How Sleep Apnea Affects People Differently

Sleep apnea is a serious sleep disorder which is characterized by interruptions in breathing during sleep. There are two main types of sleep apnea, obstructive sleep apnea (OSA) and central sleep apnea (CSA). OSA occurs when throat muscles relax, blocking the airway, while CSA occurs when the brain fails to send proper signals to the muscles which control breathing. Both types of sleep apnea cause oxygen levels to drop and can have long term health complications if left untreated.

Some key sleep apnea risk factors include obesity, family history, large neck circumference, smoking, alcohol consumption, and upper airway abnormalities such as craniofacial structure. More men are affected than women, and it is more likely to occur later on in life especially between the age of 40 to 70. 

OSA, the most common type of sleep apnea, involves repeated upper airway collapse during sleep. Risk factors of OSA include high blood pressure, cardiovascular conditions and diabetes. There are also ethnic disparities, with higher prevalence among African Americans, Hispanics, and Native Americans. 

Across various demographics, factors such as age, gender, hereditary risk and genetic predisposition, shape who is most at risk for sleep apnea.

One of the most common symptoms of sleep apnea is persistent loud snoring. Other symptoms include waking up feeling exhausted despite a full night's sleep, and struggling with daytime fatigue that impacts your work and relationships. This is the daily reality for millions living with sleep apnea, and eventually it can affect your heart, brain, and overall health. 

However, sleep apnea impacts individuals differently. Variations can be seen in patients of different age groups and gender. From differences between age groups, men and women to hereditary factors such as family history and genetic predisposition, understanding these sleep apnea demographics can help identify your own predisposition or family history risks. In this article we offer key insights into how genetic factors amplify the hereditary risk, making this knowledge important in managing and addressing sleep apnea effectively.

Sleep Apnea Across Different Age Groups

Children and Adolescents

In children and adolescents, obstructive sleep apnea (OSA) is often caused by enlarged tonsils or adenoids, and obesity. It affects approximately 1–6% of young people, making it a significant pediatric health concern.

Untreated pediatric OSA can negatively impact learning, behavior, and emotional regulation. It may lead to attention problems, hyperactivity, mood disturbances, and lower school performance. This can have a negative impact on a child’s social development and their ability to function independently as they transition into adolescence.

Sleep apnea also causes serious cardiovascular and metabolic consequences. Younger patients face a higher risk of elevated blood pressure and other cardiometabolic changes. Also, those with untreated OSA are significantly more likely to develop high blood pressure compared to their peers without OSA.

As the symptoms in children are different to those in adult sleep apnea, for example behavioral issues or poor growth rather than obvious daytime sleepiness, it is important to monitor your child for signs like snoring, gasping, restless sleep, and daytime learning or behavior issues. Speak to your health care provider if you have any concerns and if necessary they will refer you to a pediatric sleep clinic for evaluation.

Health Risks for Adults 

In adults, OSA is often associated with obesity, anatomical upper airway factors, and lifestyle choices such as alcohol consumption and smoking. It is characterized by loud snoring, witnessed apneas, and daytime sleepiness that affects concentration and safety.

Adult OSA poses clear health risks, including higher blood pressure, an increased likelihood of cardiovascular disease, impaired glucose metabolism, and cognitive complaints. These risks tend to escalate with the severity of OSA and with concurrent conditions such as obesity and hypertension.

Treatment options for adults range from positive airway pressure (PAP) therapies and oral appliances to weight management, positional therapy, and, when necessary, upper airway surgery. If you suspect that you or a loved one may be suffering from sleep apnea then it is important that you speak to your health care provider. They can evaluate your symptoms and either recommend a sleep study or put together an individually tailored treatment plan for you. 

Health Risks for the Elderly

The prevalence of sleep apnea increases with age. This is due to changes in muscle tone, airway collapsibility, and comorbid illnesses that make apnea events more frequent and sometimes harder to identify, as daytime sleepiness may be attributed to aging or other conditions.

In elderly patients, OSA increases cardiovascular risks and can speed up cognitive decline, mood disorders, and daytime functional impairments. When putting together a treatment plan your health care provider will take into consideration any underlying conditions and existing medication. A sleep specialist or a healthcare provider experienced in geriatric care would be able to offer the best advice.

How Gender Affects Sleep Apnea

Sleep apnea prevalence is higher in men compared to women, with community studies showing a ratio of 2:1 to 3:1, and up to 8:1 in clinical settings. However, it is thought to affect women differently. Severity of symptoms are often milder, women encounter more events during REM sleep (62% in women vs. 24% in men) and have significantly fewer cases limited to the supine position.

In men, OSA is often linked to greater upper airway collapsibility and fat distribution around the neck. On the other hand, women, especially those who are premenopausal, benefit from protective factors provided by sex hormones. Post-menopause, this protective effect diminishes, narrowing the gap, although women still generally exhibit lower apnea-hypopnea index (AHI) levels.

Interestingly, despite these differences, women with OSA often face worse outcomes. They have a 28% higher mortality risk, compared to 3% in men, increased healthcare utilization before diagnosis, and greater daytime impairment, even at similar severity levels of the condition.

Gender,  Symptoms, and Diagnosis

Gender differences in sleep apnea are also evident in the symptoms. Men typically report loud snoring and observed apneas, whereas women may exhibit subtler signs such as insomnia, depression, fatigue, morning headaches, nightmares, or palpitations. These less obvious symptoms often contribute to underdiagnosis in women.

As a result, women frequently visit their healthcare providers multiple times before receiving a sleep apnea diagnosis. 

Raising awareness of these gender-specific differences in sleep apnea is important. Gender-sensitive screening can help detect OSA earlier, especially since women tend to report more sleepiness at lower AHI levels and experience clustered events during REM sleep. If you notice these symptoms, consider consulting a sleep clinic to discuss your concerns and prevent further complications later on.

Genetic Factors in Sleep Apnea

Studies estimate that genetic factors account for a significant portion of variability in OSA metrics, with more than 35–40% of apnea-hypopnea index (AHI) variance attributed to genetics. This means that having a family history of apnea increases your personal risk, even after considering lifestyle and medical factors.

Genes play a role in traits critical for airway patency and breathing control, such as craniofacial and upper airway anatomy, fat distribution (including neck fat), muscle tone in airway-supporting muscles, ventilatory control, arousal thresholds, and circadian or sleep traits. If you exhibit any of these features then factors such as obesity, alcohol use, or nasal congestion are more likely to cause sleep apnea than in individuals who do not have such traits.

Patients with Down syndrome or Prader–Willi syndrome may be more prone to developing sleep apnea than others.

Research on Genetics and Apnea

Genetic research on OSA has evolved from family and twin studies to more advanced methods like candidate-gene analyses and large genome-wide association studies (GWAS). These show that multiple gene signals are linked to OSA, and affect AHI, oxygen saturation, and daytime sleepiness. Examples include signals near genes involved in inflammation, craniofacial development, neuromuscular control, and metabolic pathways.

Recent research also confirms inflammatory and metabolic pathways of OSA, which suggests the shared genetic links between OSA and conditions like obesity, cardiovascular disease, and altered lipid metabolism.

Genetic tests do not confirm OSA, however if you do have a family history or genetic predisposition, then earlier screening is highly recommended. Genetic research is helping scientists understand the mechanisms behind OSA, identify potential biomarkers, and may eventually lead to personalized prevention or treatment strategies tailored to an individual’s genetic and phenotypic risk profile.

What’s Your Risk for Sleep Apnea?

Sleep apnea can affect patients of all sizes, ages, gender and ethnic background. It affects people differently. Children may experience behavioral problems and growth issues, adults face cardiovascular risks, and the elderly may be affected by faster cognitive decline.

Sleep apnea in men vs. women shows men are more likely to exhibit classic symptoms like snoring, whereas women experience subtler symptoms such as fatigue and insomnia, which can lead to delayed diagnoses. A genetic predisposition through family history increases the risk of OSA for everyone.

It's important to remember that factors such as upper airway characteristics, hereditary risk, and sleep apnea genetic factors play a role in determining the severity of sleep apnea. By considering elements such as age differences and gender, individuals can better understand their own likelihood of developing the condition.

Don't ignore the symptoms. Consult your healthcare provider or a sleep clinic today for screening and treatment options. Protect your heart, brain, and overall health. Take action now to achieve restorative sleep!