5 Signs Of Sleep Apnea That Most People Miss

Sleep apnea often goes untreated because it doesn’t look the way most people expect it to. Many imagine loud, disruptive snoring or dramatic gasping in the middle of the night. For many others, though, the condition is far quieter, hiding in plain sight within everyday life.

Researchers estimate roughly 30 million Americans have sleep apnea, yet as many as 80 percent of cases go undiagnosed. Part of the problem is practical. “Primary care visits are usually short, and sleep medicine is still a relatively young specialty,” says Douglas Liepert, M.D., a double-board-certified ENT and sleep medicine specialist at ADVENT in South Bend, Indiana.

But there’s also a psychological reason sleep apnea flies under the radar: People adapt. “Many people with sleep apnea have had their symptoms for such a long time that they may not realize what’s abnormal,” adds Jordan Weiner, M.D., a board-certified otolaryngologist and president of Valley ENT in Scottsdale, Arizona.

And because sleep apnea doesn’t cause pain, its warning signs are easy to chalk up to stress, aging, or just being busy. Here are the ones experts say are most often missed, and why paying attention to them matters.

1. You’re Exhausted, Even After A “Full Night” Of Sleep

Many people don’t realize how sleep apnea can affect them even during the day, making it a common source of confusion. “In determining sleep apnea, we do need to distinguish between fatigue and sleepiness as they’re really quite different symptoms with different potential causes,” Weiner explains.

Excessive sleepiness — for instance, dozing off unintentionally, struggling to stay awake while reading or driving — is a strong indicator of a sleep disorder. Fatigue, on the other hand, is easier to rationalize away. “Feeling tired despite eight hours of sleep is a serious symptom of sleep apnea, and this needs to be looked into,” says Bijoy E. John, M.D., a sleep specialist and founder of Sleep Fix Academy in Brentwood, Tennessee.

Liepert notes that your specific personality can also hide symptoms. In our hustle culture, powering through fatigue is a badge of honor. He’s seen patients with severe sleep apnea who test “normal” for sleepiness, not because they’re well-rested, but because their brains have learned to compensate just to keep up.

2. You’re Experiencing Brain Fog, Irritability, Or Mood Changes

Difficulty concentrating, memory slips, and just feeling emotionally frayed often get chalked up to stress, age, or “just life.” But chronic sleep disruption can quietly drive all of that. “Difficulty maintaining focus and concentration during the day, problems with libido, having a short fuse, or being irritable are all things that can be the result of being sleep deprived,” says Liepert.

What’s going on during sleep apnea helps explain why. When the airway keeps collapsing during sleep, oxygen dips, and the brain briefly jolts the body awake to get breathing going again. You may not remember it happening, but these micro-arousals can stack up quickly — sometimes dozens of times a night. That fragmentation pulls you out of the deeper stages of sleep that help with memory and emotional regulation, while stress hormones like cortisol surge in response to each breathing disruption.

The brain feels this, even if you don’t realize it. Research shows that people with moderate to severe sleep apnea perform worse on tests of attention, memory, and executive function, and those deficits correlate with how often oxygen drops and sleep gets fragmented. In daily life, that can look like constant overwhelm, low mood, or a sense of burnout — symptoms that often get mistaken for anxiety or depression rather than a sleep disorder.

3. You Have Unexplained High Blood Pressure Or Weight Gain

The condition is closely tied to cardiovascular and metabolic health, yet it’s often overlooked in patients being treated for high blood pressure, weight gain, or type 2 diabetes. “Sometimes, sleep apnea is missed because physicians treat the symptoms rather than look for the root cause,” says Liepert.

Normally, blood pressure dips during sleep. In people with obstructive sleep apnea, it doesn’t. Instead, repeated oxygen drops and arousals activate the body’s stress response, pushing blood pressure up at night. Early on, the body compensates, but over time, that strain spills into the daytime, showing up as newly diagnosed hypertension.

“Anyone with a recent rise in high blood pressure, uncontrolled blood sugar, heart rhythm issues, or persistent cognitive complaints should consider a sleep evaluation, especially if other risk factors are present,” says John.

4. You’re Breathing Noisily At Night (Not Just Snoring)

Snoring is probably the most normalized symptom of all. Everyone knows someone who snores, which is exactly why experts wish people took it more seriously. “Intermittent snoring at any age should be questioned,” says Liepert, noting that the sound reflects increased airway resistance, even if breathing doesn’t fully stop.

That said, snoring doesn’t necessarily mean sleep apnea, and not everyone with apnea snores. Some people with this condition don’t snore at all, which makes things even easier to miss. In those cases, other nighttime cues can be more revealing. Weiner urges people to listen beyond volume: “Any witnessed gasping or abnormal sounds made during sleep should be considered suspicious and taken seriously,” he says. Your partner may be the first to notice these episodes (especially if your sleep noises are keeping them awake!), but apps, wearables, and even simple voice recordings can surface patterns you’d otherwise miss.

5. You’re Waking Up With A Dry Mouth, Sore Throat, Or Headache

“Dry mouth happens due to mouth breathing and a sore throat from the effects of snoring,” John explains, noting that when the airway narrows during sleep, people instinctively switch to breathing through their mouth to pull in more air. Liepert adds that mouth breathing, however, further destabilizes the airway. When the tongue and throat muscles relax during sleep, breathing through the mouth makes the soft tissues of the upper airway more likely to collapse, even if full apneas don’t occur.

If you’re experiencing headaches when you wake up, that can also be a red flag. “They’re caused by blood vessels stretching to deliver oxygen after repeated drops overnight,” says John. On their own, these symptoms feel minor, but together, they suggest sleep that’s far more disrupted than it seems.

If any of these signs sound familiar, it’s worth bringing up with a sleep specialist or asking your primary care doctor about a sleep study. OSA is highly treatable — and treatment often means better sleep, better mood, smoother mornings, and far less guessing about why you never feel quite like yourself. You spend a third of your life asleep; it’s worth making sure that time is actually working for you.

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