Sleep Apnoea

Sleep apnoea is a condition in which breathing repeatedly stops and starts during sleep, most commonly due to relaxation of throat muscles blocking the airway (obstructive sleep apnoea). It disrupts sleep quality and, if untreated, is linked to increased risk of hypertension and cardiovascular disease.

• Loud, habitual snoring, often noticed by a bed partner
• Witnessed pauses in breathing during sleep, sometimes followed by gasping or choking
• Excessive daytime sleepiness or fatigue despite seemingly adequate sleep time
• Morning headaches
• Difficulty concentrating, irritability, or mood changes related to poor sleep quality

• Most commonly results from relaxation of the muscles supporting the throat during sleep, causing the airway to narrow or collapse repeatedly (obstructive sleep apnoea).
• Risk is increased by obesity, particularly excess weight around the neck, older age, male sex, large tonsils, and alcohol or sedative use before sleep.
• A less common form (central sleep apnoea) results from the brain not sending consistent signals to breathe, often related to other underlying conditions.

• Suspected based on the characteristic history of loud snoring, witnessed breathing pauses, and excessive daytime sleepiness, often reported by a bed partner or family member.
• A sleep study, where available, is the definitive test to confirm the diagnosis and assess severity by measuring breathing pauses and oxygen levels during sleep.

Weight loss, where relevant, can significantly reduce the severity of obstructive sleep apnoea and is recommended as a first step for those who are overweight.

Avoiding alcohol and sedative medicines close to bedtime, and sleeping on the side rather than the back, can help reduce symptoms for some people with mild sleep apnoea.

Continuous positive airway pressure (CPAP) therapy, a device that keeps the airway open during sleep using gentle air pressure, is the most effective treatment for moderate to severe obstructive sleep apnoea where available.

For some people, particularly with enlarged tonsils contributing to the blockage, a procedure to address the anatomical cause may be considered.

Untreated sleep apnoea is associated with increased long-term risk of hypertension, heart disease, and stroke, making diagnosis and treatment important beyond just improving sleep quality.

• Maintain a healthy body weight, since excess weight is a major modifiable risk factor.
• Avoid alcohol and sedative medicines close to bedtime.
• Sleep on your side rather than your back if this is a known trigger for snoring or breathing pauses.
• Seek medical assessment for loud, habitual snoring with witnessed breathing pauses or excessive daytime sleepiness, since sleep apnoea is both diagnosable and treatable.