How Sleep Apnea Can Worsen Your Asthma

Obstructive sleep apnea is a disorder that causes interrupted breathing during sleep. The temporary episodes decrease airflow and cause a person to wake up from sleep. The diminished airflow can reduce oxygen levels in the bloodstream and, over time, increase the risk of heart disease. This condition is associated with several other medical issues, and it can complicate asthma.

Person wearing sleep apnea equipment
D. Sharon Pruitt Pink Sherbet Photography / Moment / Getty Images

Most people who have OSA snore loudly, stop breathing during sleep, and have gasping, choking, gagging, and coughing episodes that wake them up frequently during the night.

Often, the person isn’t aware that they are waking up dozens of times throughout the night. But these episodes lead to restless sleep and therefore daytime fatigue, regardless of how many hours the person tries to sleep.

While most people who have OSA do not have asthma, you can have both conditions. OSA is highly prevalent (34% of males and 17% of females have OSA), and asthma is reasonably prevalent (affecting about 8% of the population), so overlap is not uncommon.

Sleep Apnea and Asthma Symptoms

OSA, especially severe forms, may worsen asthma and asthma symptoms and have a negative impact on the quality of life for people who have asthma. And severe asthma can worsen OSA as well.

Some ways that OSA may influence asthma symptoms are through weakening or irritation around the airways, or narrowing of the airways.


There are several treatment options for sleep apnea. The most common, and gold-standard, therapy is a continuous positive airway pressure (CPAP) machine. Other treatments include an oral appliance, which involves wearing a device similar to a retainer while you sleep, and surgery.

Continuous Positive Airway Pressure

Continuous positive airway pressure (CPAP) is the preferred therapy for obstructive sleep apnea. CPAP involves wearing a mask while sleeping. The mask provides a continuous stream of pressurized air to keep the airways open.

CPAP is used at home at night, and it reverses many of the harmful effects of sleep apnea.

Oral Appliance

Despite its industrial-sounding name, an oral appliance is much like an orthodontic retainer. Different types of oral appliances either prevent your tongue from blocking your airway or move your lower jaw forward to keep your airway open while you sleep.

Although CPAP has been shown to be better at reducing interrupted breathing episodes and arousals, an oral appliance is a good option if CPAP therapy isn't working for you.

When getting an oral appliance for sleep apnea, it's best for a dentist to fit you with a custom one.


There is a surgical option for the treatment of obstructive sleep apnea, called uvulopalatopharyngoplasty (UPPP or UP3). This procedure is used to treat several ailments, and it is the most commonly performed surgery for obstructive sleep apnea.

UPPP involves taking out the tonsils and part of the soft palate and uvula. It's recommended for patients who are not overweight or obese. After UPPP surgery, many people still need CPAP therapy.

9 Sources
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  1. Gonzaga C, Bertolami A, Bertolami M, Amodeo C, Calhoun D. Obstructive sleep apnea, hypertension and cardiovascular diseases. J Hum Hypertens. 2015;29(12):705-12. doi:10.1038/jhh.2015.15

  2. Lin JL, Feng XK, Zhang DM, Sun HY. Clinical features and risk factors in patients with asthma complicated with obstructive sleep apnea-hypopnea syndrome: a hospital-based study. Sleep Breath. 2021 Mar;25(1):339-345. doi:10.1007/s11325-020-02127-9

  3. Kong DL, Qin Z, Shen H, Jin HY, Wang W, Wang ZF. Association of obstructive sleep apnea with asthma: A meta-analysis. Sci Rep. 2017;7(1):4088. doi:10.1038/s41598-017-04446-6

  4. Ragnoli B, Pochetti P, Raie A, Malerba M. Interrelationship between obstructive sleep apnea syndrome and severe asthma: From endo-phenotype to clinical aspects. Front Med (Lausanne). 2021 Jun 30;8:640636. doi:10.3389/fmed.2021.640636

  5. Kim SY, Kim HR, Min C, Oh DJ, Park B, Choi HG. Bidirectional association between GERD and asthma in children: two longitudinal follow-up studies using a national sample cohort. Pediatr Res. 2020;88(2):320-324. doi:10.1038/s41390-020-0749-1.

  6. Tingting X, Danming Y, Xin C. Non-surgical treatment of obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol. 2018;275(2):335-346. doi:10.1007/s00405-017-4818-y

  7. University of Michigan Health. Continuous positive air pressure (CPAP) therapy for obstructive sleep apnea. Updated Oct, 2020.

  8. Semelka M, Wilson J, Floyd R. Diagnosis and treatment of obstructive sleep apnea in adults. AFP. 2016;94(5):355-360. PMID: 27583421

  9. Yaremchuk K. Palatal procedures for obstructive sleep apnea. Otolaryngol Clin North Am. 2016;49(6):1383-1397. doi:10.1016/j.otc.2016.07.011

By Daniel More, MD
Daniel More, MD, is a board-certified allergist and clinical immunologist. He is an assistant clinical professor at the University of California, San Francisco School of Medicine and currently practices at Central Coast Allergy and Asthma in Salinas, California.