Sleep Apnea or Allergies?

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If you snore or breathe abnormally in your sleep, you might wonder if you have allergies, sleep apnea, or both. While both conditions can affect how you breathe at night, they differ from one another in key ways, including how they’re treated.

Both sleep apnea and allergies can disrupt sleep, but the two conditions are very different and present with a different set of symptoms.

Different types of allergies can produce different symptoms, but the symptoms most similar to sleep apnea are associated with a type called allergic rhinitis. Allergic rhinitis refers to allergic reactions relating to the nose. 

Allergic rhinitis is associated with seasonal or environmental allergens. Breathing in these allergens irritates the nose, leading to symptoms like sneezing or a stuffy nose. Although symptoms start in the nose, they can lead to several other effects and even impact your sleep.

Symptoms of allergic rhinitis include:

• Sneezing 
• Runny nose
• Stuffy nose
• Itchy nose, eyes, or mouth
• Postnasal drip
• Cough
• Irritability

These symptoms can be uncomfortable and make it harder to sleep at night for people with moderate to severe allergies. People with allergies may breathe using their mouth while they sleep because the nose is too stuffed up. 

Similarly to sleep apnea, allergies can also cause fatigue, daytime sleepiness, and morning headaches. Unlike sleep apnea, allergic rhinitis causes nasal and breathing symptoms that aren’t limited to sleep.

People with sleep apnea temporarily stop breathing many times while they’re asleep. Of the different types of sleep apnea, obstructive sleep apnea (OSA) is most likely to mimic allergies, because it is caused by a physical blockage in upper airways like the nose and throat.

Symptoms of obstructive sleep apnea include:

• Loud snoring 
• Choking or gasping during sleep 
• Feeling sleepy during the day
• Restless sleep 
• Waking up to urinate
• Memory troubles

Not everyone who snores has obstructive sleep apnea, but particularly loud snoring, especially when combined with choking or gasping, can be a telltale sign. Often people with OSA don’t know they snore or gasp, but a bed partner or roommate may notice these signs. A home sleep test is often the first step in diagnosing sleep apnea.

Allergies may lead to many sleep problems including insomnia, daytime sleepiness, difficulty waking up, and restless sleep. This happens for a few reasons.

• Inflammatory signals: Allergic reactions trigger inflammation and the release of chemicals in the body that may lead to excess tiredness and sleep problems. 
• Nasal blockage: Allergies may cause nasal blockages, such as a stuffy nose, which can make it more difficult to breathe normally and fall asleep. These blockages can also lead to snoring. 
• Allergy medications: Some allergy medications are known to cause drowsiness or disrupt sleep. 

Unlike an allergy, obstructive sleep apnea is a sleep disorder and is therefore specifically known for its impact on sleep. Repeated pauses in breathing cause a sleeper to wake up slightly to catch their breath. As a result, people with OSA have fragmented sleep and often don’t spend enough time in important deep sleep stages. 

Compared to allergies, obstructive sleep apnea is much more likely to be linked with excessive daytime sleepiness or falling asleep during the day. For that reason, untreated OSA can be a safety risk when driving.

Allergies are one factor linked to developing obstructive sleep apnea. Because allergies often come with nasal congestion, they contribute to the airway blockage associated with OSA. Congestion is also thought to worsen existing OSA.

People with allergies are more likely to breathe through their mouths while asleep. When breathing this way, the tongue can partially block the upper airways, which may further increase the risk of OSA. 

Although allergies may contribute to obstructive sleep apnea, they are not among the primary risk factors associated with the condition. 

About The Author

Afy Okoye

Staff Writer, Sleep Health

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Afy is a writer and creative strategist in San Francisco with a master’s degree in international health policy from the London School of Economics. She has written for VeryWell Health, BlackDoctor.org, and Paste magazine and edited peer-reviewed journal manuscripts for Elsevier. Afy says her work with The Sleep Doctor is anything but “sleepy.” She enjoys the opportunity to learn new information and share knowledge that gives people the power to make better choices. Afy also likes to read non-fiction, do creative writing, and travel solo.

• POSITION: Side Sleeper
• TEMPERATURE: Hot Sleeper
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