Can You Have Sleep Apnea and Not Feel Tired?

Symptoms Vary and Those with Insomnia May Not Feel Sleepy

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Some people become incredulous when the possibility that they may have sleep apnea is presented to them. Snoring men may reluctantly come to see a sleep doctor at their bed partner’s request, for example. Though symptoms of sleep apnea may be known, not everyone experiences every one of them. You might wonder: Can you have sleep apnea and not feel tired or sleepy? Learn the answer and discover how to sort out if you have the condition.

Common Symptoms of Sleep Apnea

There are a handful of symptoms that are commonly associated with sleep apnea. It is possible to have disrupted breathing in sleep without having all, or even most, of these symptoms. Some of the most common symptoms include:

Many people develop problems associated with sleep apnea – ranging from these symptoms to medical disorders like hypertension, diabetes, and heart failure – that can be improved with treatment.

Can Sleep Apnea Occur without Sleepiness?

Sleepiness can come from many causes. It may occur with inadequate total sleep time or poor quality sleep.

It might be secondary to medication side effects. Sleepiness increases due to homeostatic sleep drive and may be enhanced at times by the circadian rhythm. Why does sleep apnea contribute to sleepiness?

Sleep apnea results when the upper airway collapses during sleep. This results in a drop in the blood oxygen levels and an increase in carbon dioxide levels.

The brain realizes this is occurring and responds via the sympathetic nervous system: a burst of stress hormone (cortisol) leads to a spike in pulse rate, blood pressure, and an awakening. This occurs at least 5 times per hour, by definition, but it may occur more than 100 times. These events disturb sleep: leading to full awakenings or moving the affected person from deep to lighter sleep. Sleep becomes less refreshing, and daytime sleepiness may result.

Not everyone is overly sleepy with sleep apnea. In fact, women are more prone to insomnia complaints. The presence of insomnia may lead to lighter sleep at night, more time spent awake after awakenings, and less sleepiness during the daytime. People with insomnia are more awake at night and more awake during the daytime as well.

In addition, it is common for both sleep apnea and insomnia to occur together. This can complicate treatment due to the inability to become comfortable with CPAP therapy.

Sleepiness can also be masked by caffeine use.

Some people don’t consider themselves sleepy, even though they drink excessive amount of coffee, tea, or soda pop.

If you believe you may have some symptoms that could be attributed to sleep apnea, there is really only one foolproof way to sort it out: get a sleep study. Mild sleep apnea may be missed by home sleep tests, so you may require an in-center polysomnogram to finally get an answer.

Don’t dismiss your chance of identifying sleep apnea just because you don’t feel sleepy (or have any specific symptom, such as snoring). You may surprise yourself and actually feel and sleep better by finally getting the treatment that you need.


Kryger, M.H. et al. "Principles and Practice of Sleep Medicine." ExpertConsult, 5th edition, 2011.

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