Yes, You Can Have Sleep Apnea Even if You Don’t Snore

Loud snoring is one of the best-known signs of obstructive sleep apnea (OSA). But don’t assume you can rule out this condition just because you’re a quiet sleeper.

Did you know that you can have obstructive sleep apnea without snoring? It’s not just possible, but it’s also relatively common, says sleep medicine specialist Sunjeet Kaur, MD.

Dr. Kaur explains how “silent sleep apnea” can happen and what symptoms to watch for.

Can you have sleep apnea without snoring?

Sleep apnea can happen even if you don’t snore loudly … or at all.

“Less than 50% of cases of obstructive sleep apnea present without audible snoring,” Dr. Kaur reports. “But it absolutely happens. You may have no snoring or just very light, intermittent snoring.”

OSA happens when the muscles and tissues in your throat relax too much during sleep, which partially or fully blocks your airway. Snoring is a common symptom — the sound of air that can’t move easily through a narrowed airway.

But not everyone with obstructive sleep apnea snores (or snores loudly enough for it to be noticed). And if you sleep alone, you may not realize you snore at all.

So, how can you tell? Let’s take a look.

Symptoms of silent sleep apnea

Even without snoring, obstructive sleep apnea can still cause symptoms that affect your sleep, energy levels and overall health.

Dr. Kaur says common signs of silent sleep apnea may include:

• Excessive daytime sleepiness
• Feeling unrested when you wake up
• Morning headaches
• Multiple nighttime awakenings
• Fatigue

If you share a bedroom with someone, they may tell you they’ve noticed pauses in your breathing while you sleep, even without obvious snoring.

And Dr. Kaur points out that women, in particular, are especially likely to experience OSA differently from the stereotype of a loud, rattling snorer.

“In women, obstructive sleep apnea commonly presents with multiple nighttime awakenings, with no history of loud snoring,” she explains.

What causes silent sleep apnea?

Silent sleep apnea has the same underlying causes as other forms of obstructive sleep apnea — a blocked airway while you sleep. The only difference is that in some people, OSA doesn’t cause snoring (or as much snoring).

But on the whole, there are many factors that raise your risk of OSA, including:

• Obesity or overweight
• Older age
• Family history of sleep apnea
• Nasal congestion
• Smoking
• Alcohol use
• Large tonsils or certain jaw structures
• Hormonal changes, including menopause

Does central sleep apnea cause snoring?

Central sleep apnea (CSA) happens when your brain doesn’t properly signal your body to breathe while you’re asleep.

“Central sleep apnea presents without snoring,” Dr. Kaur says.

Central sleep apnea is much less common than obstructive sleep apnea. It’s more common in people who have certain health conditions, like congestive heart failure, chronic opioid use or stroke.

When to seek treatment

If you regularly wake up exhausted, struggle with daytime sleepiness or frequently awaken at night, it’s worth talking to a healthcare provider, even if you don’t snore.

Dr. Kaur reiterates that many people associate sleep apnea with loud nighttime breathing noises. So, a lack of snoring can sometimes delay diagnosis.

“People who don’t snore — or who don’t realize they snore — often assume they can’t have sleep apnea,” she emphasizes. “It’s common for individuals in these situations to postpone seeking evaluation by a healthcare provider.”

But without treatment, sleep apnea can increase your risk of:

• High blood pressure
• Heart rhythm problems, like atrial fibrillation
• Metabolic conditions
• Cognitive impairment

Daytime sleepiness is also a major risk factor for motor vehicle injury.

“Given both the short- and long-term consequences of untreated sleep apnea, it’s important to seek evaluation by a healthcare provider in a timely manner,” Dr. Kaur stresses.

The good news is that sleep apnea is treatable. Lifestyle changes, CPAP therapy and other treatments can help improve your sleep quality and protect your long-term health.