Which substances commonly worsen obstructive sleep apnea?

• A. Caffeine
• B. Water
• C. Vitamin C
• D. Alcohol, sedative-hypnotics, and opioids

Answer: (D)

Substances that worsen obstructive sleep apnea are those that relax the muscles keeping the airway open or depress the brain’s ability to respond to airway blockage. The airway is normally held open by pharyngeal dilator muscles; when sleep causes these muscles to relax too much, the airway can collapse and cause apneas. Alcohol and sedative-hypnotics relax these throat muscles and blunt protective reflexes, making airway collapse more likely and protracting apneas. Opioids also depress respiration and can further reduce upper airway muscle tone, increasing obstruction and dampening the body's response to blockage. Caffeine is a stimulant and can disturb sleep but doesn’t specifically worsen airway collapse; water and vitamin C don’t have direct effects on airway patency during sleep.