Is Sleep Apnea Genetic?

Key Takeaways

• Genetic factors, environmental factors, and lifestyle factors can all impact a person's risk of developing obstructive sleep apnea.
• Research shows that obstructive sleep apnea tends to run in families, but this connection could be the result of genes or similar lifestyles among family members.
• A genetic test cannot determine whether or not a person will develop obstructive sleep apnea, but researchers are working on identifying genes linked to the disorder.

Genetic Factors That Influence Sleep Apnea Risk

Studies suggest that obstructive sleep apnea can develop as the result of a person's genes. That said, researchers haven't pinpointed specific genes that directly cause sleep apnea. Genes may directly cause the disorder among some people, but among others, genes may influence factors that make sleep apnea more likely to develop, such as body weight, face and head anatomy, and ethnicity.

Body Weight

People who have overweight or obesity are much more likely to develop obstructive sleep apnea. Also, the higher a person’s body weight, the more severe their OSA tends to be. Because obesity has a genetic component, genes that increase a person's risk of becoming obese may also increase their risk of developing OSA.

Environmental factors can make it more or less likely that a person will gain weight. For example, widespread sugary drinks and a decline in regular exercise are also linked to obesity, especially when they were present early in life.

OSA often improves when a person loses weight. Though it may not cure OSA completely, weight loss is associated with less severe symptoms, as well as lower blood pressure and better overall health.

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Head and Face Shape

The shape and structure of a person's head are often inherited from their parents, and certain shapes can increase the risk of developing OSA. For example, an unusually small jaw can put pressure on the upper airway and crowd the surrounding tissue, leading to airway blockages. Additionally, having a large tongue or enlarged tonsils can block the airway, making sleep apnea more likely.

Some of these characteristics do not lead to OSA unless a person gains weight. Others may occur regardless of body weight, as the result of genetic disorders or natural variation. 

Ethnicity

People who belong to certain racial or ethnic groups might be at greater risk for OSA. In some instances, this may be due to physical characteristics, while in other cases, the risk may come from environmental or social factors. 

Imaging studies have found that some anatomies that are more common among certain ethnic groups can crowd the airway, making OSA more likely. For example, people of Icelandic heritage are more likely to have more soft tissue around their upper airways, which can encroach on breathing space. People of Chinese heritage are more likely to have smaller jaws and more tissue on the roof of the mouth, both of which may limit airway space.

African American people, especially those under 35, have a higher rate of OSA. This may be due to inherited genetic risk. It may also be affected by socioeconomic factors affecting body weight, like how affordable and accessible healthy food is and how walkable one’s neighborhood is.

Sleep Apnea in Children

OSA affects around 1% to 5% of children under the age of 18 and is most common in kids between 2 and 6 years of age. When OSA occurs in infants, it’s often due to an anatomic or genetic disorder.

Many factors can increase the risk of OSA in children. As with adults, some of these may have a genetic component.

• Obesity: Having overweight or obesity is a significant risk factor for OSA, especially among teenagers.
• Large tonsils: Kids who have larger tonsils are at increased risk for developing OSA. This can be hereditary or linked to illnesses and infections. 
• Genetic disorders: OSA is more common among children with Down syndrome, achondroplasia, and Prader-Willi syndrome, among other inherited conditions.
• Orthodontic issues: Problems with the teeth and jaws, such as bite misalignment and crooked teeth, can lead to OSA.
• Environmental conditions: Kids exposed to secondhand smoke are more likely to develop OSA. Asthma and sinus problems, which can be triggered by environmental allergens, are also associated with childhood sleep apnea.
• Head and face shape: Just like adults, children can develop OSA due to differences in their head and face structures, such as a small jaw. 

Other Risk Factors for Sleep Apnea

Genetics are only one factor that play a role in a person's risk of developing obstructive sleep apnea. These other factors have been linked to an increased risk for the disorder:

• Age: A person's risk of OSA increases as they age, beginning in young adulthood. People in their 60s and 70s face the highest risk of developing the disorder. 
• Sex assigned at birth: People assigned male at birth have double or triple the risk of developing OSA throughout much of life. However, once people assigned female at birth reach menopause, their risk of sleep apnea is just as high as men's risk.
• Body weight: As mentioned, the more a person weighs, the greater the risk of developing OSA. One study found that each 10% increase in a person's body weight results in them being six times more likely to develop sleep apnea.
• Head and face shape: Being born with a smaller than average jaw, enlarged tonsils or adenoids, or other anatomical features that may crowd or shrink the airway increases a person's chances of developing sleep apnea.
• Smoking: Smoking is a lifestyle factor that can increase a person's risk of OSA. One study found that people who smoke face triple the risk of having sleep apnea compared to those who don't smoke.
• Certain substances: Consuming certain substances may relax muscles in the airway, leading to more blockages that increase the risk of OSA. These substances include alcohol, along with certain pain and anti-anxiety medications.
• Other health conditions: OSA is more common among people with certain other health conditions, like congestive heart failure, high blood pressure, kidney disease, lung disease, strokes, thyroid problems, Parkinson's disease, polycystic ovary syndrome (PCOS), fibromyalgia, gastroesophageal reflux disease (GERD), Down syndrome, and more. Sleep apnea also becomes more common during pregnancy.

It should be noted that central sleep apnea has different risk factors than obstructive sleep apnea. Like obstructive sleep apnea, central sleep apnea involves lapses in breathing during sleep, but these stem from brain signaling problems rather than airway obstructions. Risk factors for central sleep apnea include health problems that impact the brain, as well as medications, like painkillers.

How to Lower Your Risk of Sleep Apnea

While you cannot completely control whether or not you develop sleep apnea, there are actions you can take to lower your risk. These involve changing your lifestyle to modify the risk factors that are within your control. 

For example, you can maintain a healthy weight or lose weight if necessary by eating a healthy diet and exercising regularly. When recommended by a doctor, weight-loss surgery or weight-loss medications may also help. 

You can also lower your risk of developing sleep apnea by avoiding smoking and limiting your intake of alcohol and sedative medications. If you're on a drug that has sedative effects, talk with your doctor, rather than going off of it all on your own. Your doctor can help you determine the pros and cons of each medication you take, as well as help you taper off a medication if necessary.

Some people experience more breathing issues during sleep when lying on their backs. If this is true for you, avoiding the back sleeping position may help reduce your risk of sleep apnea. That said, changing your sleeping position alone may not properly treat sleep apnea, so if you think you might have the disorder, be sure to get evaluated.

When to Talk to Your Doctor

It’s important to let your health care provider know if you or a family member are experiencing symptoms of sleep apnea. Untreated sleep apnea is linked to a host of health problems and other concerns. However, it is a treatable condition that often responds well to treatment.

Be sure to talk to your doctor if you or your bed partner notice sleep apnea symptoms, such as:

• Loud or frequent snoring
• Daytime sleepiness
• Fatigue
• Choking or gasping at night
• Insomnia