Everyone snores occasionally, especially after a long day or when suffering from a blocked nose. But persistent loud snoring, gasping during sleep, or waking up exhausted despite spending enough time in bed could be signs of something more serious: sleep apnoea.

Sleep apnoea is a common sleep disorder that causes breathing to repeatedly stop or become significantly reduced during sleep. These interruptions can lower oxygen levels, disrupt sleep quality, and place stress on the body over time.

Despite being common, many people remain undiagnosed because the warning signs are often mistaken for normal tiredness, stress, ageing, or a busy lifestyle.

What Is Sleep Apnoea?

Sleep apnoea occurs when breathing is disrupted during sleep, preventing the body from getting enough oxygen.

Dr Chelsie Rohrscheib, a neuroscientist and sleep expert at Wesper, explains that sleep apnoea is a disorder of respiration during sleep that causes long pauses in breathing and sharp drops in blood oxygen levels.

There are three main types:

  • Obstructive sleep apnoea (OSA): The most common type, caused by the upper airway repeatedly becoming blocked or collapsing during sleep. Around 20% to 26% of adults are estimated to have OSA.
  • Central sleep apnoea (CSA): A less common form where the brain fails to send the correct signals to the muscles responsible for breathing. Around 1% to 2% of adults are affected.
  • Complex sleep apnoea: A combination of obstructive and central sleep apnoea.

While obstructive sleep apnoea is most common, all types can affect sleep quality and overall health.

Common Sleep Apnoea Symptoms

Because sleep apnoea happens while someone is asleep, many people do not realise they have it. Often, a partner or family member notices the signs first.

Dr Meghna Dassani, a dentist and sleep and airway health expert, says many people assume they would know if they had sleep apnoea, but this is often not the case.

'Because these breathing interruptions occur during sleep, patients are often unaware of them. Frequently, it is a bed partner who notices loud snoring, gasping, choking, or pauses in breathing long before the individual seeks medical attention.'

Common warning signs include:

Loud, Persistent Snoring

Snoring is one of the most recognised signs of obstructive sleep apnoea. While not everyone who snores has sleep apnoea, loud and frequent snoring may indicate that airflow is being restricted.

Dr Rohrscheib explains that the same tissues and structures involved in snoring can contribute to airway blockage during sleep.

Pauses in Breathing During Sleep

A partner may notice periods where breathing appears to stop, followed by choking, gasping, or sudden snoring.

These pauses occur because the airway becomes blocked or breathing signals are disrupted, depending on the type of sleep apnoea.

Gasping or Choking at Night

Some people wake suddenly feeling short of breath or as though they are choking. However, these episodes may be subtle or go unnoticed, particularly for people who sleep alone.

Excessive Daytime Sleepiness

One of the biggest signs of sleep apnoea is feeling tired despite getting enough hours of sleep.

When breathing repeatedly stops, the brain briefly wakes up to restore normal breathing. These repeated interruptions prevent deep, restorative sleep.

This can lead to:

  • Daytime fatigue
  • Reduced concentration
  • Memory problems
  • Irritability
  • Poor decision-making

Morning Headaches

Some people wake with headaches caused by repeated drops in oxygen levels overnight.

Dr Rohrscheib explains that morning headaches can occur because reduced oxygen levels activate the body's stress response system.

Dry Mouth and Sore Throat

Breathing through the mouth during sleep, particularly due to airway obstruction, can cause dry mouth, throat irritation, and dental problems.

Other possible symptoms include:

  • Increased night-time urination
  • Teeth grinding
  • Low libido
  • Acid reflux (GERD)
  • Weight gain
  • Feeling unrefreshed after sleep

Who Is Most at Risk?

Although sleep apnoea is often associated with older adults or people living with obesity, it can affect people of all ages and body types.

Risk factors include:

  • Being overweight or obese
  • Increasing age
  • A family history of sleep apnoea
  • A larger neck circumference
  • Narrow jaw structure
  • Enlarged tonsils or tongue
  • Nasal obstruction or allergies
  • Smoking
  • Alcohol use
  • Certain sedating medications, including opioids

Dr Dassani says excess weight is only one factor and that sleep apnoea can also occur due to airway anatomy, facial structure, menopause, and other medical conditions.

Women may also be underdiagnosed because they do not always present with classic symptoms such as loud snoring. Instead, they may experience fatigue, insomnia, mood changes, or difficulty concentrating.

Sleep Apnoea in Children

Children can also develop sleep apnoea, although symptoms may look different from adults.

Instead of obvious daytime sleepiness, children may experience:

  • Behavioural problems
  • Hyperactivity
  • Learning difficulties
  • Poor concentration
  • Poor growth

Parents should speak with a GP if they notice persistent snoring or unusual breathing patterns during sleep.

Why Does Sleep Apnoea Matter?

Untreated sleep apnoea is more than a sleep problem. Repeated oxygen drops and disrupted sleep can affect many systems in the body.

Research has linked sleep apnoea with an increased risk of:

  • High blood pressure
  • Heart disease
  • Stroke
  • Irregular heart rhythms
  • Heart failure
  • Type 2 diabetes
  • Depression and anxiety

It can also increase the risk of accidents because excessive daytime sleepiness can affect reaction times and alertness.

When Should You See a GP?

Speak to your GP if you regularly experience:

  • Loud snoring
  • Pauses in breathing during sleep
  • Gasping or choking episodes
  • Excessive daytime sleepiness
  • Morning headaches
  • Poor concentration
  • Feeling tired despite sleeping enough

Dr Rohrscheib says people should not ignore persistent daytime sleepiness, even if they do not have obvious symptoms.

'If you have excessive daytime sleepiness, even without dramatic sleep apnea symptoms, it's important to see your provider to assess whether you need a sleep study since OSA is so common.'

Seek prompt medical advice if severe daytime sleepiness affects your ability to drive safely or if you wake with significant breathing difficulties.

How Is Sleep Apnoea Diagnosed?

Medical Check-Up / Diagnosis / Patient Assessment / Doctor /Hospital
Sleep apnoea is diagnosed through sleep tests that monitor breathing, oxygen levels and other changes during sleep, either at home or in a clinic. DC Studio via Magnific

Diagnosis usually begins with a medical assessment, followed by sleep testing.

A sleep study may be carried out:

  • At home: A portable monitoring device records breathing patterns, oxygen levels, and other information while you sleep.
  • In a sleep clinic: An overnight polysomnography test monitors breathing, brain activity, heart rate, oxygen levels, and sleep stages.

Home sleep testing has improved access to diagnosis, particularly as traditional sleep clinic appointments can involve long waiting times.

How Is Sleep Apnoea Treated?

Treatment depends on the severity and type of sleep apnoea.

Options may include:

CPAP Therapy

Continuous positive airway pressure (CPAP) is considered the gold standard treatment for many people with moderate to severe obstructive sleep apnoea.

The machine delivers a steady flow of air through a mask to keep the airway open during sleep.

Lifestyle Changes

For some people, weight management, reducing alcohol intake, improving sleep habits, and treating nasal congestion can help reduce symptoms.

Oral Appliances

Mandibular advancement devices are custom-made dental devices that help move the lower jaw forward to keep the airway open.

Positional Therapy and Surgery

Some people experience sleep apnoea mainly when sleeping on their back. Positional therapy may help in these cases.

Surgery may be considered when other treatments are unsuitable or ineffective.

Key Takeaways

Sleep apnoea is not simply a problem of snoring or poor sleep. It is a medical condition that can affect oxygen levels, energy, concentration, and long-term health.

Recognising the warning signs, including loud snoring, breathing pauses, daytime tiredness, and morning headaches, is the first step towards getting help.

With appropriate diagnosis and treatment, many people with sleep apnoea can significantly improve their sleep quality, daily functioning, and overall health.

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