CPAP vs. Untreated Sleep Apnea

Key Takeaways

• Untreated sleep apnea is associated with a variety of physical and mental health issues, such as high blood pressure, congestive heart failure, and depression.
• CPAP therapy is the most commonly prescribed treatment for sleep apnea, but many people struggle to follow the therapy as directed due to side effects that are often manageable or easily resolved.
• If you've been prescribed CPAP therapy, it's important to continue therapy and troubleshoot any obstacles, because CPAP therapy may reduce daytime tiredness, the risk of car crashes and accidents, and the risk of multiple negative long-term health effects.

What Is CPAP Therapy?

Continuous positive airway pressure (CPAP) therapy is a medical treatment commonly used for sleep apnea. A CPAP machine delivers pressurized air through a tube and a mask into a person's airway as they sleep, acting as a “pneumatic splint” and preventing the airway from collapsing. CPAP and other PAP therapies are the most commonly prescribed sleep apnea treatments, as they’re the most effective way to keep the airway open during sleep. 

With obstructive sleep apnea, a person's breathing repeatedly stops or slows during sleep because the airway becomes blocked or collapses. These breathing interruptions activate the body’s stress response and inflammation, repeatedly disrupting sleep, lowering blood oxygen levels, and contributing to daytime fatigue, other symptoms, and a range of health risks.

Because CPAP reduces airway blockages and collapses, the therapy can reduce daytime sleepiness, along with the risk of car crashes, high blood pressure, and other potential health problems linked to untreated sleep apnea.

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What Happens With Untreated Sleep Apnea?

When sleep apnea goes untreated, a person experiences an excessive number of breathing interruptions during sleep. These breathing interruptions result in lower oxygen intake and lower blood oxygen levels. They can also cause brief awakenings and disrupt sleep patterns, leading to sleep that doesn't fully restore a person and causes daytime tiredness. 

Over time, the long-term effects of untreated sleep apnea include a lower quality of life, a greater risk of car crashes, high blood pressure, heart failure, stroke, other heart problems like atrial fibrillation (AFib), mental health disorders, sexual dysfunction, and a greater risk of early death. OSA has also been linked to obesity, insulin resistance, cognitive deficits, cancer, gastroesophageal reflux disease (GERD), and other sleep disorders. 

CPAP vs. Untreated Sleep Apnea

Researchers have consistently found CPAP therapy has a positive impact on the short- and long-term effects of sleep apnea. By keeping the airway open during sleep, CPAP helps reduce breathing disruptions, improve sleep quality, and relieve common symptoms such as daytime sleepiness.

Effects on Daytime Functioning

Sleep apnea can negatively impact how a person functions day-to-day. People with sleep apnea are more likely to feel tired during the day, struggle to focus, experience memory problems, have negative moods, and get into accidents, especially car crashes. 

Studies demonstrate that treating sleep apnea with CPAP therapy helps with many of these problems. Specifically, researchers have found that CPAP therapy results in less daytime sleepiness, increased feelings of vitality, and a greater overall quality of life.

Compared to people with untreated sleep apnea, those who comply with CPAP therapy are 70% less likely to get in a car crash. This difference is believed to be due to CPAP therapy improving sleep apnea symptoms and increasing alertness, which leads to better driving.

Long-Term Health Risks

Sleep apnea is linked to high blood pressure and other heart-related problems, including an increased risk of cardiovascular disease, atrial fibrillation, heart attack, and stroke. The disorder has also been associated with an increased risk of other health problems, including cancer and metabolic disorders, such as type 2 diabetes, prediabetes, insulin resistance, and obesity. Finally, sleep apnea is linked to cognitive decline, Alzheimer's, and dementia.

The relationship between sleep apnea and various long-term health risks isn't fully understood, but in many cases, it’s assumed likely that sleep apnea contributes to the risk of other health issues.

While more research is needed, existing studies have found that treating sleep apnea with CPAP therapy can help reduce certain health problems, like high blood pressure, depression, and erectile dysfunction. For people with sleep apnea and heart disease or high blood pressure, consistent CPAP use is an important part of protecting long-term cardiovascular health.

Quality of Life

In addition to impaired daily functioning and increased health risks, other long-term effects of untreated sleep apnea include a lower quality of life across multiple realms. Daytime tiredness can negatively impact a person's ability to perform well at work or fully show up in relationships. Because the disorder can cause a person to wake up during the night, sometimes while gasping or choking, sleep can feel unsatisfactory. Bed partners may also be bothered by the snoring often caused by sleep apnea.

Treating sleep apnea with CPAP therapy has been repeatedly found to increase a person's quality of life. Quality of life likely improves as the result of more restorative sleep, reduced daytime tiredness, increased energy and alertness, and improved mood.

Common Concerns About CPAP

Despite the many benefits of CPAP therapy, about half of people prescribed a CPAP machine don’t use it as often as directed. Often, the reasons for not using CPAP therapy as prescribed stem from side effects that should be troubleshooted. People may also choose to stop using CPAP if they don't understand how beneficial it can be.

A common obstacle to successful CPAP therapy is an uncomfortable or poorly fitting mask, which can cause air leaks that reduce treatment effectiveness. These leaks may create extra noise that disrupts both the user’s sleep and their partner’s, allow moisture and air to escape leading to dry mouth, or direct airflow toward the eyes, causing dryness or irritation.

In some cases, the discomfort or leaking air may even cause people to remove the mask unintentionally during sleep, which can ultimately lead to reduced use of the therapy or stopping it altogether.

Some people may also become claustrophobic or feel uncomfortable breathing against the air released by a CPAP device. Others may develop nasal congestion, dry mouth, nausea, or other symptoms like aerophagia, which is excessive air swallowing that can lead to burping, stomach discomfort, and bloating.

If you've been prescribed a CPAP machine and are experiencing side effects, it's important that you talk with a doctor rather than quit treatment. Doctors and sleep technicians have multiple techniques available to help address CPAP therapy difficulties, such as adjusting the mask or headgear, trying different mask types, addressing other health issues that may be causing interference, and adjusting the machine's air pressure levels or humidification settings.

When to Talk to a Doctor

Anyone who thinks they may have sleep apnea should talk with a doctor. Also, those who’ve been diagnosed with sleep apnea and prescribed CPAP therapy but are struggling to adhere to the therapy guidelines, should visit a doctor or sleep specialist.

Talk to a doctor if you experience daytime tiredness or your sleep doesn't feel refreshing. Also, tell a doctor if you have other symptoms of obstructive sleep apnea, such as loud snoring or nighttime wake-ups, especially those that involve gasping for air or a choking sensation. Sleep apnea symptoms in women differ and may include morning headaches, nightmares, insomnia, and depression.

If your doctor deems it appropriate, a home sleep test through Sleep Doctor can be a convenient first step. Sleep Doctor’s at-home testing allows you to assess your risk for sleep apnea without an in-lab visit, with results reviewed by a licensed physician who can recommend next steps if treatment is needed.

Frequently Asked Questions

Can untreated sleep apnea cause weight gain?

Yes, untreated sleep apnea can contribute to weight gain. Sleep apnea disrupts sleep patterns, which can in turn impact eating habits and hormones related to hunger and appetite.

That said, the relationship between sleep apnea and body weight is considered bidirectional, which means each affects the other. While sleep apnea may impact weight, it’s also well-known that having overweight or obesity can also contribute to the development of sleep apnea.

Is untreated sleep apnea dangerous?

Untreated sleep apnea is considered dangerous, especially because it's associated with an increased risk of car crashes and other errors and accidents. When a person has severe obstructive sleep apnea in particular, they’re at risk of falling asleep during the day or being drowsy while doing critical, high-attention activities and experiencing an accidental injury.

Sleep apnea is also linked to an increased risk of death, especially from heart-related issues. More research is needed to determine if CPAP therapy can reduce this risk.

Does sleep apnea get worse if untreated?

Although the topic hasn't been widely researched, untreated sleep apnea could become more severe over time. Because sleep apnea has a bidirectional relationship with many other disorders, not treating it could worsen other health problems, which could then worsen the sleep apnea.

Even without the presence of other disorders, sleep apnea is considered a progressive disease, and the consequences of untreated sleep apnea are numerous and serious. Increases in related health risks, like the risk of heart-related problems, cancer, and even death, are likely to persist without treatment. For this reason, treating sleep apnea is important to maintaining overall health and preventing negative health outcomes.