What is Sleep Apnoea? Types, Symptoms & Treatments | Resmed UK
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What is sleep apnoea?

Sleep Health Sleep issues Symptoms

Sleep apnoea is a condition where breathing stops and restarts many times throughout the night. These interruptions can make it harder for your body to get enough oxygen.1

Sleep apnoea is a serious medical condition that can impact your health and well-being. It’s important to know the signs of sleep apnoea, if you’re at risk and how to get diagnosed and treated.

Sleep apnoea definition and meaning

Sleep apnoea can lead to pauses in breathing that may last from 10 seconds to over a minute. These pauses can starve your organs from getting oxygen.

But what does that actually look like over the course of a night? For someone with moderate sleep apnoea, breathing can stop up to 29 times an hour. Over eight hours, that could mean your breathing pauses as many as 232 times.2 As a result, if you suffer from sleep apnoea, this lack of sleep often leaves you feeling exhausted, with low energy and craving caffeine during the day.

Types of sleep apnoea

Even though sleep apnoea is a blanket term, there are actually a few distinct types of sleep apnoea:

  • Obstructive sleep apnoea (OSA)
  • Central sleep apnoea (CSA)
  • Complex sleep apnoea (TESCA)

You and your doctor will work together to understand the best treatment options for you based on your sleep concerns and sleep apnoea type.

Obstructive sleep apnoea (OSA)

Obstructive sleep apnoea (OSA) is a condition where your upper airway becomes blocked repeatedly during sleep, making it harder for air to flow. These blockages can reduce or completely stop the flow of air, causing your breathing to pause throughout the night.1

Central sleep apnoea (CSA)3

A less common type of sleep apnoea, central sleep apnoea (CSA), occurs when the brain fails to send a signal to the muscles that control your breathing, resulting in pauses in breathing during sleep.

Complex sleep apnoea3

Sometimes referred to as treatment-emergent central sleep apnoea (TECSA), it is a form of central sleep apnoea that emerges during the early stages of treatment for obstructive sleep apnoea. In most cases, TECSA resolves on its own without the need for further intervention.

 woman snoring in bed as partner looks annoyed

Symptoms of sleep apnoea4

Everyone has a bad night’s sleep now and then. But, as a chronic condition, sleep apnoea makes the effects of regularly disrupted sleep even more intense. From work to relationships to your overall motivation, untreated sleep apnoea can take a toll on many aspects of your life.

Snoring

Snoring is one of the most common symptoms of sleep apnoea. It occurs when your neck muscles relax and your throat partly closes and becomes narrow, causing the vibration sound known as snoring.

Waking up gasping for air

When your breathing is restricted, your brain sends a signal to wake up to breathe. This can cause a sudden and startling gasp for air.

Difficulty concentrating during the day

A lack of restful sleep interrupts your body’s natural circadian rhythm and can impair cognitive function. Daily activities that require attention, critical thinking or memory can be impacted by sleep apnoea.

Consistent daytime tiredness

Sleep apnoea can make you feel like you’re sleepwalking through life. Sleep is a time for our bodies to rest and repair, and missing key stages of the sleep cycle can leave you feeling drained.

Morning headaches

Periods of disrupted breathing can cause your blood oxygen levels to drop during sleep, resulting in morning headaches. While the headaches may not last for long, they may be an indicator of sleep apnoea.

Difficulty staying asleep

Sleep apnoea and insomnia can be a vicious cycle. You may wake up from apnoeas and worry about not sleeping, then struggle to sleep because you’re worried.

Waking up with a dry mouth

When your airway is blocked, it can lead to snoring or breathing with your mouth open, both of which can cause you to wake up with a dry mouth.

Irritability and mood swings

A lack of quality sleep can leave you feeling tired and irritable. This can make even the simplest tasks a struggle, which can impact your mood. There’s also a strong link between sleep apnoea and mood disorders. In fact, 35% of people living with sleep apnoea have symptoms of depression.5

Sleep apnoea causes

Each type of sleep apnoea comes with its own causes. Understanding the cause behind your sleep apnoea can help you address some symptoms and get the most effective treatment for your condition. While some causes are unavoidable or genetic, you may be able to make lifestyle changes that reduce your risk.

Obstructive sleep apnoea causes

Causes may include alcohol use, smoking, narcotic drug use and excess weight. Other causes can include age, gender, allergies, a narrow airway, enlarged tonsils or adenoids, a receding chin or a deviated septum.

Central sleep apnoea causes

Causes can include high altitude, narcotic drug use or underlying medical conditions, such as heart failure or stroke.

Complex sleep apnoea causes

While complex sleep apnoea, otherwise known as treatment-emergent sleep apnoea is not fully understood, a small percentage of patients develop it during treatment for obstructive sleep apnoea.

Sleep apnoea risk factors

While it’s true that people who snore, are older, have other medical conditions and are male may be at risk of sleep apnoea, they’re not the only ones. Sleep apnoea can affect people of all ages, races, genders, shapes and sizes. However, there are some general risk factors to keep in mind. Knowing more about these risk factors can help you have a conversation with your doctor about sleep apnoea.

Obesity

Weight can be a common sleep apnoea factor. People with excess weight or obesity tend to have fat deposits in their upper respiratory tract, narrowing the airway and causing obstructed breathing.

Gender

Men are more susceptible to sleep apnoea than women. The prevalence of moderate-to-severe sleep disordered breathing is 23.4% in women and 49.7% in men,6 although women become more susceptible during pregnancy and after menopause.

Age

Ageing naturally impairs the brain’s ability to control the throat muscles. People over 40 are more likely to develop OSA.

Neck size

Excess weight around your neck can narrow your airway when you lie down. A neck circumference of 43 or more cm in men and 40 or more cm in women can increase the likelihood of developing sleep apnoea.2

Smoking and alcohol use

Smoking affects your respiratory system and can cause inflammation and narrowing in your upper airway. Alcohol can slow your breathing and over-relax your throat muscles. Both can cause or make sleep apnoea symptoms worse.

Long-term effects of sleep apnoea

While the short-term symptoms of sleep apnoea can be frustrating, its long-term effects can be potentially life-threatening. If left untreated, sleep apnoea can lead to heart disease, stroke, high blood pressure and cognitive decline. Because sleep apnoea interrupts a much-needed good night’s rest, it can impact organ function, mood and daily energy levels. Early detection, diagnosis and treatment is the best way to potentially avoid these long-term risks.7

 Male patient in exam room with doctor

How is sleep apnoea diagnosed?

Your doctor can make a recommendation or referral to a sleep specialist based on your current symptoms. It’s important to discuss your symptoms with your doctor early, so they can determine if a sleep test is the right step to take next.

There are two types of sleep tests your doctor can recommend:

Home sleep test (HST): Your doctor may recommend a home sleep test if you’re showing symptoms of a sleep disorder and have not been diagnosed with any other chronic medical conditions. HSTs can be conveniently completed from the comfort of your own bed, reducing the amount of time you have to wait to get tested.8

In-lab polysomnography sleep study (PSG): Your doctor may recommend a PSG if you have a more complex medical history and may benefit from comprehensive sleep monitoring. PSGs are usually conducted overnight in a sleep lab or hospital, where a trained sleep physiologist can monitor your sleep.8

Here are a few of the key steps involved in diagnosing sleep apnoea:

1. Initial doctor visit:

Make an appointment with your doctor to discuss your current symptoms and how they relate to typical risk factors and causes of sleep apnoea. Your doctor will be able to measure your symptoms against your broader health history to determine if you should see a sleep specialist.

2. Sleep specialist visit:

A referral to a medical sleep specialist will include a more in-depth evaluation of your sleep patterns, current symptoms and overall past health record. The sleep specialist will help determine if you need further evaluation.

3. Sleep apnoea test:

An official sleep apnoea test can either occur at home or at a sleep clinic. This test is an overnight evaluation that involves monitoring your breathing and other bodily functions—such as your blood oxygen levels and heart rate—while you sleep.

4. Sleep apnoea test results review:

After completing a sleep apnoea test, your test results will include measurements of breathing patterns, arm and leg movements, blood oxygen levels, heart rate and overall airflow. A specific measurement linked directly to sleep apnoea is the apnoea-hypopnoea index (AHI), which will also be assessed during the overnight sleep apnoea test.

Your AHI measures the severity of sleep apnoea based on the number of times your breathing was excessively shallow (hypopnoeas) or when it stopped altogether (apnoea) during each hour of sleep.

  • AHI Ranges2
    • < 5 Normal
    • 5 – 14 Mild sleep apnoea
    • 15 – 29 Moderate sleep apnoea
    • 30+ Severe sleep apnoea
 Woman using CPAP therapy (P30i)

Sleep apnoea treatment options

If you are officially diagnosed with sleep apnoea, your healthcare provider will discuss treatment options for the specific type of sleep apnoea you have. Treatment options can include a mixture of lifestyle changes, sleep devices and medications, or even surgical treatments. It may take a little time to get used to these changes in your routine, but ultimately, your sleep apnoea treatment plan should have a positive impact on your sleep and improve your quality of life.

CPAP therapy

Continuous positive airway pressure (CPAP) therapy is highly effective and is the most used and understood method for treating sleep apnoea.9 It involves a mask that fits over your nose and/or mouth and connects to a machine that pushes air through the mask. This flow of air is continuously delivered to your airway and helps prevent the stops and pauses in overnight breathing that sleep apnoea can cause. In short, CPAP helps you breathe during the night, so you wake up feeling refreshed and well-rested.

Other airway pressure devices

Some people may have trouble getting used to CPAP. In those cases, auto-adjusting positive airway pressure (APAP) therapy allows the level of delivered air to adjust based on the person’s needs. It only delivers the amount of pressure needed at any given moment.

Lifestyle changes

Whether or not you have sleep apnoea, lifestyle changes may benefit you. Your doctor may recommend you lose weight, cut down on alcohol or quit smoking to help improve your sleep apnoea symptoms.

Oral appliance therapy

CPAP therapy is the gold standard for treating mild to moderate sleep apnoea, although doctors may prescribe oral appliance therapy as an alternative option. An oral appliance, or a mandibular repositioning device (MRD), holds your lower jaw in a forward position while you sleep. A part of the device expands the space behind the tongue and puts tension on the walls of the throat to help keep the airway open and reduce palate vibration.

Medication changes

Your doctor may review your medications to determine if they’re contributing to your sleep apnoea symptoms. Medications such as antihistamines, opiates and benzodiazepines for anxiety can exacerbate sleep apnoea symptoms by causing the airway to relax and narrow.

Nasal decongestants

If you’re suffering from allergies or chronic nasal congestion, your doctor may prescribe nasal sprays or decongestants to help reduce swelling and open your airway.

Surgery

While surgery isn’t generally a first line of defence against sleep apnoea, some surgical treatments are available.

For people with moderate to severe OSA who may not respond to CPAP or oral appliance therapy, another option is hypoglossal nerve stimulation (HGNS), also known as upper airway stimulation (UAS). This is an implantable therapy that is intended to help keep the airway open during sleep.10

Other less common surgical options include nasal surgery to fix a crooked or deviated septum, jaw surgery to change the position of the jaw, surgery to remove the tonsils or adenoids or somnoplasty, which uses radiofrequency to shrink the tissue in the upper airway.11

Sleep apnoea tips: What to do if diagnosed with sleep apnoea

If you or a loved one has sleep apnoea, there are things you can do to reduce symptoms and improve your quality of life. As always, consult your doctor before starting new therapies, diets or exercise programmes.

Talk with your doctor

Communicate regularly with your doctor or sleep care team about any concerns or challenges you may be facing with the proposed treatment.

Use your CPAP consistently

CPAP can take some getting used to, but the more consistent you are with your therapy, the more likely you are to reap the health benefits.

Maintain a healthy weight

Managing your weight can help take pressure off your airway, helping you sleep more comfortably and improving your sleep apnoea symptoms.

Reduce alcohol intake

Alcohol can exacerbate sleep apnoea symptoms. Your best bet is to drink in moderation (or not at all) and avoid alcohol before bedtime.

Stop smoking

Smoking may increase inflammation and narrowing in your upper airway. Quitting is a positive step towards improving your sleep and your health.

Treat allergies

Allergies create nasal congestion and can dry out your mouth or block your airways. Consult your doctor about the best medical recommendation for treating your allergies.

Are you or a loved one experiencing sleep issues or potential sleep apnoea symptoms?

Take our online sleep assessment and discuss the results with your doctor.

Resmed’s sleep assessment

References

  1. Sleep Apnea – What Is Sleep Apnea? | NHLBI, NIH. 9 Jan. 2025,https://www.nhlbi.nih.gov/health/sleep-apnea.
  2. Slowik, Jennifer M., et al.“Obstructive Sleep Apnea.” StatPearls, StatPearls Publishing, 2025. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK459252/.  
  3. Roberts, ErinGrattan, et al.“The Pathogenesis of Central and Complex Sleep Apnea.” Current Neurology and Neuroscience Reports, vol. 22, no. 7, July 2022, pp. 405–12. DOI.org (Crossref), https://doi.org/10.1007/s11910-022-01199-2
  4. Sleep Apnea – Symptoms | NHLBI, NIH. 9 Jan. 2025,https://www.nhlbi.nih.gov/health/sleep-apnea/symptoms.   
  5. Garbarino, Sergio, et al. “Association of Anxiety and Depression in Obstructive Sleep Apnea Patients: A Systematic Review and Meta-Analysis.” Behavioral Sleep Medicine, vol. 18, no. 1, 2020, pp. 35–57. PubMed,https://doi.org/10.1080/15402002.2018.1545649. 
  6. Rezaie, Leeba, et al. “Compared to Individuals with Mild to Moderate Obstructive Sleep Apnea (OSA), Individuals with Severe OSA Had Higher BMI and Respiratory-Disturbance Scores.” Life, vol. 11, no. 5, Apr. 2021, p. 368. PubMed Central,https://doi.org/10.3390/life11050368
  7. Knauert, Melissa, et al. “Clinical Consequences and Economic Costs of Untreated Obstructive Sleep Apnea Syndrome.” World Journal of Otorhinolaryngology – Head and Neck Surgery, vol. 1, no. 1, Sept. 2015, pp. 17–27. PubMed Central,https://doi.org/10.1016/j.wjorl.2015.08.001.  
  8. Rosenberg, Russell, et al. “The Role of Home Sleep Testing for Evaluation of Patients with Excessive Daytime Sleepiness: Focus on Obstructive Sleep Apnea and Narcolepsy.” Sleep Medicine, vol. 56, Apr. 2019, pp. 80–89. PubMed,https://doi.org/10.1016/j.sleep.2019.01.014.   
  9. Understanding PAP | Sleep Medicine.https://sleep.hms.harvard.edu/education-training/public-education/sleep-and-health-education-program/sleep-health-education-37.   
  10. Olson, Michael D., andMithriR. Junna. “Hypoglossal Nerve Stimulation Therapy for the Treatment of Obstructive Sleep Apnea.” Neurotherapeutics, vol. 18, no. 1, Jan. 2021, pp. 91–99. PubMed Central, https://doi.org/10.1007/s13311-021-01012-x.   
  11. Stuck, Boris A., et al.“Uvulopalatopharyngoplasty with or without Tonsillectomy in the Treatment of Adult Obstructive Sleep Apnea – A Systematic Review.” Sleep Medicine, vol. 50, Oct. 2018, pp. 152–65. PubMed,https://doi.org/10.1016/j.sleep.2018.05.004.

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