Alcohol and Sleep Apnea: How Drinking Affects Sleep Quality

💡 Key Takeaways

• Alcohol's Impact on Sleep Apnea: Drinking alcohol has been linked to an increased risk of sleep apnea. While alcohol does not directly cause someone to develop sleep apnea, it can exacerbate symptoms and lead to related health issues.
• Worsening Symptoms: Alcohol can aggravate sleep apnea symptoms by increasing snoring, reducing sleep quality, and lowering oxygen levels in the blood, leading to more frequent sleep apnea episodes.
• Alcohol's Effect on Breathing: Drinking can cause muscle relaxation, leading to airway obstructions during sleep. Additionally, alcohol can cause nasal congestion, making Obstructive Sleep Apnea more likely.
• CPAP Therapy's Role: Continuous positive airway pressure (CPAP) therapy remains the leading treatment for sleep apnea. While alcohol consumption can impact sleep apnea, CPAP therapy can still effectively manage the condition, even if you consume alcohol.
• Recommendation: Limit or avoid alcohol consumption if you have sleep apnea. If you choose to drink, it's essential to maintain your CPAP therapy routine.

While many risk factors contribute to the development of sleep apnea, one of the most significant is drinking. Studies have shown a clear link between alcohol and sleep apnea. Without lifestyle changes, this complex relationship can lead to serious impacts on your health and wellness, which we will explore further today.

In this article, we will discuss the all-too-common complications that arise when sleep apnea and drinking alcohol are combined. Plus, we’ll share what you can do to reduce the impact that it has on your sleep apnea.

Drinking alcohol has long been associated with an increased risk of sleep apnea. A 2018 data analysis of more than twenty previous studies found that this correlation may be more pronounced between those who struggle with sleep apnea and heavy drinking.

According to this report, individuals who consume higher amounts of alcohol are 25% more likely to develop sleep apnea compared to those who do not drink at all or only drink occasionally.

While there is a lot of evidence to support this relationship, it is important to note that we do not yet know if drinking alcohol directly causes sleep apnea. Experts say that more research is needed to better understand this relationship.

At the very least, it does increase your risks of developing other health issues which have been proven to lead to sleep-related respiratory changes—for example, obesity and chronic illness.

Sleep apnea causes changes in your breathing and oftentimes leads to respirations temporarily stopping. In mild cases, you may experience a handful each hour, but for more serious ones, it can be hundreds.

When your brain senses this pause, it arouses you from the stages of deep sleep so that you can return to normal breathing for the time being.

There are two main categories of these apnea episodes:

• Obstructive Sleep Apnea: OSA is caused by a blockage of the upper airway, which occurs when the muscles that make up the tongue, soft palate, uvula, tonsils, etc., become over-relaxed and collapse into the back of the throat during sleep.
• Central Sleep Apnea: CSA arises from two main issues. Sometimes it is triggered when the brain cannot sense that your body needs to take another breath. Other times, the brain is unable to control the muscles that are involved in breathing. Regardless of the cause, Central Sleep Apnea results in your body being unable to stimulate inhalation.

There are a few reasons why alcohol makes sleep apnea worse. Let’s go over them!

Higher Arousal Threshold

Alcohol can impact your brain’s ability to sense and respond to your sleep apnea-related breathing changes. When your breathing pauses during a sleep apnea episode, it causes carbon dioxide to build up in your blood.

Usually, your brain senses this shift and tells you to wake up so that you can correct your breathing. But when you drink alcohol, it causes your brain to become less sensitive to carbon dioxide.

As a result, your brain allows your breathing to remain paused for much longer before sending the alarm that you need to wake up and take a breath.

Muscle Relaxation

Drinking tends to increase the likelihood of airway obstructions while you are asleep. This is because alcohol consumption has a pretty major effect on the strength of your muscles and their ability to contract.

Essentially this makes it easier for the muscles that make up your tongue, mouth, and throat to become over-relaxed, which leads to more incidents of airway blockages.

Increased Nasal Congestion

One factor that a lot of people don't often associate with alcohol and sleep apnea is nasal congestion. Certain alcoholic beverages can cause your sinuses to begin producing extra mucus.

Additionally, these drinks tend to cause dehydration, which leads to swelling in your sinuses. Finally, some people have difficulty breaking down the alcohol in their bodies, resulting in a slight allergic reaction.

Together, both of these things make you more likely to rely on mouth breathing which can make Obstructive Sleep Apnea more likely.

Alcohol seems to aggravate sleep apnea symptoms significantly. Drinking is believed to worsen existing cases, with one recent report stating that consuming alcohol may increase your likelihood of experiencing:

• Increased snoring
• Poorer sleep quality
• More frequent sleep apnea episodes
• Lower oxygen levels in the blood
• Increased risk of developing sleep apnea-related health issues, such as drowsy driving and cardiovascular problems

Continuous positive airway pressure (CPAP) therapy is the leading treatment option for most people with Obstructive Sleep Apnea and mild to moderate Central Sleep Apnea. It involves delivering pressurized air through the airway and into the lungs.

In the case of OSA, this stream of air helps to keep the airway open. For people with Central Sleep Apnea, it allows the lungs to fill with air despite not having total control over their respiratory muscles.

Few studies have measured the impact of CPAP therapy on the effects of alcohol on sleep apnea. However, the research that has been done looks promising, and experts generally consider continuous positive airway pressure therapy to be the preferred method for managing the additional impacts of alcohol consumption on sleep apnea.

In the handful of studies that have been performed, drinking does not seem to reduce the effectiveness of CPAP on sleep apnea itself. Furthermore, one study did find that higher air pressure settings were sometimes needed to resolve snoring in people who were otherwise showing no other signs of Obstructive Sleep Apnea.

Sleep apnea is not the only breathing issue that arises during sleep! There are a few different conditions that fall into this category, and alcohol affects each one.

• Snoring: Alcohol can make you snore, even if you don’t have sleep apnea, but it tends to have a much more significant impact on people who already snore at night. This happens as a result of the effect that drinking can have on the soft tissue/muscles of your mouth and throat.
• Upper Airway Resistance Syndrome (UARS): This condition is kind of like having pre-Obstructive Sleep Apnea. People with this diagnosis have partial airway obstruction, it’s just not leading to breathing changes yet. So when you drink alcohol, it worsens UARS for many of the same reasons it does OSA.
• Sleep-Related Hypoxemia Disorder: Hypoxemia disorder arises when the oxygen levels in your blood drop, but the carbon dioxide levels do not increase. Drinking alcohol can cause your body to have a harder time bringing in oxygen, which can cause and/or worsen this disorder.
• Sleep-Related Hypoventilation: Hypoventilation occurs when the body is low on oxygen, but also has high amounts of carbon dioxide. When you consume alcohol, your body can respond by slowing your breathing significantly, causing more carbon dioxide build-up.

Research suggests that alcohol increases your likelihood of experiencing poor sleep, and can even lead to a sleep disorder. Plus, it can make things like daytime fatigue much worse.

American Addiction Centers states that more than one-third of people who drink experience insomnia. Additionally, a 2013 data review found that when non-alcoholics drink any amount of alcohol they:

• Take Longer to Reach Stage 4 Deep Sleep: While you may be able to fall asleep faster, it will take you a lot longer to reach REM sleep.
• Get Fewer Hours of Stage 4 Deep Sleep: Your total number of hours spent in REM sleep will be significantly shorter, even if you do not have a habit of excessive alcohol consumption.

Most health experts advise that anyone with sleep apnea avoid drinking alcohol as much as possible. At the same time, we also understand that you may wish to enjoy a drink from time to time. If so, we suggest keeping it to no more than one drink at a time and plan to stop drinking within three to four hours of going to sleep.

If you require a CPAP machine, your healthcare provider will most likely suggest limiting your alcohol intake. However, if you choose to drink, it is highly encouraged that you keep up with your CPAP therapy routine. So far, there is no evidence to suggest that alcohol makes CPAP less effective.

Yes! Alcohol consumption is associated with lower oxygen levels, particularly during sleep. There are a few reasons for this, including the fact that alcohol slows your breathing and makes it harder for your body to actually take in oxygen.

There are a lot of factors that contribute to the development of things like Obstructive Sleep Apnea or Central Sleep Apnea. It is unlikely that addressing just one risk factor is going to completely reverse your condition. Instead, quitting alcohol should be just one step in a larger, personalized treatment plan that includes other lifestyle changes as well.

Drinking is a well-known risk factor for many forms of sleep-disordered breathing. If you have Central Sleep Apnea or Obstructive Sleep Apnea, understanding the complex relationship between alcohol and sleep apnea is critical.

Drinking not only increases your likelihood of developing either form of sleep apnea, but it can also make existing cases worse. There is good news, however! Through lifestyle changes and continuous positive airway pressure therapy, you can significantly reduce the impact that alcohol has on your health.

And if you have not yet been diagnosed with sleep apnea, but have concerns that you may be one of the millions of undiagnosed cases, we encourage you to reach out to your healthcare provider to speak about undergoing a Home Sleep Test. Armed with the correct tools and information, you can take control of your well-being!