You May Not Be Sleeping As Well As You Think

by Phil Ringman | June 04, 2026

The American Academy of Sleep Medicine estimates 85.6 million American adults suffer from sleep apnea, roughly 30 percent of the U.S. adult population. Only 17 million sleep apnea cases have been diagnosed, which means an estimated 68.5 million people may have it and don't know it.

I recently found that I was one of those.

Sleep apnea is when breathing repeatedly stops during sleep, causing drops in oxygen levels, forcing the brain to briefly wake you up to resume breathing. If untreated, sleep apnea can potentially lead to strain on the cardiovascular system, which in turn can lead to a variety of severe cardiac issues. The conventional treatment for sleep apnea is a CPAP (continuous positive airway pressure) machine, which delivers a steady stream of pressurized air through a mask to keep airways open while you sleep, preventing your throat from collapsing and allowing you to breathe without interruption.

I'm grateful to have made it into my eighth decade of life with no significant health issues. I am not on any medications. My cholesterol numbers have been well within normal ranges my whole adult life. I went through my first 12 years of school without missing a day due to illness, and today I rarely even have a cold. (I had covid, but didn't even know it at the time. I only learned it later when I had an antibody test.) I've always been serious about fitness, running for more than 50 years, strength training for the last 13 years, and training with coach Rusty Holcomb at Wichita Falls Athletic Club for the last 4 1/2 years.

But I have had high blood pressure readings in recent years during my once-a-year visits to the doctor, which I always attributed to "white coat syndrome," where blood pressure is high in a medical setting but normal at home, which my home readings are – most of the time.

My doctor sent me a couple years ago for a calcium scan, which shows calcified plaque buildup in the arteries. The result was a score of 38, with scores under 100 considered low risk for a cardiac event. Earlier this year he sent me for an echocardiogram. The report stated “pulmonary hypertension is present,” but I have had none of the visible signs of pulmonary hypertension – shortness of breath, fatigue, chest pain, dizziness or fainting. In fact, just the opposite. I train hard three days a week, I am currently close to my limits on all the lifts, and readily recover in time for the next session.

After getting the echocardiogram results, my doctor then prescribed a sleep test. He said sleep apnea can be a cause of high blood pressure, due to forcing the heart to work harder.

The sleep test showed that I had an average of 12 apnea events per hour while sleeping, which means I stopped breathing up to 80-90 times that night. And the sleep doctor said sleep tests tend to undercount the actual number of apnea events. My apnea is classified as "mild" (5 to 15 apnea events per hour). Sixteen to 30 is "moderate," and above 30 is "severe." Less than 5 apnea events per hour is considered "normal." I've read testimonies from some people with up to 60 apnea events per hour.

On my first night with the CPAP machine I had an average of 1.2 events per hour, a 90 percent reduction from my sleep test number of 12. And on most nights since then the number of events per hour has been well below 1.0.

Yes, sleeping with a mask hooked up to a machine takes some getting used to, particularly after 71 years of sleeping without a mask. But at this writing (a little less than two months in) it has become routine. Not normal, but doable, and getting a little better everyday. Blood pressure is down modestly versus pre-CPAP. My sleep doctor says it can take 3-4 months to see more pronounced changes, and to get more completely used to the machine.

One change that occurred almost immediately: I gained 3-4 pounds of body weight within the first few days of using the CPAP machine. Prior to CPAP treatment I could lose up to three pounds a night. I was losing weight at night, according to my sleep doctor, due to my heart having to work harder to keep me alive and breathing, and thus burning more calories. Now my heart does not have to work as hard as before, so I am burning fewer calories.

A misconception about CPAP treatment is that it allows you to sleep longer. Not so, he says. He said it allows more "quality" sleep, so 6-7 hours of sleep with the CPAP can be the equivalent of 8-9 hours without CPAP treatment.

Do I have more energy during the day? Hard to quantify, but something is definitely happening. Blood pressure readings, during periodic checks at home, are starting to go down, and I have data each morning from the CPAP machine (and a companion phone app) that shows I am having significantly fewer apnea incidents, which means the CPAP treatment is working.

To get a sleep test, a doctor has to order it. The test is done at home with a sensor worn on your finger while you sleep, tracking blood oxygen levels, heart rate, and breathing patterns.

I thought I was sleeping well. Turns out, I wasn't. With an estimated 68.5 million undiagnosed sleep apnea cases, there is a chance you might not be sleeping as well as you thought either. Check it out.