January 29, 2024 3 min read

Many conditions seem to have a seasonal pattern. Respiratory infections are more common during the colder seasons, some affective disorders also peak in the winter and the same seems to be true for sleep apnea. 


If you’ve noticed you often wake up with headaches, a dry mouth and feeling unrefreshed more frequently in winter, this could be a good sign of sleep apnea that’s worse in winter. Several studies have found a worsening in sleep apnea severity during cold weather. If you’ve already been diagnosed with this condition, there are ways to improve your sleep quality that we’ll explain here. 

Does Sleep Apnea Change With the Seasons?

According to one large study published in the journalChest, AHI scores seem to jump during winter and improve during the summer months [1]. The study examined 10 years of data from over 7,500 patients who underwent polysomnography testing. It found that the average AHI in the winter was around 18 compared to 15 during the warmer seasons.

A study looking into Google queries came to a similar conclusion. The  2015 study collected Google Trends data from January 2006 to December 2012 for terms like “snoring” and “sleep apnea,” as well as "snoring children" and "sleep apnea children" [2]. All searches peaked in the winter but also in early spring, sometimes up to 50%. 


And there’s also one interesting study that investigated how different room temperatures affected sleep apnea [3]. What’s surprising is that the study found that lower temperatures (16°C vs. 20°C and 24°C) increased sleep apnea severity but also improved sleep efficiency in sleep apnea patients. 

Why Is Sleep Apnea Worse in Winter?

We don’t know yet why sleep apnea seems to worsen in winter. However, there are a couple of theories: 


Respiratory tract infections 

The common cold and flu are in season during the colder months. Irritated airways are less efficient and can lead to worsening AHI scores. 


Air pollution 

In densely populated areas, air pollution that tends to get worse during winter could be another contributing factor here. A study analyzing data from participants in MESA (Multi-Ethnic Study of Atherosclerosis) found that those living in air with greater air pollution were more likely to also have sleep apnea [4].


Low humidity

Cold weather paired with central heating and space heaters means less humidity in your home. Low humidity levels can also irritate your airways. 

What You Can Do

If you were already diagnosed with sleep apnea, it’s important to keep using your CPAP humidifier. If you have an old CPAP machine without this function, it’s a good idea to have it replaced with one that does. 


Besides that, improving air quality in your home with an air humidifier, turning down the thermostat, and regularly letting fresh air in can also make a difference. 


To keep your airways healthy, you can reduce your risk of respiratory tract infections with regular hand washing and by keeping your immune system strong with a healthy diet, regular exercise, vitamin D supplements, and good sleep hygiene.


And if you suspect you might have sleep apnea, the first thing you should do is speak to your doctor. Sleep apnea is a serious condition that gets worse without treatment. 


References: 


  1. Cassol CM, Martinez D, da Silva FABS, Fischer MK, Lenz MDCS, Bós ÂJG. Is sleep apnea a winter disease?: meteorologic and sleep laboratory evidence collected over 1 decade.Chest. 2012;142(6):1499-1507. doi:10.1378/chest.11-0493.https://pubmed.ncbi.nlm.nih.gov/22700779/#:~:text=Conclusions%3A%20More%20sleep%2Ddisordered%20breathing,circumference%2C%20and%20relative%20air%20humidity.

  1. Ingram DG, Matthews CK, Plante DT. Seasonal trends in sleep-disordered breathing: evidence from Internet search engine query data.Sleep Breath. 2015;19(1):79-84.doi:10.1007/s11325-014-0965-1

  1. Valham F, Sahlin C, Stenlund H, Franklin KA. Ambient temperature and obstructive sleep apnea: effects on sleep, sleep apnea, and morning alertness.Sleep. 2012;35(4):513-517. Published 2012 Apr 1.doi:10.5665/sleep.1736

  1. Billings ME, Gold D, Szpiro A, et al. The Association of Ambient Air Pollution with Sleep Apnea: The Multi-Ethnic Study of Atherosclerosis. Ann Am Thorac Soc. 2019;16(3):363-370.doi:10.1513/AnnalsATS.201804-248OC



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