Sleep apnoea is a common sleep-related breathing problem that can leave you exhausted however long you spend in bed. This article explains the signs, how it is diagnosed, and what treatment on the NHS involves.
What is sleep apnoea?
Sleep apnoea is a condition in which breathing repeatedly stops and starts during sleep. The most common form is obstructive sleep apnoea, often shortened to OSA. In OSA the airway becomes too narrow while you sleep, which interrupts normal breathing.
The NHS stresses that sleep apnoea needs treatment because, left alone, it can lead to more serious problems. That is a reason to take the signs seriously, but not a reason for alarm: it is a recognised, diagnosable condition with well-established treatments.
Because the pauses in breathing happen during sleep, many people are not aware of them. Often it is a partner, family member or housemate who notices first.
Which signs should make you think of it?
According to the NHS, symptoms mainly happen while you sleep. They include:
- breathing that stops and starts
- gasping, snorting or choking noises
- waking frequently
- loud snoring
Daytime effects can include:
- tiredness
- difficulty concentrating
- mood swings
- morning headaches
None of these is proof of sleep apnoea on its own. Snoring is very common and many people who snore do not have the condition, and tiredness has a long list of possible causes, from poor sleep habits to low mood to other medical problems. The pattern matters: witnessed pauses in breathing, gasping or choking at night, and persistent daytime tiredness together are what point towards a GP conversation.
If you have been waking regularly at night and are not sure why, our piece on why you might be waking at 3am covers the more common explanations, and sleep apnoea is one possibility to keep in mind.
Who is more likely to develop it?
The NHS lists a number of factors linked to sleep apnoea. Some can be changed and some cannot.
| Linked factor | Can it be changed? |
|---|---|
| Obesity | Often, with support |
| Large neck | Not directly |
| Older age | No, though children and young adults can also be affected |
| Family history | No |
| Alcohol | Yes |
| Smoking | Yes |
| Large tonsils or adenoids | Sometimes, via a specialist |
| Sleeping on your back | Yes |
| COPD | Managed, not changed |
Being in one of these groups does not mean you have the condition, and having none of them does not rule it out. The list simply helps explain why the airway may narrow during sleep.
Alcohol is worth a particular mention because it is both a linked factor and something the NHS says to avoid heavily, especially shortly before sleep. If you want to understand how your drinking compares with guidance, our explainer on alcohol units and practical ways to cut back is a useful starting point.
Why does untreated sleep apnoea matter?
The NHS links untreated sleep apnoea with several problems:
- high blood pressure
- stroke
- type 2 diabetes
- heart disease
- depression or changes in mood
- a higher risk of serious accidents caused by tiredness
- difficulty concentrating at work or school
- strain on relationships with partners
“Linked with” is the important phrase. These are associations the NHS lists as potential complications of untreated sleep apnoea; they are not certainties for any individual, and treating sleep apnoea is not a guarantee that any of them will be avoided. It does, however, explain why getting a persistent problem checked is sensible. If blood pressure is already on your mind, our guide to blood pressure numbers and what they mean explains how readings are interpreted.
When should you speak to a GP?
The NHS advises seeing a GP if you have the main symptoms, such as breathing that stops and starts during sleep, gasping or choking noises, or constant tiredness during the day. If someone has seen you have these symptoms, it helps to bring them to the appointment, because they can describe what they have witnessed and you may have no memory of it.
It can also help to jot down a few notes beforehand: how you feel in the daytime, how often you wake, whether you snore, and how much alcohol you drink. This gives the GP something concrete to work with.
If you ever feel so sleepy that you nod off while driving or doing something that needs your attention, treat that as a safety matter and speak to a GP promptly. NHS 111 can help if you are unsure how urgent your situation is.
How is sleep apnoea diagnosed?
A GP may refer you to a specialist sleep clinic. There, you wear devices overnight that monitor your breathing and heartbeat. The NHS says this is usually done at home, although sometimes it involves an overnight stay at a clinic.
The results are used to produce a score called the AHI, or apnoea-hypopnoea index, which grades how severe the condition is. The NHS gives these bands:
| AHI score | Severity |
|---|---|
| 5 to 14 | Mild |
| 15 to 30 | Moderate |
| Over 30 | Severe |
The grade helps guide treatment, but it is not the whole picture. How sleepy you feel and how much the condition affects your daily life also matter, and your clinic will take these into account.
What treatments are available?
Treatment depends on the type and severity of the condition and on your circumstances. The options the NHS describes are below.
Lifestyle changes
The NHS says lifestyle changes may be all that is needed if sleep apnoea is mild. These include:
- losing weight if you are overweight
- stopping smoking
- cutting down on alcohol
- exercising regularly
- keeping a regular sleep schedule in a dark, quiet bedroom
- sleeping on your side
Weight loss and exercise are easier said than done, and your GP or practice team can help you find support. Protecting your sleep is worth the effort.
CPAP
For many people, the main treatment is a CPAP machine, short for continuous positive airway pressure. The NHS describes it as a device that gently pumps air into a mask worn over your nose, or nose and mouth, while you sleep, which helps keep the airway open. It is available free on the NHS if you need it, and it works best when used every night. If the mask is uncomfortable, the NHS advises telling your doctor rather than giving up, as adjustments are often possible.
Other options
The NHS also lists a mandibular advancement device, which is similar to a gum shield and holds the airway open as you sleep; surgery, such as removing large tonsils; mouth and facial muscle exercises; and hypoglossal nerve stimulation, which uses electrical signals to the nerve that controls the tongue. Which of these, if any, is suitable is a specialist decision.
Are sleeping pills a good idea if you are tired?
No, not without medical advice. The NHS says not to take sleeping pills unless a doctor recommends them, because they can make sleep apnoea worse. That matters because people who sleep badly often reach for something to help, when the underlying problem is disrupted breathing rather than difficulty getting off to sleep.
If you do take a prescribed medicine, do not change or stop it without talking to the prescriber. And if you have trouble falling or staying asleep without breathing symptoms, insomnia and CBT for insomnia is a different route worth exploring with your GP.
Does sleep apnoea affect driving?
It can. The NHS says you may need to tell the DVLA about your sleep apnoea, and that you must not drive until symptoms such as feeling very tired are under control. The exact rules depend on your circumstances, so ask your clinic or GP what applies to you and check the official government guidance. Driving while excessively sleepy is dangerous for you and for other road users.
Getting breathing and rest back on track
Sleep apnoea is common enough, treatable enough and serious enough to deserve attention rather than a shrug. Loud snoring, breathing pauses seen by someone else, gasping at night and persistent daytime tiredness together are worth a GP appointment, not months of putting up with it. Diagnosis is usually done at home, and treatments range from lifestyle changes to a CPAP machine that is free on the NHS.
This is general information, not a substitute for advice from a doctor or other qualified health professional. If you are concerned about your sleep or breathing, speak to your GP or call NHS 111.
Sources: NHS
