Is Sleep Apnea Hereditary? 4 Genetic Risk Factors Doctors Say You Shouldn’t Ignore
See the simple ‘tongue-in-cheek’ exercises that improve your breathing during sleep
You got your laugh from your mom and your hayfever from your dad. For better or worse (thanks, dad!), so many of our traits are hereditary. But is sleep apnea genetic too? “Yes, definitely,” declares integrative sleep medicine physician and women’s sleep expert Valerie Cacho, MD. “If you have a first-degree family member [parent, sibling or child] with the condition, your risk of developing sleep apnea—a blockage of the upper airway during sleep—increases by 50 percent,” she says.
In fact, a study in Current Genomics shows that 35 to 40 percent of the variables that cause sleep apnea, including a family history of the condition, are indeed genetic. Keep reading to learn more about the main hereditary factors and a few simple strategies proven to mitigate them.
4 common genetic risk factors for sleep apnea
There are a few key factors at play when it comes to your risk of developing obstructive sleep apnea (OSA), the most common type of sleep apnea. Four of the most common:
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1. Type 2 diabetes
There’s a strong genetic component to type 2 diabetes, and a lot of overlap between it and sleep apnea, says sleep physician Brandon R. Peters, MD, author of The Sleep Apnea Hypothesis and Guest Lecturer at Stanford University. That’s because the former triggers the release of the stress hormone cortisol, which leads to insulin resistance.
The good news: “If you treat their sleep apnea, people with diabetes often become less dependent on diabetes medications.” In fact, he recalls one study in which diabetes patients using CPAP experienced a drop in levels of hemoglobin A1C (a measure of blood glucose levels) akin to “taking oral diabetes medication.” (Tip: If you can’t tolerate a CPAP device, discover sleep apnea treatments that don’t need a CPAP.)
2. Hypothyroidism
The thyroid, a butterfly-shaped gland at the base of our neck, plays a key role in hormonal health. And while both congenital and environmental factors contribute to how it functions, research shows a whopping 65 percent of thyroid hormone production is genetic.
And hypothyroidism, or an underactive thyroid gland, has been linked with sleep apnea. That’s largely because a sluggish thyroid “can cause weight gain due to metabolic slowing,” reveals Sudha Tallavajhula, MD, sleep neurologist at UTHealth Houston and director of the Neurological Sleep Medicine Center at TIRR Memorial Hermann in Houston, Texas. “This can contribute to obstructive sleep apnea [as excess weight affects the airway] in individuals who are prone to developing it.”
Additionally, hypothyroidism may compromise breathing due to the presence of a goiter, enlargement of the tongue, swelling of the muscles lining the airway or reduced respiratory drive, adds Dr. Peters.
What about the other way around: Can sleep apnea lead to hypothyroidism? In a word, yes. Sleep apnea can affect the thyroid hormones, according to Dr. Tallavajhula. “There is also some data to suggest that obstructive sleep apnea can increase the incidence of thyroid disorders and make pre-existing thyroid disease worse. The mechanism behind this, however, is not well understood.”
While treatment with thyroid hormone replacement alone doesn’t seem to alleviate sleep apnea, notes Dr. Peters, there is hope for relief. “As the conditions have overlapping symptoms, it may be helpful to approach both with treatment for greater impact.”
3. Polycystic ovary syndrome (PCOS)
“Going through menopause at an early age or having PCOS increases your risk of sleep apnea,” reveals Dr. Peters.
That’s because increased levels of testosterone can lead to loose or “floppy” muscles in the airway, he says, adding that up to 80 percent of women with PCOS have sleep apnea. It makes sense, therefore, that men who take testosterone replacement therapy are also more likely to have sleep apnea, adds Dr. Cacho.
4. A small or recessed jaw
When it comes to sleep apnea, size matters. The size of your jaw, that is. “Think of your jaw and throat like a room,” says Dr. Cacho. “A big, open throat is like a large room—there’s lots of space for air to pass through it. But a small jaw is more like a closet that gets cramped easily, leading to a potential blockage of the airway.”
3 non-genetic risk factors for sleep apnea
While sleep apnea can be hereditary, your genetics aren’t the only thing at play when it comes to your odds of developing the condition. Here’s what else may be to blame for your trouble breathing during sleep:
1. Obesity
This is a tricky one because obesity is complex, owing to both genetic and environmental factors. But it bears repeating that being overweight—women with a body mass index (BMI) above 30—dials up the chances of developing sleep apnea, says Dr. Cacho.
“Higher levels of fat in the tongue or a neck circumference of 16 inches or more [in women] increases the risk,” she notes. The good news is we only need to lose five percent of our body weight (about eight pounds. for a 165-pound woman) to relieve symptoms dramatically, per research by the American Thoracic Society.
2. Menopause
“As estrogen and progesterone fade out during menopause, a woman’s risk of sleep apnea increases because these hormones help tighten the airway,” confirms Dr. Peters.
To give us some perspective, he breaks down our risk by the numbers: “About 1 in 200 young women have sleep apnea, while 1 in 20 perimenopausal women develop it. By the time they reach 65 years of age, 1 in 4 women are affected.”
In short, simply being blessed enough to blow out more candles on our birthday cake makes us increasingly prone to sleep apnea. “A lot of my female patients resist the idea that they may have the condition because they’re not overweight,” adds Dr. Cacho. “But as we get older, our airway muscles are just not as strong, upping our risk.”
3. Alcohol or dairy consumption
A glass (or two) of red wine, doesn’t just loosen our inhibitions, it loosens our airway muscles, which can lead to sleep apnea, explains Dr. Peters. He adds that consuming dairy, which may produce airway-clogging mucus, is another risk factor we can easily sidestep.
What you can do to reduce symptoms of sleep apnea
You already know losing weight will slash the likelihood of you developing sleep apnea and alleviate symptoms if you have it. But you may be surprised that there’s no need to do your best Jane Fonda impersonation and sweat till you drop.
“Any generalized exercise, like moderate walking, strengthens your airway,” notes Dr. Cacho. “There’s also physical therapy you can do for your tongue and jaw muscles, called myofunctional therapy, proven to strengthen facial muscles and help with sleep apnea.”
For a few easy exercises, just check out the video below:
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