Most people who have sleep apnea think they just snore.

They've been told by a spouse or a family member that they make noise at night, they wake up feeling less rested than they'd like, and they feel tired by mid-afternoon. They assume it's aging. They assume it's the way things are now.

They're wrong — and for many older adults, that assumption is genuinely dangerous.

Sleep apnea is not a snoring problem. It is a condition in which your airway repeatedly collapses during sleep, cutting off oxygen to your brain and heart dozens or even hundreds of times per night. Each time this happens, your body wakes itself just enough to restart breathing — often without you ever becoming fully conscious. You may experience this 30, 60, or 100 times per hour and have no memory of it in the morning.

What you do have is a body that spent the night in a stress response. And over months and years, that takes a serious toll.

The 5 Warning Signs to Take Seriously

These five symptoms are regularly dismissed as normal aging. They are not. Each one, especially in combination with others, is worth mentioning to your doctor.

1. Morning headaches

Waking with a dull headache that fades over the first hour or two of the day is a classic sign of sleep apnea. It happens because your oxygen levels drop repeatedly during the night. The headaches are typically felt across the forehead or at the temples. Many people take an aspirin and move on — but if this happens several times a week, it deserves investigation.

2. Waking with a dry mouth or sore throat

When your airway is partially or fully blocked during sleep, your body often compensates by breathing through the mouth. This leads to a dry, scratchy mouth or throat first thing in the morning. People often blame this on medications (some do cause dry mouth), but if it's a daily pattern, sleep apnea is worth ruling out.

3. Witnessed gasping or breathing pauses

If a spouse, partner, or family member has ever noticed that you stop breathing during sleep — or suddenly gasp and lurch awake — that is the clearest warning sign of obstructive sleep apnea. The gasping is your airway forcing itself back open. Many people have been told about these episodes for years without seeking evaluation.

4. Excessive daytime fatigue

Feeling genuinely sleepy — not just a bit tired, but struggling to stay awake while reading, watching television, or riding in a car — after what seems like a full night's sleep is a sign that your sleep is not restorative. This level of fatigue is not a normal part of aging. It impairs concentration, reaction time, and increases the risk of falls and driving accidents.

5. Mood changes, irritability, or depression

Chronic sleep deprivation — even when you're not aware of it — has well-documented effects on mood. People with untreated sleep apnea report higher rates of irritability, anxiety, and depression. If your mood has shifted over the past year or two and you've chalked it up to getting older, sleep quality is worth evaluating.

The Real Health Risk: It's Not Just About Feeling Tired

Sleep apnea in older adults is linked to a significantly elevated risk of serious health conditions. The research on this has become increasingly definitive.

Heart failure: The repeated oxygen drops and stress-hormone surges of untreated sleep apnea place enormous strain on the cardiovascular system. Studies show that adults with untreated moderate-to-severe sleep apnea have significantly higher risk of developing heart failure — research puts that increase at up to 140%. [1,2]

Stroke: Sleep apnea is an independent risk factor for stroke — with untreated OSA associated with up to a 60% higher stroke risk. [1,2] The mechanism involves irregular heart rhythms (particularly atrial fibrillation), elevated blood pressure, and reduced blood flow during apnea episodes.

Type 2 diabetes: Oxygen deprivation disrupts insulin sensitivity. Adults with untreated sleep apnea have markedly higher rates of insulin resistance, even after controlling for weight and other factors.

Dementia: Multiple large studies have found that untreated sleep apnea is associated with earlier onset of cognitive decline and dementia. The brain clears metabolic waste during deep sleep — repeated disruptions to that process appear to have long-term consequences.

Getting Tested: Easier Than You Think

Many people avoid sleep evaluation because they picture an overnight stay in a hospital connected to dozens of wires. That picture is out of date for many patients.

Home sleep tests are now the standard first-line evaluation for most adults suspected of having obstructive sleep apnea. A small device — typically worn on the wrist and finger, sometimes with a nasal clip — records your breathing, oxygen levels, and movement overnight in your own bed. You pick it up from a sleep specialist or have it mailed, wear it for one or two nights, and return it for analysis.

Most major insurance plans, including Medicare, cover home sleep tests when ordered by a physician. Confirm your coverage with your doctor's office or your insurance provider before scheduling.

For complex cases, or when a home test doesn't provide a clear result, an in-lab polysomnography (full overnight sleep study) may be needed.

Treatment Options in 2025 and Beyond

The good news is that treatment for sleep apnea has expanded well beyond the CPAP machine that many people have tried and abandoned.

CPAP (Continuous Positive Airway Pressure) remains the most effective treatment for moderate and severe sleep apnea. Modern CPAP machines are significantly quieter, smaller, and more comfortable than older models. Many patients who tried CPAP years ago find that today's machines — and the wide variety of mask options now available — are much easier to tolerate.

Oral appliances are a strong alternative for mild-to-moderate sleep apnea. These custom-fitted devices, made by a dentist or sleep specialist, reposition the jaw slightly forward during sleep to keep the airway open. They have no hoses, no electricity, and no noise. Many patients who couldn't tolerate CPAP do very well with an oral appliance.

Positional therapy works for some patients whose apnea occurs primarily when sleeping on the back. Simple interventions — from positional pillows to wearable devices — can reduce episodes significantly.

Erie County Sleep Resources

DENT Neurologic Institute

3980 Sheridan Dr., Amherst, NY 14226

716-250-2000

DENT offers comprehensive sleep medicine services including home sleep testing and in-lab studies.

Buffalo General Medical Center Sleep Center

100 High St., Buffalo, NY 14203

Contact through KALEIDA Health: 716-859-5600

Both facilities accept Medicare and most major insurance plans. Ask your primary care doctor for a referral — or call either center directly to ask about the referral process.