Sleep apnea in high performers: common and often missed

The symptom everyone blames on work

Waking unrefreshed, dragging through afternoons, needing caffeine to function, feeling irritable or forgetful: in a demanding job, these get filed under 'busy.' But they're also classic signs of obstructive sleep apnea (OSA), where the airway repeatedly narrows or closes during sleep, breaking it up dozens of times an hour without you knowing.

MedlinePlus notes that the snoring and breathing pauses are usually noticed by a bed partner, not the person with apnea. If you sleep alone or travel often, there may be no one to tell you.

It's also worth knowing that many people with apnea don't feel sleepy in the classic sense. They describe themselves as wired but tired, irritable, or simply not as sharp as they used to be.

How common it is

The U.S. Preventive Services Task Force cites estimates that moderate to severe OSA affects about 13% of men and 6% of women aged 30 to 70. In specific groups it can be far higher. In a 2026 study of nearly 2,000 former professional football players, about a third already had a diagnosis, and including those whose screening suggested elevated risk raised the estimate to roughly 69%. More than half of those diagnosed didn't regularly use CPAP.

Why driven professionals may be at higher risk

• Midlife age and male sex, though women are often underdiagnosed because they may present with insomnia or fatigue rather than loud snoring.
• Higher body weight, a thick neck (17 inches or more in men, 16 or more in women, per MedlinePlus), and jaw or airway shape.
• Alcohol and sedating medicines in the evening, which relax airway muscles.
• Sleeping on your back, irregular schedules and travel.
• A former contact-sport career, especially with significant weight gain.

What screening can and can't do

Questionnaires such as STOP-Bang ask about snoring, tiredness, observed pauses, blood pressure, BMI, age, neck size and sex. The USPSTF review found they're good at catching people who might have apnea (sensitivity of 87% to 94% in original studies) but poor at ruling it out precisely, with many false positives. They tell you who should be tested, not who has it.

Blood tests can't detect sleep apnea. They are useful for ruling out other causes of fatigue such as thyroid problems, anemia, low B12 or iron, and blood sugar problems. Consumer wearables can hint at disrupted sleep or oxygen dips, but they aren't diagnostic devices.

How it's actually diagnosed

Diagnosis requires a sleep study. MedlinePlus notes it can be done at home or in a sleep lab. In-lab polysomnography records brain activity, airflow, oxygen levels and breathing effort; home tests record fewer signals but suit many people with a high likelihood of moderate to severe apnea.

The USPSTF found insufficient evidence to recommend screening adults who have no symptoms. If you do have symptoms, that's different: it's a reason to be evaluated.

Why it matters beyond feeling tired

The National Heart, Lung, and Blood Institute notes untreated sleep apnea raises the risk of heart attack and stroke and affects concentration, memory and decision-making. MedlinePlus also lists high blood pressure, heart rhythm problems, heart failure, anxiety, depression, low sex drive and accidents from drowsy driving among complications. Much of this evidence is observational, but the pattern is consistent.

What treatment looks like

• Positive airway pressure (such as CPAP), the main treatment for moderate to severe apnea.
• Oral appliances that hold the jaw forward, an option for those who prefer them or can't tolerate CPAP.
• Weight loss for people with overweight or obesity; tirzepatide (Zepbound) is FDA-approved for moderate to severe OSA with obesity.
• Avoiding alcohol and sedatives before bed, and side-sleeping for positional apnea.
• Surgery for selected people with specific anatomy, usually after other options.

Small steps while you wait for testing

• Skip alcohol in the three hours before bed, since it relaxes airway muscles.
• Try sleeping on your side if a partner notices snoring or pauses mainly when you're on your back.
• Avoid driving when drowsy, and pull over if you notice yourself nodding off.
• Keep a consistent sleep window, even when traveling, where you can.
• Ask a partner or use a recording app to capture snoring or gasping to share with your clinician.

How HealifyMD can help

HealifyMD clinicians can screen for sleep apnea, order labs to rule out other causes of fatigue, and discuss related issues such as weight, blood pressure and testosterone. We don't perform sleep studies or prescribe CPAP, so if screening suggests apnea, your clinician will recommend a sleep evaluation. The comprehensive lab panel is listed at $199, confirmed at your eligibility review.