Nate Devore - Sleep Health Educator
Written and Edited by Nate Devore. Nate Devore is the Content Marketing Manager at CPAP.com, specializing in transforming complex CPAP information into engaging, accessible content. With a talent for simplifying intricate topics, Nate plays a crucial role in our mission to demystify sleep apnea and make CPAP therapy more approachable for all users.
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In this article, we want to discuss how your physical and mental health will change before and after CPAP therapy. We’ll go over how untreated sleep apnea impacts your body, plus the reason why CPAP is so effective. We will discuss how CPAP improves your health and wellness and share one of our favorite success stories. Finally, we’ll address common questions, concerns, and misconceptions about this topic.
Impacts of Sleep Apnea Before Starting CPAP Therapy
Sleep apnea is characterized by a constant cycle of normal breathing patterns that are temporarily interrupted by pauses in respiration. Your brain responds to this through arousal, which causes you to briefly wake up so you can breathe normally again. This is the reason why so many people with sleep apnea struggle with fatigue, even after a whole night of sleep. Untreated sleep apnea can have significant impacts on both your physical and mental health. Sleep apnea disrupts your breathing patterns during sleep, leading to frequent awakenings and oxygen deprivation.
Physical Effects of Sleep Apnea
When you get a good night’s rest, it allows your body to repair itself from the damage sustained during the day. However, the repeated sleep disruptions associated with sleep apnea can cause this rest and recovery process to come to a halt. Studies suggest that regular sleep disturbances cause increased stress on the body and may even heighten your sensitivity to pain. And even a temporary reduction in oxygen levels can cause inflammation throughout the body, which is linked to the development of chronic illness and aging.
Some of the many physical effects of sleep apnea include:
- Fatigue
- High Blood Pressure
- Headaches
- Sore Throat
- Weight Gain
- Sensitivity to Pain
- Irregular Heartbeat
- Night Sweats
- Damaged Blood Vessels
Mental and Emotional Effects of Sleep Apnea
Healthy sleep is a critical factor in our mental health and cognitive abilities. Experts believe that being awake for just 24 hours leaves you cognitively impaired to the same degree as someone with a blood alcohol level of 0.10. Then there are the physical changes to the brain each time your oxygen falls. In fact, in 2008, a team of scientists found evidence that individuals with Obstructive Sleep Apnea experience a form of brain damage typically associated with traumatic brain injuries.
For individuals with sleep apnea, these issues often cause significant psychological and neurological impacts, such as:
- Irritability
- Cognitive Impairment
- Depression
- Anxiety
- Changes in Mood
- Decreased Alertness
- Lower Productivity
- Memory Loss
Long-Term Health Risks Associated with Untreated Sleep Apnea
While the short-term effects of sleep apnea can be life-altering, they can be even more serious if left untreated and may even lead to an untimely death. For example, studies show that individuals with Obstructive Sleep Apnea who do not seek treatment are 86% more likely to have a stroke. These individuals are also three times more likely to die prematurely.
Untreated sleep apnea has been linked to a multitude of chronic conditions, such as:
- Alzheimer’s Disease
- Cardiovascular Disease
- Diabetes
- Cancer
- Rapid Aging
- Stroke
There is good news, however! These numbers significantly decrease upon starting Continuous Positive Airway Pressure (CPAP) therapy.
Examining the Purpose of CPAP Therapy
For most people with sleep apnea, the first line of treatment is continuous positive airway pressure (CPAP), which delivers a constant stream of pressurized air to the lungs through a face or nose mask. As the primary treatment option, this therapy has a high success rate. It is estimated that in 80% of cases, the total number of hourly breathing episodes is cut by at least half.
How CPAP Fights Sleep Apnea
This constant airflow seeks to address the two main causes of sleep apnea— soft tissue airway obstructions due to Obstructive Sleep Apnea (OSA) and the inability to stimulate inhalation caused by Central Sleep Apnea (CSA).
- Preventing Obstructive Sleep Apnea: OSA arises when the muscles that make up the tongue, soft palate, uvula, tonsils, etc., relax to the point that they block the back of the throat or upper airway. However, when pressurized air flows through those areas, it acts as a brace against those soft tissues. This prevents these types of blockages from occurring in the first place.
- Addressing Central Sleep Apnea: CSA occurs due to a loss of control over the muscles involved in inhalation. But thanks to the airflow provided by the CPAP machine, the lungs are able to fill with air, similar to blowing up a balloon. This treatment tends to be more successful in mild to moderate cases. Other forms of treatment may be necessary for individuals who have severe CSA.
Health Improvements After Starting CPAP Therapy
For some people, the improvements associated with continuous positive airway pressure therapy begin almost immediately, depending on how often and how long they sleep with their machine. In other cases, it could take a few weeks as some people need more time to adjust to their therapy.
Ultimately, Even if you choose to slowly ease into CPAP therapy, you’ll still be cutting down on the number of sleep apnea episodes that you experience each night. And as a result, you’ll be decreasing your odds of experiencing all those unpleasant side effects that come with this condition.
Improved Sleep Quality
One of the most obvious differences between life before and after CPAP is the improvement in your sleep health! CPAP significantly reduces the number of times your breathing slows or stops as you sleep. As a result, the number of times your body rouses in response to those episodes also decreases, meaning your sleep quality increases.
According to a study published by Sleep and Breathing, individuals with Obstructive Sleep Apnea who kept up with their therapy for a minimum of six months experienced significant improvements in several areas associated with sleep quality. For example, 87% of participants reported a reduction in the number of times they experienced restless sleep.
Because sleep health is closely linked to both physical and mental health, improving your sleep quality can have a ton of benefits, including improved mood, better cognitive function, and increased energy levels. Additionally, those who follow through with their treatment plan are often better equipped to reach their full potential at work and in their personal lives.
Reduced Daytime Fatigue
As you can likely guess, cutting down on the number of sleep disturbances that occur each night leads to more hours of better-quality sleep, and, ultimately, less fatigue during the day! Scientists examined this issue in 2011 and found that individuals with Obstructive Sleep Apnea saw a significant improvement in both their daytime fatigue and their energy levels after only three weeks of CPAP therapy.
Other than simply being a hindrance to daily life, feeling worn down constantly can really wear on your ability to function day to day and can lead to increased risk for depression, anxiety, and productivity. It can lead to issues in seemingly unrelated aspects of daily life. According to the American Academy of Sleep Medicine, people with untreated sleep apnea are 2.5 times more likely to get into a car accident, in large part due to the daytime sleepiness that is associated with this condition. However, this risk falls by 70% for those who rely on CPAP for at least four hours a night.
Better Cardiovascular Health
If left untreated, sleep apnea is pretty rough on your cardiovascular system and, as a result, can seriously increase your risk of death. There is even evidence to suggest this sleep-breathing disorder can result in direct damage to your blood vessels after missing only one night of CPAP therapy.
Currently, 89% of young adults with unexplained high blood pressure are suspected of having undiagnosed Obstructive Sleep Apnea. Other related cardiovascular issues include an 86% higher likelihood of having a stroke and a 71% increased risk of developing cardiovascular disease.
Despite these effects, studies show that CPAP therapy can improve many of these issues, especially when worn for more than four hours each night. While hypertension may not entirely resolve itself after CPAP therapy, it still leads to at least some decrease in blood pressure. Also, a recent study found that individuals who stick with CPAP therapy long-term are less likely to experience a stroke compared to those with untreated sleep apnea.
Lower Risk of Heart Failure
Obstructive Sleep Apnea and Central Sleep Apnea are both associated with an increased risk for heart issues. A 2008 study found that individuals with OSA have a 140% increased likelihood of developing heart failure. But this is a bi-directional relationship, which means that having sleep apnea can increase your chances of developing heart failure, while having heart failure can also increase your risk of having sleep apnea.
Sadly, individuals who have both conditions are far more likely to die compared to those who only have one. However, much like the cardiovascular issues that we talked about above, CPAP has proven to reduce your risk of developing and/or dying from sleep apnea-related heart failure, particularly in elderly populations.
Evidence of this can be seen firsthand based on the decrease in heart rate that many people experience when comparing the physical differences between before and after CPAP therapy. These findings are likely due to the reduced workload that is placed on the heart when a person follows through with their treatment plan.
Enhanced Mental Well-Being
Of course, sleep apnea also impacts you cognitively and emotionally, which often affects people’s personal and private life. According to a 2014 study, 53.9% of participants with OSA experienced anxiety, while 46.1% showed signs of depression. Experts attribute these issues to two main factors— sleep deprivation caused by repeated arousal and brain damage due to the temporary loss of oxygen during each apnea episode.
There is good news, however! These changes are largely reversible. In 2017, a Chinese team examined the effect of continuous positive airway pressure therapy and found that regularly sleeping with your CPAP machine helps to ease the signs and symptoms of sleep apnea-related anxiety and depression.
Fewer Headaches
Sleep apnea headaches tend to arise right when you wake up. However, people with sleep apnea may be prone to headaches at any time of day. They typically last less than an hour, but in some cases, they can linger for hours. These headaches are believed to arise due to changes in the amount of carbon dioxide in the blood, plus the dilation of blood vessels along the head and neck. They usually cause pain and pressure in both sides of your head but do not involve sensitivity to light.
A recent data review estimates that 30% of Obstructive Sleep Apnea cases involve morning headaches. However, research from a 2009 study found that 90% of people who experienced this issue saw their headaches totally disappear after starting CPAP therapy.
Increased Alertness
People who have sleep-breathing disorders tend to struggle with staying alert throughout the day. One of the main indicators of this is the issue of having a shortened attention span. Other affected areas include working memory and executive function. This means people with untreated sleep apnea may have difficulty with problem-solving, performing tasks, and recalling important information.
In one 2005 study, researchers found that 95% of adult participants with moderate to severe OSA, showed at least some level of attention deficit while performing a series of cognitive tests throughout the morning hours.
Several studies have been performed in an attempt to measure the impact of CPAP therapy on these types of cognitive functions. Although many of these studies have been rather small, most have shown very promising results. In fact, a 2015 study measuring the differences between the effects of CPAP after one night versus three months, found that just one night of treatment may improve cognition, while people who remain compliant with their therapy have significantly better results than those who don’t.
Improved Diabetes Symptoms
One of the more interesting complications of sleep apnea is that it can actually increase your risk for and worsen existing cases of Type II Diabetes. It is estimated that 18% of all Type II Diabetics have Obstructive Sleep Apnea, while a much higher 86% of obese Type II Diabetics are thought to be affected. The reason for this phenomenon is believed to be caused by the carbon dioxide build-up in your blood during each apnea episode. As a result of this build-up, your cells have a harder time linking up with insulin, which means they cannot take in glucose as effectively as they normally would.
Although the link between CPAP therapy and the risk of developing diabetes has been debated in the past, recent research looks more promising. In 2022, a team of scientists found that CPAP improves blood sugar levels and minimizes fluctuations in patients who have both Obstructive Sleep Apnea and Type II Diabetes. Additionally, there is also evidence to suggest that suddenly halting CPAP therapy leads to sleep apnea-related increases in blood sugar levels overnight.
Fewer Male Reproductive Issues
Research into this topic is a bit newer regarding studies comparing before and after CPAP treatment. But recent evidence suggests that sleep apnea may impact male fertility. A 2021 Taiwanese study found that you are nearly 25% more likely to deal with infertility if you are a man with Obstructive Sleep Apnea. Those odds become much higher if you do not receive treatment, with your risk for infertility reaching 80% more likely than the average person.
The reason for these findings stems from the idea that sleep apnea has been linked to low testosterone in some individuals. Another contributing factor is likely the damage that sleep apnea causes to the body, increasing the build-up of toxins and limiting the amount of restorative sleep you get each night. While more studies are needed on this topic, current evidence supports the idea that maintaining your CPAP therapy plan can improve sleep apnea-related sexual dysfunction, which suggests the very likely possibility that it also impacts fertility.
Healthier Pregnancy
Did you know that pregnant women are more prone to developing sleep apnea as a result of the hormonal shifts that they experience? And while some women are at a higher risk than others due to pre-existing factors, the increase in estrogen means that all pregnant women have an increased likelihood of developing a sleep-breathing disorder.
It is estimated that up to 26% of third-trimester pregnancies will develop Obstructive Sleep Apnea. This is concerning because sleep apnea is associated with several very concerning pregnancy-related conditions such as pre-eclampsia, gestational diabetes, and potentially even fetal growth restriction.
Like male reproduction, this area of research has not yet been widely researched. Therefore, there are few, if any, large studies on the use of CPAP therapy in pregnant women. However, the studies that do exist do support the idea of using this form of treatment to combat sleep apnea, particularly in the case of sleep apnea-related hypertension.
Weight Loss
Weight and sleep apnea have a complicated relationship. To put it simply, they tend to feed off each other. Obesity is a risk factor for both Central Sleep Apnea and Obstructive Sleep Apnea. However, the high prevalence of obese people with sleep apnea may be partly because the factors that lead to obesity, such as genetics, lifestyle choices, and underlying conditions, often also increase your chances of developing sleep apnea.
On the other hand, there is also evidence to suggest that sleep apnea can lead to weight gain because it slows down your metabolism. There is also some evidence to suggest that treating your sleep apnea with continuous positive airway pressure therapy may help you lose weight. This fits with more recent research into the effects of CPAP on metabolism, such as a 2016 study that found that participants who stayed on CPAP therapy for at least three months improved their metabolic rate. But unfortunately, many of these studies fail to give definitive answers.
CPAP Success Stories About Life Before and After CPAP Therapy
CPAP therapy can be truly life-changing! In addition to the physical and mental health benefits, many users also report changes in their life when comparing before and after CPAP therapy, including impacts on their general demeanor and energy levels. Effective treatment may even boost your professional achievements and improve your personal life. Some people have even suggested that CPAP saved their marriages, as their spouses could finally get their own good night’s sleep without being awoken by constant loud snoring.
https://www.youtube.com/watch?v=aXTvGp3csps
Understanding the Goals of CPAP Therapy
You may be surprised to hear that the goal of CPAP therapy is not to bring your number of breathing episodes, also known as an AHI score, down to zero. While any doctor would say that zero interruptions would be ideal, most healthcare providers recognize that this isn’t realistic for everyone. In most cases, the target number is typically less than five per hour (ten for more severe cases).
But generally speaking, the real goal is to reduce the total number of apnea episodes you experience by as much as possible. And as a result, you are able to limit the damage that sleep apnea is able to do to your body over time.
For this reason, experts consider sleeping with a CPAP, even part-time, beneficial. Although it is highly encouraged that you sleep with it as often as possible. Most health insurance companies require you to sleep with your CPAP machine for at least four hours a night, five nights a week, to be considered “compliant” with your treatment plan.
So, while sleeping with a machine attached to your face long-term may seem daunting, you have the freedom to take an incremental approach to this process. This makes sticking with your CPAP truly doable because you have the ability to ease into sleeping with it full-time, while still seeing the benefits.
Common Misconceptions About CPAP Therapy
There are many misconceptions about CPAP therapy, including the idea that it is always uncomfortable or noisy. While there's an adjustment period, most users get used to the machine fairly quickly. Plus, many modern CPAP machines have features that make the transition much easier, for example:
- Heated Humidifiers
- Ultra-Quiet Machines
- Portable-Friendly Designs
- Automatic Pressure Adjustments
Also, keep in mind that if you find yourself continuing to struggle with CPAP therapy, there are many other treatment options that may be better suited to your needs. These include Oral Appliance Therapy for Obstructive Sleep Apnea or even surgery. Or, if you simply need some extra support, these solutions can be combined with CPAP for an even more effective outcome.
If you have questions about CPAP therapy, don't hesitate to ask your doctor or a sleep specialist. And for more information about selecting user-friendly devices, check out our article on the best CPAP machines of 2023!
What to Do if You Think You May Have Sleep Apnea
Have you been told that you snore too loudly or have recently found yourself waking up while gasping for air? It may be time to speak with your healthcare provider about sleep apnea! If you are experiencing these symptoms along with trouble waking or daytime fatigue, your doctor may decide to order a sleep study, which can be done either at a clinic or in the comfort of your own home, using the Home Sleep Apnea Test. Based on your results, you and your doctor will have the opportunity to plan out
Frequently Asked Questions About Life Before and After CPAP
How Soon Do You Feel Better After CPAP?
How quickly you notice a change between before and after CPAP depends on a few factors. Some people who have mild Obstructive Sleep Apnea and adjust quickly to sleeping with a CPAP machine may begin to wake up feeling refreshed after a single night of good sleep! If you have a severe case of OSA or have Central Sleep Apnea, this could take a bit longer. Of course, the long-term damage caused by repeated breathing episodes will take some time to reverse.
How Long Does It Take to See Results With CPAP?
The number of apneas and/or hypopneas that you experience will likely begin to decrease immediately. With these changes, you or your partner may start to notice that your snoring improves as well, along with the number of times that you find yourself waking up gasping for air. Other numbers could take a bit of time to return to pre-sleep apnea levels, such as the increased number of inflammation markers that show up in your lab work.
Related Reading: How long does CPAP Take to Work?
What Changes Happen After Starting CPAP?
If you regularly sleep with your CPAP machine, you can expect to see improvements in both your physical and mental health. Decreasing the number of times that you experience a drop in oxygen levels can reduce your risk for dangerous chronic conditions such as cardiovascular disease and cancer. And the subsequent improvement in your sleep health can have significant impacts on your mood and energy levels.
What Should You Expect After Starting CPAP Therapy?
Some people just starting out with Continuous Positive Airway Pressure therapy may complain of experiencing a few unpleasant issues. These include CPAP-related headaches, dry mouth, nose, and eyes, sinus congestion and irritation, and/or gas and bloating. However, many of these can be resolved by adjusting your mask and humidity levels. Also, it is important to remember that these short-term negative effects will be far outweighed by the benefits of sticking with CPAP therapy, such as improved mood, increased energy, and reduced risk for health complications and even death.
How Long Can a Patient Be On CPAP?
Technically you can be on CPAP for the rest of your life, but this primarily depends on the cause of your sleep apnea. Central Sleep Apnea is often the result of some underlying condition. If this applies to your, treatment of such ailments may lead to a complete reversal of your sleep apnea. Similarly, if your Obstructive Sleep Apnea is caused by enlarged tonsils, you may not require CPAP after undergoing surgery to remove your tonsils. That said, most cases of sleep apnea are considered to be long-term, without any permanent solutions.
Does Sleep Apnea Go Away After Using CPAP?
By itself, CPAP therapy will not make sleep apnea go away altogether. It can prevent certain types of sleep apnea episodes or decreases in oxygen levels. However, the moment you stop sleeping with your CPAP machine, these breathing issues will come right back.
How Do I Know if CPAP Therapy Is Working?
There are both subjective and objective ways to tell whether your sleep apnea is responding to your CPAP therapy. The most straightforward method is to check your AHI score to see if it’s going down at all. Remember, the goal is below five per hour, but any significant reduction is generally a good thing as long as your numbers are progressively improving. You can also go off of whether your signs and symptoms are improving. For example, your snoring may decrease, or you may realize you are waking up more energized each morning.
How Do You Feel After the First Night of CPAP?
The first night of sleeping with your CPAP may be one of the bigger hurdles between life before and after CPAP therapy. It is normal to initially struggle with falling asleep as you adjust to wearing a mask or sleeping with a machine right beside you. However, if you do find that you are able to settle into bed and fall asleep, you will likely wake up experiencing the early signs of better sleep quality immediately.
Related Reading: How Long Does It Take To Get Used To CPAP?
Final Thoughts
While starting Continuous Positive Airway Pressure therapy can seem a bit scary, it's important to remember why you're doing it. The goal is to improve your health, sleep, and overall quality of life, even if this therapy takes some time to get used to. Ultimately, if you stick with it, you will see not only a boost in your mood and energy levels before and after CPAP but also a reduced risk of chronic health issues that are caused by the damage that is caused by repeated periods of reduced oxygen levels.
If you suspect you have sleep apnea, please speak with your healthcare provider. And remember, you're not alone in this journey. There are numerous resources and communities to help you navigate this path to better sleep and better health!