Is Sleep Apnea Hereditary? Know Your Risk Factors

Each person is unique in their traits, characteristics, body shape, posture, and facial structure. You inherit half of your genes from your mother and the other half from your father. The genetic makeup of every individual is full of instructions covering every aspect of your physical shape, structure, along with our vulnerabilities to certain diseases.

Throughout your life, you may find yourself at risk for a different set of conditions than the person sitting next to you, based on the genetics passed down from one generation to the next. Sleep apnea is no different. Some of us are more prone to developing certain sleep apnea risk factors than others, and the risk factors can be what ultimately causes sleep apnea.

Sleep apnea can be hereditary though not always. That’s because there are many factors that influence whether or not a person is likely to develop sleep apnea and some of them are made up of things decided by family history.

For example, some people are born with a more naturally narrow airway than others or with excess tissues due to nothing other than family history. When combined, it can create the right conditions for sleep apnea to develop within your genealogic tree.

Let’s take a pause here to better understand genetics and heredity. When we talk about medical conditions being passed down, it’s common to use the two synonymously, but that’s incorrect.

You may already know from junior high biology that your body’s genes are made of deoxyribonucleic acid (DNA). If your body were a house, builders would use DNA as the prime material to build you. Your body is composed of over 20,000 genes, and 99% of them are the same in virtually everyone.

The other 1%? Heredity—meaning something that is passed down from generations via genes and includes information such as hair and eye color and predispositions to certain medical conditions.

While genes are something your body has, heredity is technically the right term to use when we talk about whether or not a trait your body possesses was handed down from your parents’ genes or if it's something that your body developed over time.

Snoring is caused by the vibrations of certain parts of the airway as air rushes past during sleep. The airway vibrates because the tissues of the mouth and throat are relaxed during sleep.

Genetics provide the geometry of a person’s airway, and those with a family history of snoring are more likely to snore than people that didn’t report snoring in their family.

In a landmark 1995 study published in the medical journal Chest, researchers examined the incidence of snoring and whether or not current snorers had any family history of snoring. The study found that many participants with a family history of snoring were more likely to snore than ones with no family history of snoring, meaning there’s a hereditary component to snoring that can be passed to the next generation.

Only because you snore doesn’t necessarily mean you will develop one of the three types of sleep apnea though your odds of doing so are certainly higher.

When a person is at risk for developing Obstructive Sleep Apnea (OSA), generally, the following risk factors are present. In order to better understand them, let’s break them down by heredity, genetics, or controllable factors, such as obesity, alcohol consumption, or exercising.

Genetics:

• Male Gender
• Small Lower Jaw and Certain Other Facial Configurations
• Large Neck Circumference
• Large Tonsils
• Menopause
• Hypothyroidism (Low Levels of Thyroid Hormone)
• Acromegaly (High Levels of Growth Hormone)

Hereditary:

• Family History of OSA or Snoring

Controllable:

• Obesity. Approximately two-thirds of people with OSA are overweight or obese.
• Alcohol Consumption. A 2019 study found that if you drink, then you are 25 percent more likely to develop sleep apnea.

Some of these risk factors, like family history, large tonsils, a small lower jaw, and a large neck circumference are all purely genetic and can lead to developing OSA later in life. Other risk factors, like obesity and alcohol consumption, are both factors that most of the time we have some control over.

Now that you know the difference between heredity and genetics, which one is it: is OSA hereditary or genetic? OSA is largely attributed to genetics. In 2019, researchers studied the genetic structure of adults with OSA and concluded that OSA is best conceptualized as a chronic, complex disease that likely reflects the influence of multiple genetic factors.

There are three types of sleep apneas. Now that you know about the most common one, OSA, let’s have a look at the other two: Central Sleep Apnea (CSA) and Mixed or Complex Sleep Apnea. The latter is sometimes referred to as CompSA to not confuse it with CSA.

With a condition like CSA or CompSA, there’s something other than a blocked airway to consider. At least some of the time, the brain isn’t sending the signal to breathe. There could be any number of reasons for this including:

• Cheyne-Stokes Breathing. With Cheyne-Stokes Breathing, over time breathing effort and intensity gradually decreases and eventually leads to a point where no breathing occurs. Cheyne-Stokes Breathing generally occurs among individuals who have congestive heart failure or stroke.
• Opioid Treatments. Sometimes people undergoing opioid treatment experience CSA, as the opioids treating the disease have a side effect of seizing the rest of the body. Opioids can impact the brain’s ability to send a signal to the lungs to breathe, and the result is CSA.
• High Altitudes. Sometimes merely being at a high altitude can create a Cheyne-Stokes Breathing pattern, which can cause CSA.

Complex Sleep Apnea is a condition in which both OSA and CSA exist at the same time. So not only is there a blockage of the airway, but there’s also a component to the condition in which at times, the brain simply isn’t sending the signal to breathe. Treating CSA requires managing both types of sleep apnea simultaneously and is normally doing using a BiPAP machine. A BiPAP machine allows your doctor to dial in two different pressures: one for inhaling and one for exhaling to make breathing more comfortable and effective.

There have been no direct links found between heredity and CSA or CompSA, although there certainly are links between heredity and some of their underlying causes.

Typically, sleep apnea is diagnosed by undergoing a sleep study. The sleep study measures heart rate, respiration, blood oxygen content, among other things, and can help determine if you have sleep apnea.

Depending on the results of the study, you may be diagnosed with mild, moderate, or severe sleep apnea. From there, your doctor will recommend a course of treatment which may include CPAP therapy.