How Untreated OSA Can Affect Metabolic Health (and What to Do About It)
Published on October 23, 2026
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Waking up multiple times every hour, often gasping for breath, sounds exhausting. Yet 30 million Americans live with a sleep disorder called obstructive sleep apnea (OSA) and experience these very symptoms. The right care can help people breathe better and sleep sounder at night, but 80 percent of OSA cases in the United States remain untreated.
Not only does untreated OSA cost the healthcare system almost $150 billion per year, but it can increase the risk of potentially serious health issues, too. “Untreated OSA can lead to daytime sleepiness, impaired concentration, mood changes, and increased motor vehicle accident risk,” says Xinhang Tu, a sleep medicine physician at University of Michigan Health in Ann Arbor who is board-certified in internal medicine, sleep medicine, and obesity medicine and is a diplomate of the American Board of Obesity Medicine.
Moderate to severe OSA can also affect your metabolic health, increasing the risk of high blood pressure and stroke, says Dr. Tu. Read more about what untreated OSA can do to the body — including your metabolic health — and how you can find the right care based on your symptoms.
Why Leaving OSA Untreated Is Harmful to Metabolic Health
Sleep isn’t just something we do to help us wake feeling energized in the morning. “Quality sleep — that’s well-oxygenated and uninterrupted — is critical for body self-repair,” says Wayne Ho, MD, a spokesperson for the Obesity Society and a diplomate of the American Board of Obesity Medicine. “Without it, there is increased systemic inflammation and oxidative stress, and neurohormonal effects that lead to worsening cardiovascular and kidney health,” Dr. Ho adds.
Thus, untreated OSA can seriously affect your metabolic health.
Whether you’re in good metabolic health is determined by factors like your blood sugar, blood pressure, triglycerides, “good” HDL cholesterol levels, and weight circumference. When three of the five numbers are off, doctors clinically refer to that as metabolic syndrome.
Untreated OSA, says Ho, can increase the risk of metabolic health–related diseases including:
- Hypertension (high blood pressure)
- Dyslipidemia (abnormal levels of fats like cholesterol or triglycerides in the blood)
- Coronary artery disease
- Cardiomyopathy (a disease of the heart muscle)
- Heart failure
- Insulin resistance
- Type 2 diabetes
- Obesity
Research shows that 63 percent of people with metabolic syndrome also have OSA. Unfortunately, each health issue can make another health issue worse. For example, more visceral fat that’s associated with metabolic syndrome can make nighttime breathing more difficult, creating more issues with OSA.
Also, multiple night wakings due to OSA can increase a person’s blood sugar, which is a risk factor of metabolic syndrome.
Other Health Effects of Untreated OSA
The consequences of leaving OSA untreated go beyond metabolic health. “Let’s not forget also the neurocognitive effects of OSA from periods of decreased oxygenation to the brain and disrupted sleep,” says Ho.
Because a person with OSA wakes up so many times throughout the night, it can lead to exhaustion in the morning. This may cause people to fall asleep suddenly (also known as “sleep attacks”) in the day, resulting in car or workplace accidents.
Extreme tiredness can bring other challenges, like more difficulty with focus and high-level thinking and understanding, and lower energy that can impede quality of life, says Ho.
And it’s not just short-term issues. “Possible longer term effects include increased risk of cognitive impairment and dementia,” says Ho.
Leaving OSA untreated can contribute to:
- Morning headache
- Depression
- Dry mouth after waking
- Loud snoring
- Decreased libido
- Irritability
- Extreme daytime sleepiness
- Memory problems
- Increased risk of dementia
- Chronic kidney disease
How to Get an OSA Diagnosis and Find Treatment
If you suspect you have OSA, make a doctor’s appointment as soon as possible. “Ideally, primary care providers will identify symptoms that may suggest OSA — like excessive fatigue, daytime sleepiness, the need for regular daytime naps, loud snoring, and sudden awakenings at night,” says Ho.
They may administer a questionnaire to get a better understanding of your risk of OSA, adds Ho. If the risk is considerable, they’ll likely refer you to a sleep medicine specialist for evaluation or directly order a sleep study. “This test will measure your breathing pattern and blood oxygen levels at night,” Ho adds.
The interventions depend on the severity of OSA and the underlying cause, says Ho, and could include:
- Behavioral therapies (improved sleep hygiene, change of sleep position, weight-management lifestyle interventions)
- Medical and surgical devices (oral devices, positive airway pressure machines like CPAP and APAP, and surgically implanted devices that stimulate the upper airway to prevent airway collapse during sleep)
- A GLP-1/GIP medication option called Zepbound (tirzepatide) if excess weight is a significant contributor to OSA, which may help decrease the severity of OSA
Tips for Improving Your Metabolic Health With OSA
Ready to take action? “Focusing on a healthy lifestyle can improve your OSA and metabolic health,” says Ho. These steps can support metabolic health if you have OSA.
1. Find Substitutes for Processed Food
“See if there are processed foods that you can decrease or cut out from your diet and find healthier replacements that perhaps have less processed sugars or saturated fats or more dietary fiber,” says Ho. Eating healthfully (with foods low in saturated fat, sodium, and sugar) can stabilize blood sugar and improve heart health.
2. Set a Movement Goal
“Find enjoyable ways you can move more and set a realistic and achievable goal around this activity that you can maintain long term, even during busy weeks,” says Ho. That could be starting small with 10 minutes of activity two to three days a week. The more achievable, the better!
3. Check Out Food Labels
“Evaluate your energy intake — both from a total caloric intake and a quality of energy perspective,” suggests Ho. You’ll want to make sure you’re within your calorie range for the day (an app that tracks calories can help) and that you’re choosing nutritious foods. “Looking at nutrition labels will help with this,” Ho adds. For more individualized calorie and nutrition intake advice, consider working with a registered dietitian nutritionist, which you can find at Eatright.org.
4. Ask if Tirzepatide Is Right for You
“Tirzepatide addresses obesity, which is an important underlying driver of OSA in many patients, and its benefits develop gradually with weight loss,” says Tu.
5. Keep Up Your OSA Treatment
A CPAP machine, for example, can lower a person’s stress hormones and blood pressure (in addition to helping a person have fewer night wakings). For a patient with metabolic syndrome, these benefits can reinforce each other.
EDITORIAL SOURCES
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Resources
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