Can I have sleep apnea if I don’t snore?

You might think that snoring is the ultimate giveaway for sleep apnea, right? Well, not always! It's totally possible to have sleep apnea without ever making a peep.

What is sleep apnea?

First things first, what exactly is sleep apnea? Imagine your breathing stops and starts repeatedly while you sleep. This disruption lowers your oxygen levels and messes with your sleep cycles, leaving you feeling tired and groggy the next day, even if you think you've slept through the night ^[2].

Because here's the thing: every time your breathing stops, your body wakes up just enough to start breathing again, which means you never reach those deeper, more restorative stages of sleep. The reason why your breathing stops and starts depends on the type of sleep apnea you have: obstructive, central, or complex.

The two main types of sleep apnea

1. Obstructive sleep apnea (OSA) 

This is the most common type of sleep apnea, caused by the relaxation of throat muscles. When these muscles relax too much, they block your airway. This can happen due to factors like being overweight, consuming alcohol before bed, or simply the natural aging process.

2. Central sleep apnea 

This type of sleep apnea occurs when your brain doesn’t send the right signals to the muscles that control breathing. It’s not a physical blockage but rather a communication issue between your brain and body. This condition is often linked to heart failure or a stroke.

Additionally, certain medications, especially respiratory sedating medications such as narcotics and benzodiazepines, or sleeping at high altitudes can also contribute to central sleep apnea. This is why it's important for your sleep medicine specialist to know your full medication list.

Why is snoring common in sleep apnea?

Snoring is often associated with obstructive sleep apnea (OSA) because it occurs when the airway is partially blocked during sleep ^[3]. When air flows past these blocked or relaxed tissues in your throat, it causes them to vibrate, producing the sound of snoring. It's usually more common in men than women because men generally have narrower airways than women. However, hormonal changes after menopause can make women more susceptible to snoring as well ^[4].

Here again, snoring doesn’t necessarily mean that you have sleep apnea. Occasional snoring can be caused by factors like allergies, colds, alcohol consumption, or even sleeping on your back. It’s when the snoring becomes more frequent, more than a few times a week, that it can become a sign of a more serious condition like OSA.

Can you have sleep apnea without snoring?

Absolutely. While snoring is common in obstructive sleep apnea, not everyone with sleep apnea will snore ^[5]. Here are some reasons why:

• Silent apnea: Sometimes, the airway is blocked without causing the vibrations that produce snoring.

• Anatomical differences: Variations in the structure of your airway and throat can affect whether you snore. For example, having large tonsils, a deviated septum, or a naturally narrow throat can lead to sleep apnea without snoring.

• Central sleep apnea: This type doesn’t usually cause snoring because it’s about the brain not sending the right signals to breathe, not a physical blockage.

Recognizing sleep apnea without snoring

If you don't snore, it can be trickier to recognize sleep apnea. But there are other signs to watch out for ^[6]:

Excessive daytime sleepiness

Feeling very tired during the day, even after a full night’s sleep. This is because the constant interruptions prevent you from getting restful sleep.

Morning headaches

Waking up with headaches frequently due to low oxygen levels at night.

Gasping for air during sleep

Waking up suddenly with shortness of breath. This can be a frightening experience and is a significant indicator of sleep apnea.

Difficulty concentrating

Trouble focusing and staying alert during the day. This can affect your performance at work or school and lead to accidents.

(Suspicion of sleep apnea? Check out our self-check guide!)

Diagnosing and addressing sleep apnea

To diagnose sleep apnea, you'll likely need a sleep study. This can be done in a sleep lab (polysomnography) or at home with a home sleep test prescribed by your doctor ^[7]. These tests monitor various aspects of your sleep, such as brain waves, oxygen levels, heart rate, and breathing patterns, to provide a clear picture of what's happening.

Addressing sleep apnea is crucial because ignoring it can lead to serious health problems like high blood pressure, heart disease, stroke, and diabetes ^[8]. Recognizing the signs and getting the right treatment can significantly improve your quality of life and reduce these risks.

Beyond health implications, snoring can also impact your relationships. Loud, frequent snoring can disturb your partner's sleep, leading to frustration and even resentment. In some cases, couples may resort to sleeping in separate rooms, which can affect intimacy and connection.

Fun fact: the loudest snoring ever recorded reached 112.8 decibels, as loud as a chainsaw ^[9]!

So, if you suspect you have sleep apnea, consult with a healthcare professional for a proper diagnosis. Remember, treating sleep apnea not only improves your health but can also bring harmony back to your bedroom.