Binge Drinking and Sleep Apnea: A Fatal Combination?

June 2, 2010

Former news anchor Ted Koppel's son, Andrew, was found dead after after a night of heavy drinking with friends. It's a sad occasion whenever anyone's son dies for any reason, but there were a few points in the Associated Press news article that's worth mentioning. After a night of heavy drinking, he ended up at a third friend's apartment, where they lay him down to sleep it off since he was clearly drunk. When they checked on him a few hours later, he was noted to be snoring, but had a pulse. A few hours later, he was found dead.


It's too early to tell what the cause of death was, but one thing I'm sure about is that a sleep-breathing problem was definitely an aggravating factor. Assuming that all modern humans are susceptible to breathing problems while sleeping, there were two major potential issues in this case that's worth pointing out: The fact that he was snoring means that he either already has a sleep-breathing problem such as obstructive sleep apnea or upper airway resistance syndrome. And alcohol, by relaxing his throat muscles, probably aggravated his breathing obstructions even further. 

Add to this the fact that his friends probably laid him down in bed on his back, when due to gravity, the tongue falls back the most. If you add additional muscle relaxation in deep sleep along with alcohol, Mr. Koppel was probably having significantly increased apneas or hypopneas. He was so inebriated that he was unable to wake up and turn over. He also probably never slept on his back .

I'm willing to bet that he died of either a heart attack or a stroke, both cardiovascular complications of untreated obstructive sleep apnea. I've written about this issue before: For some reason, hospitalized patients have a much higher incidence of heart attacks, then when out of the hospital. Possible explanations include being forced to sleep on their backs for the first time in years, and their inability to turn over (such as after an abdominal operation or a hip injury or a joint replacement).

This same situation occurs probably by the millions every month, after people binge drink and sleep. What do you think about my theory? Please enter your comments in the text box below.

8 Responses to “Binge Drinking and Sleep Apnea: A Fatal Combination?”

  1. Tim Limkeman on June 3rd, 2010 4:00 am

    This person could have died from heart failure or stroke, but I thought about something else.  With that much alcohol in him, and the muscles relaxed, and apneas occuring, he may have affixiated on some of his stomach contents and/or suffocated.  The apneas may have caused a vacuum which would have brought up the gastric juices into his airway.  This is very likely in the supine position and his inability to wake.  The acid and/or alcohol may have triggered an asthmatic session, also.  He seems to young to have died from heart failure or stroke.

  2. Steven Park on June 3rd, 2010 6:27 pm

    Tim,
    You're absolutely right in that reflux is probably a large part of the obstructive events. If he aspirates, then the normal protective coughing and arousal mechanisms are lost when drunk. This can cause bronchospasm or aspiration pneumonia. 
    One thing to note is that all these events are very stressful for the heart and even young people can have heart attacks or stroke. 

  3. Jen DeClue on August 12th, 2010 2:02 pm

    Hello, I just recently buried my older brother of 38 yo. He was a HEAVY drinker of straight Rum for almost 6 years. Within the past year he started living with me did not work due to the obvious reasons. The last week of July he started to lose his appetite and was dropping weight. He stayed sick all the time and he already had acid reflux issues his whole life. Within 3 days I know for a fact he had only a bite of a burrito on Friday July 30th. I had talked to him frequently throughout the weekend and he was actually downstairs visiting with a friend on Saturday. The last time I know anyone talked to him was at 9:45 pm sat. I woke up on Sunday 8/1/2010 at 10:30 am and I found my brother had passed away. He was lying on his right side with his arm under his head as a pillow. He was heavy in the stomach a little. I am messed up for life after this, he was my only brother and my best friend.
    The autopsy report showed only an enlarged heart and a little hardening of the arteries. Needless to say my small little family is devastated over this and we are now awaiting the Toxicology report to come back. We do not have any clue as to what happened to my brother besides the obvious reason. Do you have any suggestions as to what may have happened to my older brother besides the millions of things it could have been?
    Thank you, Jen

  4. Colt on December 22nd, 2011 1:11 am

    Last weekend me and some friends were drinking. My best friend doesn’t hardly ever snore. He passes out in bed and his girlfriend cam running into the other room yelling that he wasn’t breathing. She stuck her finger down his throat and gagged him which made him gasp for air. It was like he was holding his breath. His eyes were open but he was unresponsive. He the started crying and then did it all over again. Scared the crap out of me. He finally came to and we kept him up for about 20 minutes. When he went back to sleep we watched him pretty much all night and he was fine. What could have been going on?

  5. Steven Park on December 22nd, 2011 6:45 am

    Colt and Jen,

    Like what the article describes, it’s likely that in both situations, obstructive sleep apnea was the likely culprit. It’s been shown that people with sleep apnea tend to die in the early morning hours (12 midnight to 6AM), whereas those without sleep apnea die anywhere from 6AM to 12 noon. Jen, sorry for your loss.

  6. Mark on October 30th, 2013 6:16 pm

    My 50 year old younger brother died Friday night after 5 hours of heavy drinking. He had OSA and a breathing machine to help during sleep, He went to bed very drunk and never used his breathing machine. This probably lead to his sudden death leaving behind a son, daughter, parents, brothers and many nephews who miss him dearly. Don’t do it!!!!!!!!

  7. Julie on December 2nd, 2014 1:32 am

    a good friend of mine died this weekend. he was 42, and never woke up from the night’s sleep. he had bad sleep apnea. he also was a severe alcoholic. he had almost three years sober, but had relapsed earlier that week, and was on a binge. i appreciate this article and the comments. it helped me to understand what happened (physically, at least). absolutely devastating.

  8. Steven Park on December 2nd, 2014 5:22 am

    Julie,

    Sorry to hear about your friend’s untimely death.

    Steven Park

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