Fit but Fatigued: Bodybuilding and Sleep Apnea Explained

• You don’t need to be overweight to have sleep apnea—bodybuilding can increase risk.
• Fatigue, poor recovery, and brain fog may be signs of disrupted sleep.
• You can do an overnight sleep apnea test at home—no lab, no CPAP required.
• Daybreak makes diagnosis and treatment simple, comfortable, and entirely at home.

OSA is a condition where the upper airway collapses during sleep, temporarily stopping breathing and causing fragmented, poor-quality rest. While excess body fat—especially around the neck and abdomen—is a well-known risk factor, anatomy plays a significant role too.

This is where weightlifters, bodybuilders, and other muscular individuals may unknowingly fall into the at-risk category. Heavy strength training often leads to increased neck circumference due to hypertrophy in the neck, upper chest, and shoulder muscles. While a thick, muscular neck may look impressive, it can also reduce airway space and increase the likelihood of upper airway obstruction during sleep—especially when lying on the back.

It’s also important to note that many women, especially during perimenopause and menopause, are turning to weightlifting to combat slowed metabolism, muscle loss, and declining bone density. While they may not have the same thick necks as male lifters, women are not immune to sleep apnea—hormonal shifts and changes in upper airway muscle tone can increase their risk, even if they appear lean and healthy.

In addition to neck circumference, several other factors may make sleep apnea more common in those who are intensely active in the gym:

• Jaw and facial structure: Some people have anatomies (like a recessed jaw or narrow airway) that make them more susceptible to OSA regardless of body weight. These structural issues can be masked in people who appear outwardly “fit.”
• Use of performance-enhancing drugs (PEDs): Steroid use, particularly anabolic steroids, can lead to fluid retention or thickened soft tissues in the airway, both of which can increase OSA risk.
• Overtraining and poor sleep quality: If you're relying on caffeine or pre-workouts to push through the day, that fatigue could be more than just under-recovery—it could be the result of disrupted, non-restorative sleep caused by untreated sleep apnea.
• High-altitude or resistance mask training: While popular for building lung capacity, these types of training can affect nighttime breathing patterns or complicate existing breathing disorders.

Many lifters overlook or dismiss the signs of OSA because they assume fatigue, brain fog, or poor recovery are just part of the training grind. But common red flags include:

• Loud or chronic snoring
• Waking up gasping or choking
• Feeling unrefreshed despite 7–9 hours of sleep
• Daytime sleepiness or difficulty concentrating
• Grinding teeth at night (bruxism)
• Headaches upon waking

Being at risk for obstructive sleep apnea doesn’t mean you should stop lifting. Far from it—resistance training offers major benefits for strength, metabolism, and cardiovascular health. The key is awareness and early action, especially if symptoms are affecting your energy or recovery.

If you’re experiencing ongoing fatigue, brain fog, or unrefreshing sleep—or even if you’re simply curious—getting tested is a smart next step. Today’s at-home sleep studies make it possible to get answers without an overnight stay in a sleep lab.

If you’re diagnosed with sleep apnea, treatment doesn’t have to mean a bulky CPAP machine (although for some, that’s the best option). Many active individuals prefer custom-made oral devices—discreet, comfortable appliances that gently reposition the jaw during sleep to keep the airway open. They’re a great alternative for people with OSA, especially those who can’t tolerate CPAP.

How Does a Home Sleep Study Work?

An at-home sleep study uses a small, wearable sleep apnea test machine that you use in your own bed. The device monitors breathing patterns, oxygen levels, and other key signals while you sleep. After one or two nights, the data is reviewed by a licensed physician to determine whether sleep apnea is present.

For active individuals, this approach is especially appealing—it’s discreet, comfortable, and doesn’t disrupt your normal sleep routine.

At-Home Sleep Study Instructions: What to Expect Overnight

Using an at-home sleep test is a non-invasive and straightforward process. You’ll receive clear instructions on how to set up the device before bed, wear it overnight, and return it for analysis. There are no wires, masks, or lab visits involved, making the process easy to fit into even the busiest training schedule.

If you are diagnosed with sleep apnea, treatment doesn’t automatically mean using a bulky CPAP machine. While CPAP is effective for many, some lifters prefer custom-made oral devices. These discreet, comfortable appliances gently reposition the jaw during sleep to help keep the airway open—offering a CPAP-free option for many people with OSA.

Being fit doesn’t make you immune to sleep apnea. In fact, for some lifters, the very habits and physical changes that build strength and size can quietly increase risk. Sleep apnea in athletes often goes undetected because fatigue, brain fog, or stalled progress are brushed off as overtraining or stress.

You’ve worked hard to build a body that performs—now make sure it’s getting the recovery it needs. With the right screening and treatment, achieving better sleep and improved performance is within reach.

You train hard. Your sleep should work just as hard for you.

Take Daybreak’s quick 30-second assessment to see if an at-home sleep study is right for you and start sleeping—and training—at your best.

1. Does weightlifting help or worsen sleep apnea?

Weightlifting itself doesn’t cause sleep apnea and can actually support overall health and better sleep. However, increased neck and upper-body muscle mass can narrow the airway in some lifters, which may raise the risk of sleep apnea—especially when combined with certain anatomical factors.

2. Does training your neck cause sleep apnea?

Training your neck doesn’t directly cause sleep apnea, but it can increase the risk in some people. Neck training and upper-body muscle growth can enlarge the muscles around the airway, which may reduce airway space during sleep, especially when lying on your back. When combined with specific jaw structures or genetic factors, this condition can contribute to the development of obstructive sleep apnea.

3. Can testosterone or hormone changes affect sleep apnea?

Yes. Elevated testosterone levels, including those from hormone therapy or anabolic steroid use, may worsen sleep apnea by increasing soft tissue thickness in the airway or affecting breathing regulation during sleep. Hormonal changes can also play a role in otherwise healthy individuals.

4. Why do some bodybuilders develop sleep apnea despite being lean?

Sleep apnea isn’t just about body fat. Genetics, jaw structure, neck circumference, airway anatomy, and muscle mass can all contribute to the development of sleep apnea. This is why even lean, highly trained bodybuilders may experience symptoms of sleep apnea.

5. Can you do a sleep study at home if you’re physically active?

Absolutely. At-home sleep studies are designed for people of all activity levels and can accurately diagnose sleep apnea in the comfort of your own bed—no sleep lab or overnight clinic stay required