What happens during sleep apnoea
During sleep the muscles of the throat relax. In obstructive sleep apnoea (OSA) the airway narrows or collapses completely, so airflow stops for ten seconds or longer even though the chest and diaphragm keep trying to breathe. Blood oxygen falls, the brain briefly wakes to reopen the airway — often with a gasp or snort — and sleep continues. This can repeat from a handful of times an hour to several hundred times a night.
A less common form, central sleep apnoea, happens when the brain temporarily stops sending the signal to breathe. Some people have a mixture of both.
Common symptoms
Night-time signs
- Loud, persistent snoring, often reported by a bed partner
- Witnessed pauses in breathing, gasping or choking
- Restless sleep and frequent waking
- Needing to pass urine more than once a night (nocturia)
- Night sweats and a dry mouth or sore throat on waking
Daytime signs
- Excessive daytime sleepiness — dozing off while reading, watching TV or, most seriously, driving
- Morning headaches
- Poor concentration, memory lapses and irritability
- Low mood and reduced motivation to exercise
Why it matters
Untreated sleep apnoea is associated with higher blood pressure, an increased risk of cardiovascular problems, difficulty losing weight, poorer diabetes control and a markedly increased risk of road traffic accidents. In the UK, drivers diagnosed with sleep apnoea that causes excessive sleepiness have a legal duty to inform the DVLA; most people can continue driving once treatment is working.
Who is more likely to have it
- Carrying extra weight, particularly around the neck and abdomen
- A larger collar size, a set-back jaw or enlarged tonsils
- Being male, or female after the menopause
- Increasing age
- Smoking, alcohol in the evening and sedative medication
- Sleeping on the back (positional sleep apnoea)
- Nasal blockage, an underactive thyroid or a family history of the condition
Sleep apnoea also occurs in people who are slim and fit, so a normal weight does not rule it out.
How it is diagnosed
Diagnosis is made by a sleep service, not by an app. After an initial assessment you may be offered a home sleep apnoea test — a small recorder worn overnight measuring oxygen saturation, airflow, breathing effort and heart rate — or, in more complex cases, in-laboratory polysomnography. The result is usually reported as an apnoea–hypopnoea index (AHI): the average number of breathing events per hour.
Read more in our guide to sleep apnoea testing and screening.
Treatment options
CPAP
Continuous positive airway pressure is the first-line treatment for moderate and severe OSA. A small machine delivers gently pressurised air through a mask, holding the airway open. Benefits usually depend on consistent nightly use, which is why tracking your hours matters — see sleep apnoea monitoring.
Mandibular advancement devices
A custom dental splint holds the lower jaw slightly forward. Often used for mild to moderate OSA or when CPAP is not tolerated.
Lifestyle and positional measures
- Gradual weight loss, where relevant, can substantially reduce event frequency
- Avoiding alcohol and sedatives in the hours before bed
- Stopping smoking
- Side sleeping or a positional device instead of sleeping flat on the back
- Treating nasal congestion and allergies
- A consistent bedtime and wake time
Surgery
Surgical options exist for selected anatomical causes, such as very large tonsils. These are specialist decisions made in clinic.
Frequently asked questions
What is the difference between sleep apnoea and sleep apnea?
None — they are the same condition. 'Sleep apnoea' is the British spelling and 'sleep apnea' is the American spelling. Obstructive sleep apnoea (OSA) is by far the most common type.
Is snoring the same as sleep apnoea?
No. Most people who snore do not have sleep apnoea. Snoring becomes a concern when it is accompanied by witnessed pauses in breathing, gasping or choking, and daytime sleepiness.
Can sleep apnoea go away on its own?
Obstructive sleep apnoea does not usually resolve by itself, but severity can change. Weight loss, treating nasal congestion, reducing alcohol before bed and positional therapy can reduce events for some people. Any change to treatment should be discussed with your sleep clinic.
Who should I speak to if I think I have sleep apnoea?
Start with your GP in the UK. They can assess your symptoms, often using a questionnaire such as the Epworth Sleepiness Scale, and refer you to a sleep service for testing if appropriate.