The singer was given a bye into the next round of the competition last week due to illness, and she is still yet to have a full practice session this week.
It was recently claimed that Spraggan was threatening to quit the show due to being unhappy over song choices.
Her close friend and fellow contestant Rylan Clark has now said that she may decide to leave following her ongoing illness.
"Her health comes first and the show comes second at the moment," he told The Sun.
Spraggan was due to have her first rehearsal on Wednesday (October 31) since being signed off last Friday, but she cancelled due to exhaustion.
However, show sources have claimed that she has not been pressured to come back this week.
"It's completely up to her when she wants to come back to the show and there is no pressure from the producers or anyone else," said a show insider.
The X Factor continues this weekend on ITV1 with a number ones theme.
Watch Lucy Spraggan's performance of 'Gold Digger' by Kanye West below:
Photo gallery - 'The X Factor' week 3 results show:
Copyright: Ken McKay/Thames/Rex Features