What causes sleep apnea in young people who are fit at 26?

Question

Hello doctor,

I hope you are well.

I am reaching out regarding my 26-year-old cousin, who is in good health, exercises regularly, maintains a balanced diet, and has a normal BMI. Recently, his wife observed and recorded several episodes during sleep where he appeared to choke and gasp.

We are concerned, as most information we have found associates sleep apnea with older or overweight individuals. Could factors such as jaw structure, a deviated septum, or enlarged tonsils contribute to this in his case? Your guidance would be appreciated.
Would you recommend a full sleep study at this stage?
If sleep apnea is diagnosed, is long-term use of a CPAP machine typically required?

We would greatly appreciate any guidance you can provide.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com

I read your query and understand your concern.

We appreciate you for contacting us with your worries. The symptoms you described are typical of sleep apnea. Even if your relative is young and in good health, sleep apnea is typically associated with airway form rather than body weight.

For younger people, sleep apnea can happen because of a small or set-back jaw, a tongue that slips back during sleep, large tonsils, or a narrow nasal passage from something like a deviated septum. When muscles relax during sleep, the airway can close briefly, which can cause the choking or gasping you noticed. I have seen healthy people with similar symptoms where the main reason was their anatomy, not their lifestyle.

I recommend scheduling a sleep study. Your video shows there is a problem, but it does not tell us how often your cousin stops breathing, what their oxygen levels are, or how serious the issue is. We need this information to choose the best treatment.

CPAP (Continuous positive airway pressure) therapy is not always needed forever. Whether someone needs it depends on how serious the sleep apnea is and what is causing it. For mild cases or when issues like large tonsils or jaw position are the reason, other treatments such as mouthpieces or certain procedures can help. CPAP is usually for moderate to severe cases or when oxygen levels get too low. With the right care, some people can use CPAP less or even stop it over time.

Things like jaw shape, tonsil size, or a blocked nose could be causing your cousin’s symptoms. A sleep study is the best way to find out what is going on before deciding on treatment.

I hope this addresses your concerns.

Please feel free to follow up if you need any additional clarification.

Thank you.