Can Cervical Spine Problems Cause Sleep Apnea?

Yes—cervical spine abnormalities (problems in the neck area of the spine) have been strongly linked to obstructive sleep apnea (OSA). Veterans who suffer from neck issues due to conditions like rheumatoid arthritis (RA) or spondyloarthropathy may be at higher risk of developing sleep apnea. Even surgeries on the neck can affect the airway and contribute to breathing problems during sleep.

What Is the Connection?

A key study by Naoki Shoda and colleagues looked at RA patients with neck (occipito-cervical) spine damage. They found that:

• 79% of these patients had obstructive sleep apnea.
• The sleep apnea was caused by mechanical pressure on the throat and nerve dysfunction affecting the muscles that keep the airway open.

Here’s how cervical spine problems contribute to sleep apnea:

1. Mechanical Compression of the Airway

• When the neck shortens or shifts because of spinal damage, it puts horizontal pressure on soft tissues around the airway.
• This pressure narrows the throat, making it more likely to collapse during sleep.

2. Nerve Damage

• The neck area houses nerves that control the muscles keeping your airway open.
• In cervical spine diseases like RA, these nerves (cranial nerves V, VII, IX, X, and XII) can be compressed or damaged, weakening the muscles that support your airway and increasing the risk of OSA.

Neck Surgeries Can Also Trigger Sleep Apnea

Even surgery intended to repair the spine can cause sleep-related breathing problems. In one study by Guilleminault et al., 12 patients who had anterior cervical spine fusion (a common surgery to stabilize the neck) developed sleep apnea afterward. The reason? The metal plates placed at the front of the spine reduced the size of the upper airway.

Other researchers have reported:

• Improved sleep apnea symptoms after removing bony growths from the front of the cervical spine.
• OSA developing after anterior spine surgeries, likely due to airway compression or damage to critical nerves.

What This Means for Veterans

If you’re a veteran with service-connected cervical spine conditions—whether from injury, arthritis, or surgery—and you now experience:

• Loud snoring
• Difficulty breathing during sleep
• Morning fatigue or headaches
• Excessive daytime sleepiness

…there may be a direct medical link between your neck condition and sleep apnea.

This connection is supported by strong medical evidence, and it could help support a VA disability claim for sleep apnea as a secondary condition to a service-connected cervical spine disorder.