Untreated Sleep Apnea: A Silent Threat to Life Expectancy

Finding out you have sleep apnea can be overwhelming. There’s a lot of information to process and many decisions to make, and, like with any new diagnosis, it’s natural to wonder what having sleep apnea means for your health, well-being, and overall life expectancy.

So, let's talk about it! The truth is, the impact that sleep apnea has on your life expectancy depends mostly on the severity of your sleep apnea and whether or not your sleep apnea goes untreated.

Studies show that not treating your sleep apnea can lead to early death. However, the exact numbers vary a lot depending on your type of sleep apnea, the severity of your condition, and whether you have other underlying risk factors.

With CPAP therapy, you can live a long, healthy life, and there is even a range of CPAP alternatives for those with mild or moderate sleep apnea that may serve as an effective treatment, too.

Today we'll review how the factors that most significantly impact your lifespan and explain the long-term health risks that can arise when sleep apnea is left untreated. We'll explore the benefits of sleep apnea treatment, including a reduced risk of death. And finally, we'll explain some little-known CPAP alternatives for those who want to treat their sleep apnea but are wary about starting CPAP therapy.

Health experts agree that having untreated sleep apnea can reduce your life expectancy. A 2020 data review found that people with sleep apnea were, on average, 74% more likely to die of any cause.

Unfortunately, it’s difficult to calculate the average lifespan of someone who has gone untreated with sleep apnea. One reason for this is that people rarely die of sleep apnea alone. Instead, they die of conditions that are made worse or even caused by sleep apnea. Another issue is the majority of people with untreated sleep apnea don’t even know they have it.

So, while we can't say precisely how long you can expect to live with sleep apnea, we can tell you that seeking treatment, particularly with CPAP therapy, has a very positive effect on mortality rates, which we'll discuss more in a moment.

Dying from sleep apnea alone is very rare, but it can happen. Usually, when you have sleep apnea, your breathing stops or slows temporarily, but eventually, your body will wake you up so you can take a full breath of air and return to normal breathing.

It is believed that those who die specifically from sleep apnea are simply unable to return to normal breathing and, sadly, do not wake up. Usually, these individuals die suddenly and unexpectedly in their sleep. The risk of sudden death due to sleep apnea increases with age, severity, and the presence of other health issues.

To better understand your life expectancy with untreated sleep apnea, it is important to remember that your risk of dying depends on a few factors. For example, mild sleep apnea life expectancy is better than the life expectancy for people with more severe cases. Let's talk about how these factors influence your lifespan.

People with untreated sleep apnea usually have one of two types: Obstructive Sleep Apnea (OSA) or Central Sleep Apnea (CSA).

• Obstructive Sleep Apnea Life Expectancy: This condition arises when a person temporarily stops breathing after the airway becomes blocked by the tongue, soft palate, tonsils, etc., during sleep. OSA is by far the most common form of sleep apnea. It is also considered easier to treat and has a better outlook compared to CSA.

During a study on the effects of sleep apnea on American veterans, 14.9% of subjects with OSA died during the 20-year follow-up period.

• Central Sleep Apnea Life Expectancy: Like OSA, CSA causes temporary pauses in breathing. However, these breathing changes are triggered by a communication issue between the blood, brain, and respiratory muscles. This condition can be more difficult to manage and is usually triggered by an underlying condition.

In the report mentioned above, 25.1% of American veterans with CSA died over the course of that same 20-year study.

When it comes to sleep apnea and life expectancy, the most important factor seems to be case severity. Studies have found that people with severe sleep apnea are more likely to experience a wide range of complications compared to others with mild or even moderate cases of sleep apnea.

The following results came from an 18-year study with the Wisconsin Sleep Cohort. On average, participants were 50 years old.

• Untreated Mild Sleep Apnea Life Expectancy: People who experienced between 5 and 15 sleep apnea episodes per hour were 40% more likely to die compared to those without sleep apnea.
• Untreated Moderate Sleep Apnea Life Expectancy: People with 16-30 breathing events per hour were 70% more likely to die compared to the general population.
• Untreated Severe Sleep Apnea Life Expectancy: Those with sleep apnea who recorded more than 30 respiratory events per hour were 280% more likely to die than the average person.

Sleep apnea rarely occurs alone. So if you have sleep apnea, you likely also have other health conditions. This is especially true for people with Central Sleep Apnea, as most cases are triggered by an underlying condition.

There are also several conditions that are believed to cause or worsen Obstructive Sleep Apnea, including things like Huntington's Disease, Congestive Heart Failure, and enlarged tonsils. When combined with the risks of having sleep apnea, these conditions can significantly impact your life expectancy.

Between lost sleep and low oxygen levels, sleep apnea can take a huge toll on your health and wellness. This can have significant impacts in the short term, such as excessive daytime sleepiness, irritation, and difficulty concentrating.

If left untreated, sleep apnea can also cause long-term issues, including damage to your heart, nervous system changes, and imbalanced hormones. Studies show that the additional stress causes increased inflammation and can even lead to organ damage. The good news is that many of these complications can be reversed with treatment!

Over the years, studies have shown a solid link between sleep apnea and cardiovascular conditions. In 2001, a team of scientists examined the cardiovascular effects of Obstructive Sleep Apnea on middle-aged men. They found that participants with untreated sleep apnea had a 56.8% chance of developing cardiovascular disease (CVD), while those who received effective treatment only had a 6.7% risk.

In 2019, the World Health Organization reported that CVD was responsible for 32% of all deaths worldwide. Cardiovascular diseases include stroke, high blood pressure, heart conditions, Coronary Artery Disease, Aortic Disease, stroke, etc. Because of their prevalence in sleep apnea, we will further discuss a few specific CVD-related conditions.

High blood pressure is one of the most common complications associated with sleep apnea. It has been estimated that around half of all people with OSA have high blood pressure, while about a third of those with high blood pressure also have sleep apnea.

If you have sleep apnea, your likelihood of hypertension depends on your condition's severity. One older study, published in 2000, estimated that for each sleep apnea event experienced per hour, your risk of developing high blood pressure increased by 1%. In 2011, scientists estimated that 13.5% of all annual deaths were related to high blood pressure.

According to a 2010 American Journal of Respiratory and Critical Care Medicine study, males with severe sleep apnea are two or three times more likely to experience a stroke. However, these researchers did note that participants with mild sleep apnea only had a 6% increased risk for this complication. The CDC states that 41.1 people out of every 100,000 died from stroke in 2021.

Heart-related conditions are by far the most common complications associated with sleep apnea. Unfortunately, they are also among the most dangerous. The National Commission on Sleep Disorders Research estimates that 38,000 Americans with sleep apnea die from heart disease each year.

Those with more severe cases of OSA are three times more likely to have eventual heart failure. A Yale School of Medicine study found that sleep apnea can increase your chances of having a heart attack or dying by 30% over four to five years.

While the exact number is unknown, experts believe many people with Type 2 Diabetes also have sleep apnea. Untreated OSA is often associated with insulin resistance, a condition that makes it harder for your body to process glucose. Sleep apnea can also cause a related metabolic condition called glucose intolerance, which results in regular episodes of high blood sugar.

People who have diabetes have an increased risk of death. A recent study from the University of Manchester found that people with Type 2 Diabetes die an average of two years earlier than the general population.

Obesity is a known risk factor for sleep apnea, but did you know that having sleep apnea can actually increase your likelihood of becoming obese? Sleep apnea has been proven to cause hormone imbalance, which contributes to weight gain. Like sleep apnea, obesity impacts your health in many ways and increases the risk of death.

Over the years, researchers have become increasingly aware of the link between sleep apnea and cancer. In 2020, the American Thoracic Society published a summary of a recent study conducted by Dr. Tetyana Kendzerska, MD, Ph.D. Dr. Kendzerska's team found a 15% increased risk of cancer in people with severe sleep apnea and a 30% increased risk for people whose sleep apnea resulted in regular episodes of low oxygen.

Each time you experience a sleep apnea episode, the oxygen levels in your blood drop significantly. Over time this can seriously impact your brain health, with one study finding that people with sleep apnea showed signs of a specific type of brain damage linked to dementia and stroke.

People who do not treat their sleep apnea are 43% more likely to develop some form of dementia. A good night's sleep has been proven to help clear the brain of certain proteins linked to Alzheimer's Disease.

Because of how this condition affects your brain, sleep apnea has been proven to affect mood and even cause depression and anxiety. It is estimated that nearly 18% of people with Obstructive Sleep Apnea have Major Depressive Disorder. According to a national survey published in 2015, 3.5% of all deaths were attributed to depression and/or anxiety.

Sleep deprivation, like the kind you experience with sleep apnea, directly affects your brain's ability to process information and remain attentive. Studies show that being awake for only 20 hours creates the same level of cognitive impairment as having a blood alcohol level of 0.1. A person is legally too drunk to drive at 0.08.

Unsurprisingly, people with sleep apnea have a higher risk for accident-related injuries, including car and work accidents. According to a report from the American Academy of Sleep Medicine, drivers with sleep apnea are 2.5 times more likely to be involved in a car crash.

Health experts agree that the life expectancy for treated sleep apnea is much better than those who are untreated. So as scary as untreated sleep apnea sounds, it's important to remember that continuous positive airway pressure (CPAP) therapy can significantly reduce your risks of experiencing health complications and even death.

In one study, French researchers found that people who continued to use CPAP therapy to treat sleep apnea were 27% less likely to die from any cause. Participants were also 23% less likely to be diagnosed with heart failure.

Another team of scientists found that older adults with sleep apnea who underwent CPAP therapy had a five-year survival rate of nearly 94%, compared to 69% of participants with untreated sleep apnea. This same study concluded that CPAP therapy reduced the likelihood of cardiovascular events by 41.8%.

CPAP therapy is often referred to as the gold standard treatment for sleep apnea, and for good reason! Unfortunately, many choose to end their CPAP journey prematurely after struggling to adjust. A lot of people are turned off by the idea of having to sleep with a CPAP machine long term and are more interested in pursuing home remedies for sleep apnea.

If this sounds familiar, there is no need to panic just yet! While CPAP therapy is the most popular and effective sleep apnea treatment, it certainly isn't your only option. There are several CPAP alternatives these days, many of which have proven highly effective, especially if you have mild or moderate OSA.

While sleep apnea cannot always be avoided, some cases will improve with lifestyle changes. For example, if you have severe sleep apnea and have substance use disorder, getting sober may significantly reduce the number of breathing episodes you experience each night.

Experts suggest that people with sleep apnea reduce their risk factors as much as possible. If you are diagnosed with sleep apnea, your healthcare provider will likely encourage you to make the following lifestyle changes (if applicable to you):

• Practice Mouth and Tongue Exercises to Strengthen Supporting Muscles
• Get Regular Exercise to Reduce the Impact of Weight on Sleep Apnea
• Quit Smoking
• Limit Alcohol Intake, Especially Before Bed

Did you know that the position you sleep in can have a big impact on both types of sleep apnea? Studies show that sleeping on your side can significantly reduce the number of sleep apnea episodes a person experiences each night.

Oral appliances are a relatively newer treatment method for sleep apnea but have grown in popularity recently. OAT involves using an oral device to keep the tongue, soft palate, tonsils, etc., from collapsing into the airway during sleep. Options include oral implants, retainer-like devices, and sleep apnea mouthguards.

Many people don't realize that CPAP is only one treatment option out of a larger group of devices that all utilize Positive Airway Pressure. Popular alternative PAP devices include Automatic PAP, BiLevel PAP, and Adaptive Servo Ventilation. These machines are typically reserved for people with severe sleep apnea or those struggling to respond to standard CPAP therapy.

When it comes to sleep apnea treatments, there are two main types of nerve-stimulating devices— those for Central Sleep Apnea (CSA) and those for Obstructive Sleep Apnea (OSA). These devices work similarly to a pacemaker but for the muscles of the tongue or diaphragm.

There are many surgical options for treating sleep apnea, although most surgeries can only be performed depending on the underlying cause of your sleep apnea. For instance, if enlarged tonsils are blocking your airway when you lay down, you may benefit from having them removed. In most cases, surgery should only be considered as a last resort, and only after significant consultation with your healthcare provider.

Cardiovascular disease is the most common cause of death for people with severe sleep apnea. ‘Cardiovascular disease’ is an umbrella term describing significant health events and conditions such as heart attacks, strokes, high blood pressure, coronary artery disease, etc. Studies show that these risks are significantly reduced with CPAP therapy.

Sleep apnea can take a toll on your physical and mental well-being without treatment. You may experience extreme fatigue, mood changes, and brain fog in the short term. Long-term consequences include diabetes, stroke, high blood pressure, cancer, depression, and other chronic conditions, which can shorten life expectancy.

The best way to reduce the risks of severe Obstructive Sleep Apnea is to seek treatment as soon as you suspect that you have sleep apnea. CPAP therapy is the gold standard treatment for sleep apnea, but your healthcare provider will likely also suggest lifestyle changes, sleeping on your side, or even surgery.

Thanks to CPAP therapy, you can live a long and healthy life even with sleep apnea! The key to this is seeking treatment early on. It is important to speak to your healthcare provider when you notice the warning signs of sleep apnea, such as chronic exhaustion, waking up gasping for air, or loud snoring.

CPAP therapy is the most effective way to treat sleep apnea and improve life expectancy. It has been proven to reduce your risk of developing dangerous health complications related to sleep apnea and, as a result, can also extend your life. Reports show that people who use CPAP regularly have a higher five-year survival rate compared to those who do not.

We understand if the statistics around untreated sleep apnea life expectancy seem a bit daunting. It can be scary to be diagnosed with a medical condition that has so many negative long-term effects. The good news is that sleep apnea damage does not have to be permanent. With the right information and a good healthcare provider, you can improve your health and well-being before it's too late!

And if you're just starting your journey and have yet to be officially diagnosed with sleep apnea, talk to your doctor about a Home Sleep Test. Once you know for sure whether or not you are one of the millions of people affected by sleep apnea, you can take control of your health and, more importantly, your future!