesity.
• Sex: Sleep apnea is more common in men than in women. Men are more likely to have serious sleep apnea and to get sleep apnea at a younger age than women.

• Age: As you get older, normal changes in how your brain controls breathing during sleep may raise your risk of sleep apnea.
• Family history and genetics: Your genes can affect how your brain controls your breathing during sleep. Genetic conditions such as congenital central hypoventilation syndrome can raise your risk.
• Lifestyle habits: Drinking alcohol and smoking can affect how your brain controls sleep or the muscles involved in breathing.
• Opioid use: Opioid use disorder or long-term use of prescribed opioid-based pain medicines can cause problems with how your brain controls sleep.
• Health conditions: Some conditions that affect how your brain controls your airway and chest muscles can raise your risk. These include heart failure, stroke, amyotrophic lateral sclerosis (ALS), and myasthenia gravis. Also, your hormone levels can affect how your brain controls your breathing.
• Premature birth: Babies born before 37 weeks of pregnancy have a higher risk of breathing problems during sleep. In most cases, the risk gets lower as the baby gets older.

You may be able to prevent obstructive sleep apnea by making healthy lifestyle changes, such a eating a heart-healthy diet, aiming for a healthy weight, quitting smoking, and limiting alcohol intake. Your healthcare provider also may ask you to sleep on your side and to adopt healthy sleep habits such as getting the recommended amount of sleep.