Sleep-related hypoventilation describes breathing that is too slow or shallow during sleep. The first signs of hypoventilation typically occur during sleep because when we’re awake, our brain can play a more active role in regulating our breathing. When we sleep, however, our brains and muscles relax. Hypoventilation is most severe during REM sleep.
Problematically, sleep-related hypoventilation reduces sleep quality, which leads to sleep deprivation. When we’re sleep-deprived, our brain’s ability to control breathing also becomes impaired, creating a vicious cycle. Sleep-related hypoventilation can also increase your risk for pulmonary artery hypertension, right-sided heart failure (cor pulmonale), and neurocognitive disorders.
Chronic hypoventilation can appear with a number of lung and respiratory disorders. While some people exhibit hypoventilation as early as childhood, it’s more common to develop due to obesity, an underlying medical disorder, or drug use.
People with chronic obstructive pulmonary disease (COPD) are significantly more likely to have sleep-related hypoventilation. Other underlying medical conditions that have been linked to sleep-related hypoventilation include obesity, lung and respiratory diseases, and neurological and musculoskeletal disorders.
Chronic use of certain medications or drugs may also lead to sleep-related hypoventilation. Long-term use of narcotics, anesthetics, sedatives, opioids, muscle relaxants, and alcohol may all increase your risk for sleep-related hypoventilation. One study of individuals with chronic pain found that up to 50% of those on long-term opioid therapy also had hypoventilation.
People with sleep-related hypoventilation may report symptoms like:
Daytime fatigue
Difficulty exercising
Excessive daytime sleepiness
Morning headaches
Poor sleep quality
Shortness of breath
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