Alcohol and sleep apnea: what the evidence says about drinking and breathing at night

What sleep apnoea is

The NHS describes sleep apnoea as breathing that stops and starts while you sleep; the most common type is obstructive sleep apnoea (OSA). It happens when your airways become too narrow during sleep. Symptoms include breathing that stops and starts, gasping, snorting or choking noises, waking up a lot and loud snoring, and during the day feeling very tired, finding it hard to concentrate, mood swings and headaches on waking.

It needs treating: the NHS says that without treatment it can lead to high blood pressure, a higher chance of stroke, type 2 diabetes, heart disease, depression and accidents caused by tiredness.

What the research links alcohol to

The NHS lists drinking alcohol among the things sleep apnoea has been linked to, together with obesity, a large neck, getting older, family history, smoking, large tonsils, sleeping on your back and COPD.

A 2018 systematic review and meta-analysis in Sleep Medicine pooled 21 studies and found that higher levels of alcohol consumption increased the risk of sleep apnoea by 25%. The authors noted large differences between the studies and evidence of publication bias, and concluded that the findings support reducing alcohol as being of potential value in preventing and treating the condition. In a further eight studies, people with sleep apnoea drank on average two units a week more than people without it, but that difference was not statistically significant.

If you have sleep apnoea: alcohol and the evening

Among the things the NHS says you can do if you have been diagnosed with sleep apnoea is not to drink too much alcohol, especially shortly before going to sleep. It also says sleep apnoea can sometimes be treated with lifestyle changes, such as losing weight, giving up smoking and reducing how much alcohol you drink, although many people also need a CPAP machine.

Alcohol also changes sleep for people without apnoea: the NHS says that although it can help some people fall asleep quickly, it can disrupt sleep patterns and stop you sleeping deeply. Our guide on why you wake up at 3am after drinking explains what happens. If you want to cut back in the evenings, see how to stop drinking every night.

When to see a doctor about your breathing at night

The NHS advises seeing a GP if your breathing stops and starts while you sleep, you make gasping, snorting or choking noises in your sleep, or you always feel very tired during the day. Because it is hard to notice in yourself, it suggests asking someone to watch you sleep and bringing them to the appointment. A GP may refer you to a sleep clinic for an overnight test, often done at home.

If sleep apnoea with excessive sleepiness is confirmed, UK rules say you must not drive until symptoms such as feeling very tired are under control, and you may need to tell the DVLA.

Common questions

When to get help

This site offers self-help tools and information, not medical advice. Talk to a doctor, or call one of the lines below, if:

• you feel shaky, sweaty, sick or anxious when you haven't had a drink;
• you find it hard to stop once you start, or you want to cut down and can't;
• drinking is causing problems with your health, work or the people close to you.

Before you stop: It can be very dangerous to stop drinking suddenly if you are dependent on alcohol. If you get withdrawal symptoms, get medical help before you try to stop drinking.

Sources

1. Sleep apnoea. NHS. nhs.uk
2. Simou E, Britton J, Leonardi-Bee J (2018). Alcohol and the risk of sleep apnoea: a systematic review and meta-analysis. Sleep Medicine. PMID 29458744
3. Tips on cutting down on alcohol. NHS. nhs.uk