Obstructive Sleep Apnoea in Men: When Snoring, Abdominal Obesity and Fatigue Affect Health
Obstructive sleep apnoea (OSA) is twice as common in men as in women and involves repeated pauses in breathing during sleep. The condition is strongly linked to overweight, abdominal obesity and other metabolic risk factors. Untreated sleep apnoea can affect sleep quality, cause significant daytime fatigue and increase the risk of conditions including high blood pressure and cardiovascular disease.
For men living with overweight or obesity, weight loss can reduce the number of breathing interruptions and improve sleep. In this article, we explore the causes, symptoms, risks and treatment options for obstructive sleep apnoea in men.
Why Is Obstructive Sleep Apnoea (OSA) Often Diagnosed Late in Men?
Many men are unaware that they have sleep apnoea because the breathing interruptions occur during sleep. In many cases, it is a partner or family member who first notices loud snoring, restless sleep or pauses in breathing during the night.
Sleep apnoea involves repeated breathing interruptions, known as apnoeas, and periods of reduced breathing, known as hypopnoeas. These can occur many times per hour throughout the night. When breathing stops or becomes restricted, oxygen levels in the blood fall, causing the body to repeatedly wake into a lighter stage of sleep so that breathing can resume. The result is less restorative sleep, even if the individual is unaware of these awakenings.
Many people associate sleep apnoea with snoring, but snoring is not the whole picture. It is possible to have sleep apnoea without significant snoring. For many people, persistent fatigue is the most noticeable symptom. You may wake up after a full night’s sleep and still not feel rested, or find that your energy levels and concentration decline throughout the day.
Common signs of sleep apnoea in men include:
- Loud snoring
- Breathing interruptions observed by a partner
- Daytime fatigue or sleepiness
- Morning headaches
- Dry mouth upon waking
- Difficulty concentrating or reduced energy levels
- Frequent trips to the toilet during the night
Because symptoms develop gradually, they are often attributed to stress, work or ageing. However, untreated sleep apnoea is associated with an increased risk of cardiovascular disease, making it important to seek medical advice if sleep does not feel restorative or if breathing interruptions are suspected.
When Snoring, Breathing Interruptions and Fatigue Begin to Affect Daily Life
Sleep apnoea can affect sleep quality, energy levels and overall quality of life. When breathing interruptions and periods of reduced breathing occur repeatedly during the night, the normal structure of sleep is disrupted, making sleep less restorative.
During sleep apnoea, oxygen levels in the blood repeatedly fall throughout the night. The body responds by activating the stress system, leading to increased release of stress hormones, a faster heart rate and elevated blood pressure. At the same time, sleep is disrupted by numerous brief awakenings that often go unnoticed by the individual.
When this happens night after night, it can contribute to increased daytime fatigue, reduced concentration and a higher risk of conditions such as high blood pressure, cardiovascular disease and stroke. Severe fatigue can also affect daily life and increase the risk of workplace and road traffic accidents, particularly during long periods of driving.
How Excess Weight Can Increase the Risk of Obstructive Sleep Apnoea in Men
Overweight and obesity are the most important risk factors for obstructive sleep apnoea in men. Abdominal obesity in particular is common and is closely linked to insulin resistance and other metabolic changes that frequently occur alongside sleep apnoea.
Men tend to store a greater proportion of body fat around the abdomen and internal organs compared with women. Both abdominal obesity and sleep apnoea are more common in men, often occurring alongside other metabolic risk factors such as high blood pressure, insulin resistance and type 2 diabetes.
For men living with overweight or obesity, weight loss can reduce pressure on the airways and help decrease the number of breathing interruptions. Studies show that weight loss can often improve the severity of sleep apnoea.
Obstructive Sleep Apnoea Can Affect Testosterone, Sex Drive and Energy Levels
Studies have linked sleep apnoea to lower testosterone levels in some men, although the relationship is also influenced by factors such as age, overweight and general health. Sleep plays an important role in the body’s hormonal regulation, and several hormones are affected by both the quality and duration of sleep. Because obstructive sleep apnoea disrupts sleep through repeated breathing interruptions, it can affect energy levels, recovery and hormonal balance.
The relationship between sleep apnoea and lower testosterone levels in men is complex. Sleep apnoea and obesity often occur together, and both conditions have been associated with hormonal changes. Sleep apnoea has also been linked to a higher prevalence of erectile dysfunction, likely due to a combination of hormonal changes, disrupted sleep and effects on blood vessels.
Many men with sleep apnoea report symptoms such as fatigue, reduced energy, lower sex drive and a diminished quality of life.
Treatment of sleep apnoea can improve sleep quality and reduce daytime fatigue. For men living with overweight or obesity, weight loss may also contribute to improved metabolic health and reduced strain on both the airways and hormonal systems.
How Sleep Apnoea and Excess Weight Can Reinforce Each Other
For people living with overweight or obesity, sleep apnoea can contribute to a vicious cycle in which poor sleep and weight gain reinforce one another. When sleep is disrupted, several of the body’s systems involved in hunger, fullness and energy regulation are affected.
Research shows that sleep deprivation and fragmented sleep can influence hormones that regulate appetite and satiety. As a result, many people experience increased hunger, stronger cravings for energy-dense foods and greater difficulty sticking to their health goals when sleep is not restorative.
Daytime fatigue can also make it harder to stay physically active and maintain healthy lifestyle habits over time. At the same time, excess weight is a major risk factor for sleep apnoea, meaning that weight gain can in some cases worsen the condition.
For people with both sleep apnoea and overweight, treating both conditions may be important. Improved sleep quality, weight loss and increased physical activity can work together to improve metabolic health, reduce daytime fatigue and support sustainable long-term lifestyle changes.
How Weight Loss and Weight-Loss Medication Can Affect Obstructive Sleep Apnoea
For people living with overweight or obesity, weight loss is one of the most important treatments for obstructive sleep apnoea. As body weight decreases, pressure on the upper airways often decreases as well, which can contribute to fewer breathing interruptions during sleep and improved sleep quality.
Weight-loss medications such as semaglutide (Wegovy) and tirzepatide (Mounjaro) may be used as a complement to lifestyle changes for people who meet the criteria for treatment of overweight or obesity. By reducing appetite and increasing feelings of fullness, these medications can support significant and sustainable weight loss.
Studies show that weight loss often leads to improvements in the severity of sleep apnoea, measured by the number of breathing interruptions per hour (AHI). The degree of improvement varies between individuals and depends on factors such as the amount of weight lost and the severity of sleep apnoea at baseline.
For some people, weight loss may reduce the need for other treatments, while others may still require therapies such as CPAP treatment or a mandibular advancement device. In cases of moderate to severe sleep apnoea, CPAP remains an established treatment and may still be necessary even while weight loss is taking place. The most appropriate treatment is determined through an individual medical assessment.
When Men Should Seek Medical Advice for Suspected Obstructive Sleep Apnoea and Recurrent Breathing Interruptions During Sleep
If you snore loudly, feel tired despite sleeping enough hours, or if someone has observed breathing interruptions during your sleep, you should seek medical advice for further assessment.
It is particularly important to pay attention to these symptoms if you also have overweight, obesity, high blood pressure, type 2 diabetes or other metabolic risk factors, as these conditions frequently occur alongside sleep apnoea.
Assessment usually begins with questions about sleep, snoring and daytime fatigue. The diagnosis is typically made using an overnight breathing study carried out at home or in a sleep clinic. The test measures breathing, oxygen levels, heart rate and the number of breathing interruptions during the night.
Sleep apnoea often occurs alongside high blood pressure, insulin resistance, type 2 diabetes and obesity, which is why it is considered part of a broader cardiometabolic risk profile.
Summary
Obstructive sleep apnoea is common in men and is closely linked to overweight, abdominal obesity and other metabolic risk factors. The condition can affect sleep quality, energy levels, blood pressure and long-term health. For men living with overweight or obesity, weight loss can reduce the number of breathing interruptions and improve both sleep and metabolic health. Early detection and treatment are important for reducing the risk of complications and improving quality of life.
Frequently Asked Questions About Obstructive Sleep Apnoea (FAQ)
Is Sleep Apnoea Dangerous If Left Untreated?
Untreated sleep apnoea can affect both quality of life and overall health. The condition is associated with an increased risk of high blood pressure, cardiovascular disease and significant daytime fatigue.
Many people also experience concentration difficulties, memory problems and reduced energy levels. For this reason, it is important to seek medical advice if you suspect that you have sleep apnoea.
Can Sleep Apnoea Affect My Blood Pressure?
Yes. During sleep apnoea, oxygen levels in the blood repeatedly fall throughout the night, activating the body’s stress response system and increasing the release of stress hormones. Over time, this can contribute to elevated blood pressure.
Untreated sleep apnoea is associated with an increased risk of high blood pressure, cardiovascular disease, heart attack and stroke. Treatment of sleep apnoea can therefore improve not only sleep quality but also cardiovascular health.
When Should I Seek Help for Sleep Apnoea?
You should seek medical advice if you snore loudly, feel unusually tired during the day, wake up feeling unrefreshed, or if someone has observed breathing interruptions during your sleep. Diagnosis is usually made using an overnight sleep study, and treatment can improve both sleep quality and long-term health.
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