Can Alcohol Cause Sleep Apnea to Worsen? The Science Behind Alcohol and Airway Obstruction

The Science Behind This Connection

Sleep apnea is a common sleep disorder affecting a significant percentage of the adult population which is caused by narrowing or collapse of the airway during sleep. This results in interrupted breathing, loud snoring and poor quality sleep. 

Obstructive sleep apnea (OSA)  is the most common form of the disorder and can have a negative impact on overall health and well-being. It is important that these symptoms are managed correctly to prevent more serious complications later on.

There are many factors which can worsen the symptoms of sleep apnea. One of the key factors is alcohol. Alcohol relaxes throat muscles, which causes the airway to collapse, resulting in increased breathing disruptions during sleep. This results in loud snoring and poor quality sleep.

Alcohol can also reduce blood oxygen levels resulting in more serious health complications. Many individuals find that their breathing is also affected after they drink.

Recognising the link between alcohol and sleep apnea is key to managing the condition effectively. In this article we will explore the physiological effects of drinking alcohol and how it can cause sleep apnea episodes to worsen. 

We will look at the effect of alcohol on breathing, find out how much alcohol affects sleep, and also offer practical advice for managing alcohol consumption in this context.

The Physiological Effects of Alcohol on Sleep Architecture

Impact on Muscle Relaxation

In  patients who suffer from sleep apnea, the airway narrows or closes causing interrupted breathing and reduced oxygen in the body. Alcohol is a relaxant which means that it causes the muscles in the throat and mouth to relax further and can worsen airway obstruction found in sleep apnea patients. It also lowers blood oxygen levels and together this can increase the risk of serious cardiovascular complications.

Alterations in Sleep Stages

Alcohol significantly disrupts sleep architecture, impacting various stages in distinct ways. To begin with, it acts as a sedative, making you feel drowsy and helping you fall asleep quickly. It can increase deep sleep in the first half of the night however, it disrupts the normal sleep cycle and there is a delay in the onset of REM sleep. 

Reduced REM sleep has a negative impact on cognitive function and mental health. As the night progresses and the alcohol is metabolised, the sedative effect wears off resulting in frequent awakenings and difficulty returning to sleep. 

The disruptions in sleep stages caused by alcohol consumption can create a cycle of poor sleep, daytime fatigue and drowsiness, further complicating the management of sleep disorders.

Exploring the Link Between Alcohol and Increased Sleep Apnea Events

Frequency of Apnea-Hypopnea Index Increase

Alcohol consumption increases the frequency and severity of sleep apnea, as measured by the apnea-hypopnea index (AHI). The AHI is a critical metric that quantifies the number of apnea and hypopnea events per hour of sleep.

Even moderate alcohol consumption can have a significant impact. Research shows that modest alcohol consumption, resulting in a mean blood alcohol concentration of 0.07 g/dL, increased the AHI from 7.1 to 9.7 events per hour.

The Wisconsin Sleep Cohort Study found that an increment of one drink per day increased the risk of mild or worse sleep-disordered breathing (SDB) by 25%, including sleep apnea. This confirms the direct impact of alcohol on the frequency and severity of apneic events. 

Case Studies and Clinical Research

Clinical research and case studies further confirm the negative impact of alcohol on sleep apnea. Experimental studies show that drinking alcohol before sleep reduces the tone of the upper airway muscles. 

This means that alcohol can make the airway more prone to collapse, leading to longer and more frequent apneic events. Over time, this can result in more serious complications, including cardiovascular health issues. Studies show that alcohol increases sleeping heart rate. This can put added strain on the heart and combined with lower oxygen levels can increase the risk of cardiovascular disease.  

Practical Guidance on Alcohol Consumption for Sleep Apnea Patients

Recommended Alcohol Limits

Clinical research and case studies suggest that patients with sleep apnea should reduce alcohol intake considerably or avoid it altogether if possible. This can help prevent worsening of the symptoms and reduce the risk of developing more serious complications including cardiovascular disease.

This is because even moderate drinking can increase the apnea-hypopnea index (AHI) and reduce blood oxygen levels. If you are unable to avoid alcohol completely, it is advised to stop drinking at least a few hours before bedtime to minimise the impact on sleep apnea symptoms. 

Lifestyle Modifications and Management Strategies

As well as reducing alcohol intake or avoiding it altogether there are many other lifestyle modifications and management strategies which you can incorporate to help reduce the symptoms of sleep apnea

First, it is very important to maintain a good bedtime routine. Going to bed at the same time every day and making sure that you have a relaxed environment to sleep is important for a good night's sleep. 

You should reduce any distractions from your bedroom, for example mobile phones, laptops and television. Try to make sure that your bed is comfortable, changing your mattress or even your pillows and bedding can have a positive impact on your sleep. 

You may wish to incorporate relaxation techniques into your bedtime routine, for example enjoying a warm bath may help promote better sleep at night. Reading a relaxing book or listening to gentle music may also help promote sleep. It is also important to  maintain a healthy diet and participate in regular exercise especially considering obesity is a key cause of sleep apnea. 

Continuous Positive Airway Pressure (CPAP) therapy is the gold standard for management and treatment of sleep apnea. If you have a CPAP machine then it is important that you use it consistently as compliance is key for optimal therapeutic impact. CPAP can significantly reduce the number of apneic events and counter some of alcohol's adverse effects on sleep apnea

Take This Advice Seriously

Studies show that alcohol has a direct impact on sleep apnea causing episodes to worsen significantly. Alcohol causes the muscles of the upper airway to relax resulting in further obstruction of the airway in patients already suffering from sleep apnea.

It increases the apnea-hypopnea index (AHI) and lowers oxygen saturation levels. This causes breathing difficulties, increases snoring and disrupts the sleep cycle. Patients may find that they fall asleep quickly because of the sedative impact of alcohol; however by reducing REM sleep, alcohol can affect mental health and well-being. 

It is very important that patients with sleep apnea avoid alcohol consumption or reduce it considerably.  This can minimise the risk of developing serious health complications including cardiovascular disease. As well as avoiding alcohol, it is important to maintain a healthy lifestyle and incorporate lifestyle modifications which are targeted to promote better quality sleep.

If you are suffering from sleep apnea and are finding it difficult to avoid alcohol or reduce your alcohol intake then you need to speak to your doctor or healthcare provider. They will be able to put together an individually tailored treatment plan for you and help you manage your alcohol consumption so that you can improve your overall health and well-being and avoid serious complications in the future.