Sleep Apnea Causes and Risk Factors

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

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

Your age, family history, lifestyle habits, other medical conditions, and some features of your body (for example, your neck or tongue) can raise your risk for sleep apnea. But healthy lifestyle changes can help lower your risk.

Many conditions can cause obstructive sleep apnea. Some factors, such as unhealthy lifestyle habits, can be changed. Other factors, such as age and family history, 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 tongue.
• Obesity: People with obesity can have increased fat deposits in their neck that can block their upper airway. Maintaining a healthy weight can help prevent or treat sleep apnea caused by obesity.
• Large tonsils, neck, or tongue: These features can narrow your upper airway or make it more likely for your tongue to block your airway while you sleep.
• Endocrine disorders or changes in your hormonelevels: Your  hormone  levels can affect the size and shape of your face, tongue, and upper airway. People who have  polycystic ovary syndrome  (PCOS), low levels of  thyroid hormones , or high levels of insulin or growth hormone have a higher risk for 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. Your genes can also raise your risk for other health conditions, such as cleft lip and cleft palate and Down syndrome, which can lead to sleep apnea.
• Heart or kidney failure: These conditions can cause fluid to build up in your neck, which can block your upper airway.
• Lifestyle habits: Drinking alcohol and smoking can raise your risk for 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.
• Sex: Sleep apnea is more common in men than women. Men are more likely to have serious sleep apnea and to be diagnosed with sleep apnea at a younger age than women.

The following factors can raise your risk for central sleep apnea.

• Health conditions: Some conditions that affect how your brain controls your airways and chest muscles can raise your risk. These include heart failure, stroke, amyotrophic lateral sclerosis, and myasthenia gravis. Your hormone levels can also affect how your brain controls your 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.
• 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.
• Premature birth: Babies born before 37 weeks of pregnancy have a higher risk for breathing problems during sleep. In most cases, the risk decreases as the baby gets older.
• Sex: Central sleep apnea is more common in men than women.
• Age: As you get older, normal changes in how your brain controls breathing during sleep may raise your risk for sleep apnea.

You may be able to prevent obstructive sleep apnea by making healthy lifestyle changes. These changes include adopting a heart-healthy diet, aiming for a healthy weight, quitting smoking, and limiting alcohol intake.