While you sleep

How do I know if I have sleep apnea?

By GyroscopeUpdated November 14, 20266 sources

Only a sleep study can tell you. The signs doctors ask about are loud snoring, someone seeing you stop breathing, feeling sleepy in the day and high blood pressure. If someone has seen you stop breathing, or you snore loudly and you’re sleepy by day, ask your doctor.

What are the signs?

Doctors often screen with an eight-item checklist, one yes or no for each:

1. Loud snoring
2. Feeling tired or sleepy in the day
3. Someone seeing you stop breathing in your sleep
4. High blood pressure
5. A BMI over 35
6. Being over 50
7. A large neck
8. Being male

Snoring and stopped breathing happen while you’re asleep, so whoever sleeps near you usually knows them better than you do. The more of these signs someone has, the likelier a sleep study finds moderate or severe apnea.

How common is it?

Very. In a US estimate from 2007 to 2010, about 17% of men aged 50 to 70 and 9% of women the same age had moderate to severe sleep-disordered breathing, 15 or more pauses and shallow breaths an hour. Among people aged 30 to 49 it was 10% of men and 3% of women. If you sleep alone, nobody is there to hear the snoring or see the pauses, which is where a watch or ring earns its place.

Can a watch or ring tell you?

It can point you toward a test, and that’s useful. An Apple Watch Series 9 or later can send a sleep apnea notification after 30 days of motion data, and Apple says it isn’t meant to diagnose. Oura counts suspected dips in your blood oxygen as breathing regularity, and Oura says that isn’t for diagnosis either. Your nights’ lowest points help too, as long as you know what normal looks like: in 350 healthy sleepers, the lowest point averaged about 90.

What a watch can’t do is count your breathing pauses the way a sleep study does. A watch is the smoke detector. The sleep study is the fire inspector who comes in and finds out what’s going on.

What does a sleep study measure?

It records your breathing through the night and counts how often it stops or turns shallow, as events an hour (doctors call this the apnea-hypopnea index). Under the US estimate above, 15 or more an hour counts as moderate to severe. Your blood oxygen gets recorded too, which is how the dips on your watch get an explanation.

What makes it worse in the meantime?

Alcohol. In 14 trials, drinking added about 2.3 breathing events an hour on average, 4.2 in snorers and 7.1 in people already diagnosed with apnea (alcohol and blood oxygen). Sleeping on your back can too, for many people with apnea (back sleeping). Losing weight helps (weight and apnea).