Can you have sleep apnea without snoring?
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- Sleep diary or sleep log journal. Best for: Anyone preparing for a doctor's visit about possible sleep apnea. See options on Amazon
- CPAP-friendly pillow with mask cutouts. Best for: People already diagnosed and starting CPAP. See options on Amazon
- Positional side-sleeping pillow. Best for: People whose sleep doctor recommends positional therapy. See options on Amazon
Why snoring is not the whole story
The American Academy of Sleep Medicine (AASM) lists snoring as the most common symptom of obstructive sleep apnea (OSA), the most common type, where the airway is blocked during sleep. It also stresses the reverse: not everyone who snores has sleep apnea. Snoring is a clue, not a test.
Some people with apnea snore softly, sleep alone so no one hears, or have a type of apnea where snoring is not prominent. Mayo Clinic explains that in central sleep apnea, the brain does not send proper signals to the breathing muscles. Snoring can happen in both types, but it may be less noticeable in central sleep apnea, because snoring mainly reflects a partly blocked airway.
Signs of sleep apnea besides snoring
| Sign | Listed by |
|---|---|
| Pauses in breathing noticed by someone else | AASM, Mayo Clinic |
| Waking suddenly short of breath, choking or gasping | AASM, Mayo Clinic |
| Daytime sleepiness or fatigue, dozing at work, while watching TV or driving | AASM, Mayo Clinic |
| Unrefreshing sleep or insomnia | AASM, Mayo Clinic |
| Morning headaches | AASM, Mayo Clinic |
| Trouble concentrating, memory problems, irritability or mood changes | AASM, Mayo Clinic |
| Getting up at night to use the bathroom | AASM |
| Lower sex drive or erection problems | AASM |
Mayo Clinic notes that daytime sleepiness can also come from other conditions, such as narcolepsy, which is why a proper diagnosis matters.
Who is at higher risk
Obstructive sleep apnea (AASM)
- Excess weight, the major risk factor: a BMI of 25 or more is overweight and 30 or more is obesity
- A neck size of 17 inches or more in men, or 16 inches or more in women
- Male sex, with risk rising for women after menopause
- High blood pressure
- Sedation from alcohol or medicines
- Airway differences such as a deviated septum or nasal polyps, and family history
Central sleep apnea (Mayo Clinic)
- Age, especially over 60
- Heart conditions such as atrial fibrillation and congestive heart failure
- Stroke, brain tumors or brainstem changes
- Opioid use
- Sleeping at a higher altitude than you are used to
If you have these risks and the signs above, the lack of snoring should not reassure you.
How sleep apnea is diagnosed
The AASM says a medical provider can diagnose OSA with either an in-lab overnight sleep study or a home sleep apnea test. In-lab studies record brain waves, heartbeat, breathing and movement and are usually used for complex cases. Home tests use a simpler monitor and suit some people with many risk factors and no other medical disorders.
Mayo Clinic notes that OSA is usually indicated when breathing slows or stops at least five times per hour of sleep. You cannot count that yourself. The AASM warns that sleep apps and trackers may give unreliable results, but keeping a sleep diary for two weeks can help your provider.
What happens after a diagnosis
The AASM calls CPAP the frontline treatment for most patients. Oral appliance therapy fitted by a trained dentist is recommended for mild to moderate apnea when people cannot tolerate CPAP or prefer an alternative. Positional therapy, weight management and avoiding alcohol may also help. Central sleep apnea is managed by treating the underlying cause and, in some cases, with a breathing device or oxygen, according to Mayo Clinic.
If you start CPAP and sleep on your side, our CPAP pillow for side sleepers guide can help with comfort. For snoring without apnea, see how to stop snoring naturally.
What to look for when you buy
Sleep diary or sleep log journal
Best for: Anyone preparing for a doctor's visit about possible sleep apnea
The AASM says keeping a sleep diary for two weeks can help with diagnosis, and a printed log makes it easy to note bedtimes, wake-ups and daytime sleepiness.
Watch out: A diary supports a diagnosis; it does not replace a sleep test.
See options on AmazonCPAP-friendly pillow with mask cutouts
Best for: People already diagnosed and starting CPAP
Cutouts give the mask and hose room when you turn on your side, which can make the frontline treatment the AASM describes easier to stick with.
Watch out: Only useful once you have a CPAP prescription; it is not a treatment on its own.
See options on AmazonPositional side-sleeping pillow
Best for: People whose sleep doctor recommends positional therapy
The AASM lists positional therapy among options that may help, and a pillow that keeps you on your side is the simplest version.
Watch out: Use it alongside, not instead of, the treatment your sleep doctor prescribes.
See options on AmazonQuestions people ask
- Can you have sleep apnea if you don't snore?
- Yes. Snoring is common in obstructive sleep apnea but not universal, and it may be less noticeable in central sleep apnea.
- What are the signs of sleep apnea without snoring?
- Daytime sleepiness, unrefreshing sleep, waking short of breath, morning headaches, trouble concentrating and breathing pauses that someone else notices.
- Can thin people have sleep apnea?
- Yes. Excess weight is the major risk factor, but neck size, jaw shape, nasal problems, age, sex, alcohol, sedatives and family history also play a part.
- Can a sleep tracker or app tell me if I have sleep apnea?
- Not reliably. The AASM warns that sleep apps and trackers may give unreliable results. A home sleep apnea test or in-lab study ordered by a provider is needed.
Sources
- Obstructive Sleep Apnea (sleepeducation.org), American Academy of Sleep Medicine (Sleep Education)
- Central sleep apnea - Symptoms and causes (mayoclinic.org), Mayo Clinic
- Snoring - Symptoms and causes (mayoclinic.org), Mayo Clinic