How Alcohol Affects Sleep Apnea and Snoring by Relaxing Airway Muscles

Understanding Why Drinking Alcohol and Sleep Apnea Don't Mix

Drinking alcohol like beer, wine, or cocktails makes sleep apnea worse due to relaxation of muscles along the upper airway
Drinking alcohol like beer, wine, or cocktails makes sleep apnea worse due to relaxation of muscles along the upper airway. Getty Images

Alcohol consumption can induce sleep apnea and other sleep disorders. It disrupts the natural sequence and length of sleep states by changing the total amount of time you sleep and the time it takes you to fall asleep. It also has important impacts on breathing during sleep. How does alcohol affect the risk of sleep apnea and snoring by relaxing the muscles of the airway?

While about 20 percent Americans have obstructive sleep apnea (OSA), only about 10 percent have received a diagnosis.

During an episode of sleep apnea, your air passage narrows to such a degree it interrupts your natural breathing cycle and wakes you up, although you may fall back to sleep so fast you don't know you were ever awake. Sometimes the air passage completely closes.

You are more likely to have OSA than the general population if you are:

  • middle-aged or older
  • overweight or obese
  • have anatomy that narrows the airway

The Health Benefits of Sleep

No one knows the exact function of sleep but not getting enough of it causes serious consequences. If you don't get enough sleep you increase your risk of developing:

  • depression
  • poor metabolism
  • heart disease
  • insulin resistance (diabetes)

The day after an insufficient night's sleep, you feel tired the next day. Excessive daytime sleepiness caused by sleep disturbance, such as breathing interruptions, is associated with:

  • impaired function in social situations and at work
  • difficulty with remembering things
  • car accidents

These consequences are important to keep in mind when considering the effects of alcohol consumption on breathing during sleep.

Alcohol Causes Sleep Apnea and Makes It Worse

There is an association between alcohol and sleep apnea even if you don't have a diagnosis.

Studies show that moderate or heavy drinking can cause episodes of OSA in people who don't even have it. Additionally, if you have alcohol use disorder, you may be at higher risk for developing OSA, especially if you already snore. 

For those with OSA, the consequences of sleep apnea become more pronounced when you drink because alcohoI can increase the time between when you stop breathing and "wake up" to breathe again. In other words, it makes your OSA worse.

The increase in the severity of your symptoms makes the drops in your blood's oxygen levels, called desaturations, become more severe. This may lead to increased carbon dioxide levels in the body, a condition called hypercapnia, which, in severe cases, can be fatal.

Alcohol's Effect on Nighttime Breathing and Snoring

Drinking alcohol can affect the nighttime breathing of patients with sleep-disordered breathing, such as sleep apnea.

Alcohol decreases your drive to breathe, slowing your breathing and making your breaths shallow. In addition, it may relax the muscles of your throat, which may make it more likely for your upper airway to collapse. This may contribute to both snoring, which represents the vibration of the soft tissues, to complete obstruction that occurs in sleep apnea.

Should Sleep Apnea Sufferers Avoid Alcohol?

If you have sleep apnea, the best advice would be to abstain from all alcohol use. If you enjoy drinking an alcoholic beverage, even occasionally, this is unlikely. At the very least, don't consume alcohol in the several hours prior to bedtime to minimize the effects overnight. Use your treatment for sleep apnea every night.

You should also keep in mind the importance of setting up your continuous positive airway pressure (CPAP) under typical sleeping conditions. Therefore, if you drink alcohol daily but abstain prior to your titration study, the pressure may not be adequate to maintain your airway when you drink.

AutoCPAP machines that can adjust the pressures through the night may help to avoid this issue. 

To maximize your response to therapy, consider the role that alcohol use plays in optimally treating your sleep apnea.

Sources:

Finkel, KJ et al. "Prevalence of undiagnosed obstructive sleep apnea among adult surgical patients in an academic medical center." Sleep Med. 2009 Aug;10(7):753-8.

Issa, FG and Sullivan, CE. "Alcohol, Snoring, and Sleep Apnea." Journal of Neurology, Neurosurgery & Psychiatry. 1982;45:353.

National Institute on Alcohol Abuse and Alcoholism: Alcohol and Sleep (1998)

Scrima, L et al. "Increased severity of obstructive sleep apnea after bedtime alcohol ingestion: diagnostic potential and proposed mechanism of action." Sleep. 1982;5:318.

Continue Reading