What is sleep apnoea
Sleep apnoea fragments your sleep hundreds of times a night without waking you enough to remember it, which is why people live with it for years.
See a GP if any of these apply
Someone has seen you stop breathing during sleep, or you wake gasping or choking.
Loud, persistent snoring, particularly with pauses.
Heavy daytime sleepiness despite adequate time in bed.
Falling asleep unintentionally while driving is an emergency: stop driving and seek advice immediately.
This page is general information. Sleep apnoea is a medical condition requiring diagnosis and treatment.
What it is
In obstructive sleep apnoea, the muscles of the upper airway relax during sleep and the airway narrows or closes. Breathing stops or becomes very shallow, oxygen falls, and the brain briefly rouses you to reopen it.
That rousing is usually too brief to remember. It can happen dozens or hundreds of times a night, and the sleeper's own account is that they slept eight hours.
Which is why it is so often missed: the person with it feels tired rather than sleepless, and the person most likely to notice is whoever shares the bed.
Central sleep apnoea, where the brain does not send the signal to breathe, is a different and less common condition.
The signs, split by who notices them
| A partner notices | You notice |
|---|---|
| Loud snoring, often with pauses | Waking unrefreshed after a full night |
| Gaps in breathing | Heavy daytime sleepiness |
| Gasping, choking or snorting | Morning headaches |
| Restlessness and frequent position changes | Dry mouth or sore throat on waking |
| Periods of silence then a loud breath | Poor concentration, low mood, irritability |
If you sleep alone, the right column is what you have to go on, and unrefreshing sleep with daytime sleepiness is reason enough to raise it.
Who is more likely to have it
Risk factors include being overweight, particularly around the neck; being male; increasing age; a family history; smoking; alcohol, especially in the evening; and anatomical factors such as large tonsils or a narrow airway.
Two cautions. It occurs in people who are not overweight, so a normal weight does not rule it out. And it occurs in women, where it is under-diagnosed, partly because presentation can be less typical, with fatigue and insomnia rather than classic snoring.
It also occurs in children, where enlarged tonsils or adenoids are a common cause, and where it can present as behavioural problems or poor concentration rather than sleepiness.
Why it is worth treating
Untreated sleep apnoea is associated with high blood pressure, heart disease, stroke, type 2 diabetes and road traffic accidents.
The driving risk is immediate and legally significant. In the UK, you must tell the DVLA if you have been diagnosed with sleep apnoea causing excessive sleepiness, and you must not drive until symptoms are controlled. Failing to declare it is an offence.
The day-to-day effects, which people frequently attribute to age or stress, are substantial: concentration, mood, memory, and relationships affected by the snoring.
How it is diagnosed
Start with a GP appointment. Take a partner if you have one, because their account is the most useful evidence available.
The GP will usually ask about symptoms and may use a questionnaire such as the Epworth Sleepiness Scale, then refer to a sleep clinic.
Diagnosis normally involves a sleep study, frequently done at home with equipment that records breathing, oxygen levels, heart rate and movement overnight. Some cases need an in-clinic study.
Severity is graded by how many breathing events occur per hour of sleep, which determines the treatment offered.
A consumer sleep tracker cannot diagnose this. Some flag irregular breathing or oxygen patterns, which is a reason to see a GP, not a diagnosis.
What treatment involves
CPAP, continuous positive airway pressure, is the main treatment for moderate to severe obstructive sleep apnoea. A machine delivers pressurised air through a mask to hold the airway open. It is effective, and many people find it takes weeks to adjust to. Mask fit is the most common reason people give up, and clinics will refit rather than expect you to persevere with the wrong one.
Mandibular advancement devices, custom oral appliances that hold the jaw forward, are used for milder cases and are fitted by a dentist or clinic rather than bought online.
Lifestyle measures: weight loss where relevant, reducing evening alcohol, stopping smoking, and side sleeping, which helps positional cases.
Surgery in specific situations, most commonly removing enlarged tonsils in children.
What bedding can and cannot do
This site sells bedding, so it is worth being explicit: no mattress, pillow, adjustable bed or anti-snore product treats sleep apnoea.
Some help with positional snoring, which is a different thing. An adjustable base or a wedge raises the torso, which some people find reduces snoring, and side sleeping helps positional cases.
Products marketed as anti-snore may make an apnoea sufferer feel they are addressing it while the underlying condition goes untreated. If the signs in this page apply, the purchase to make is a GP appointment.
Related reading
Related sleep problems
Positional snoring
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Questions people ask
What is sleep apnoea?
A condition where the upper airway narrows or closes during sleep, so breathing stops or becomes very shallow and the brain briefly rouses you to reopen it. The rousing is usually too brief to remember, which is why it is so often missed.
What are the signs of sleep apnoea?
A partner may notice loud snoring with pauses, gaps in breathing, and gasping or choking. You may notice waking unrefreshed after a full night, heavy daytime sleepiness, morning headaches and a dry mouth.
How is sleep apnoea diagnosed in the UK?
Start with a GP, who may use a sleepiness questionnaire and refer to a sleep clinic. Diagnosis normally involves a sleep study, frequently done at home, recording breathing, oxygen levels, heart rate and movement.
Can a mattress or pillow treat sleep apnoea?
No. No mattress, pillow, adjustable bed or anti-snore product treats it. Some help with positional snoring, which is a different thing, and using them instead of seeking diagnosis leaves the condition untreated.
Do I have to tell the DVLA about sleep apnoea?
If you have been diagnosed with sleep apnoea causing excessive sleepiness, yes, and you must not drive until symptoms are controlled. Failing to declare it is an offence.