Continuous Positive Airway Pressure (CPAP) therapy is the gold standard treatment for obstructive sleep apnea (OSA). While many people understand that CPAP can reduce snoring and daytime sleepiness, fewer realize the serious long-term health consequences of untreated sleep apnea—or of being prescribed CPAP but not using it consistently.
Sleep apnea is not just a nighttime inconvenience. Left untreated, it can affect nearly every system in the body.
Obstructive sleep apnea causes repeated pauses in breathing during sleep, leading to drops in oxygen levels and frequent micro-awakenings. Even if you don’t remember waking up, your brain and body experience stress throughout the night.
When CPAP is not used, this cycle continues night after night, triggering chronic physiological strain.
One of the most well-documented consequences of untreated sleep apnea is cardiovascular disease. Repeated oxygen deprivation and surges in stress hormones raise blood pressure and strain the heart.
Long-term risks include:
Heart attacks
Heart failure
Cardiac arrhythmias, including atrial fibrillation
Increased risk of stroke
Using CPAP consistently has been shown to significantly reduce these risks, especially when started early.
Chronic sleep fragmentation and low oxygen levels negatively affect brain function. Over time, untreated sleep apnea is associated with:
Reduced attention and concentration
Slower processing speed
Executive dysfunction
There is also growing evidence linking untreated sleep apnea to an increased risk of mild cognitive impairment and dementia, particularly in older adults.
Sleep apnea disrupts emotional regulation. People who do not use CPAP are at higher risk for:
Depression
Anxiety
Irritability and mood instability
Decreased stress tolerance
Because fatigue and low mood can reinforce each other, untreated sleep apnea often creates a cycle where mental health worsens alongside sleep quality.
Untreated sleep apnea interferes with glucose metabolism and hormone regulation. Long-term consequences may include:
Insulin resistance
Type 2 diabetes
Weight gain and difficulty losing weight
Poor sleep also disrupts hormones that regulate hunger and satiety, making lifestyle changes more challenging.
Without CPAP, excessive daytime sleepiness often persists. This increases the risk of:
Workplace injuries
Errors in judgment and decision-making
Over time, chronic fatigue can affect job performance, relationships, and overall quality of life.
Untreated sleep apnea affects more than just the individual. Loud snoring, gasping, and restless sleep can disrupt a partner’s rest, leading to relationship strain. Fatigue, irritability, and withdrawal can further erode emotional connection and social engagement.
Many people don’t realize how much sleep apnea has limited their lives until effective treatment begins.
CPAP only works when it’s used consistently. Skipping nights—or abandoning therapy altogether—allows the harmful effects of sleep apnea to continue. While adjustment can be challenging, mask fit issues, dryness, pressure discomfort, and anxiety can usually be addressed with proper support.
CPAP is not a sign of weakness—it’s a tool that protects long-term health.
Not using CPAP doesn’t just mean poorer sleep—it can mean years of accumulated damage to the heart, brain, metabolism, and mental health. The long-term consequences of untreated sleep apnea are serious, but they are also largely preventable.
Using CPAP consistently is an investment in longevity, cognitive health, emotional well-being, and overall quality of life. If CPAP feels difficult, the solution is rarely to give up—it’s to seek help and optimize the therapy.
If you or someone you know struggles with sleep, please click the orange button below to take a free online sleep test and talk with one of our sleep health professionals.