How dangerous is sleep apnoea?
Untreated sleep apnoea demonstrably increases the risk of stroke, heart problems, and accidents. If you have symptoms that may point to it, get checked by your general practitioner.
Sleep apnoea is estimated to affect nearly one billion people worldwide and goes undetected in most patients. The condition causes repeated drops in blood oxygen levels and brief awakenings throughout the night. This leads to excessive daytime sleepiness, difficulty concentrating, and memory problems. People with untreated sleep apnoea have a clearly elevated risk of traffic accidents and workplace accidents.
The heart and blood vessels are at serious risk. Moderate or severe apnoea is associated with an almost twofold higher risk of stroke or death, even after accounting for other risk factors such as high blood pressure and diabetes. In people with additional conditions, the mortality risk rises considerably further: those with several other illnesses can have a risk up to 38 times higher than someone without those additional conditions. Sleep apnoea also increases the likelihood of coronary artery disease, heart failure, and cardiac arrhythmias such as atrial fibrillation. In some groups of cardiovascular patients, more than half also have sleep apnoea.
Whether treatment also reduces hard cardiovascular outcomes is less certain. CPAP, a mask that keeps the airway open during the night, demonstrably reduces daytime sleepiness and improves sleep quality. When used for at least four hours per night, treatment-resistant high blood pressure also decreases and cardiac arrhythmias diminish. However, the randomised trials conducted to date have not yet shown that CPAP also reduces the long-term risk of heart attack or stroke. Whether asymptomatic patients benefit from treatment remains unclear.
If you experience symptoms such as loud snoring, morning headaches, excessive fatigue, or waking up with a feeling of choking, discuss this with your general practitioner. For a diagnosis of moderate or severe sleep apnoea, treatment is advisable, if only to reduce the daily burden and the risk of accidents.
This answer draws on several reviews and a systematic review, supplemented by two individual studies. The evidence for the daily consequences and the association with cardiovascular disease is solid and consistent. The associations with mortality are impressively large, but come in part from observational research in which people were followed without any intervention being assigned, so cause and effect cannot be established with certainty. The evidence that CPAP also improves hard cardiovascular outcomes is still weak: the randomised trials designed to demonstrate this effect have not shown it so far.
Are sleeping pills harmful in the long term?
Long-term use of classic sleeping pills increases the risk of dependence, cognitive decline, and impaired driving ability. Therefore, do not use them for longer than two to four weeks, and discuss alternatives with your doctor if you are already a long-term user.
How harmful is shift work for your health?
Shift work is demonstrably harmful to sleep, alertness and metabolism. The best approach combines a well-designed schedule with forward rotation, strategic use of light, melatonin and, where appropriate, cognitive behavioural therapy.
What does alcohol do to your sleep?
Alcohol helps you fall asleep faster, but measurably disrupts the rest of your night, even with just two drinks. If you want to sleep better, drinking less or no alcohol before bed is the most effective step.
Is it safe to take melatonin every night?
For healthy adults, melatonin is relatively safe with short-term use, but as a sleep aid for chronic insomnia it works considerably less well than standard sleep medicines. Pregnant women, breastfeeding women, and children outside a medical indication are better off avoiding it.
Is it a problem that I often wake up during the night?
Regularly waking during the night affects your mood, concentration and, over time, your health. If it is a structural problem, it is worth doing something about it, starting with a proven behavioural approach to sleep.
Is a daytime power nap healthy or not?
A power nap of less than 30 minutes taken early in the afternoon provides a modest but measurable boost to alertness and concentration, without the health risks associated with longer naps. For most people, such a short nap does not disrupt night-time sleep either.