Sleep apnoea is a disorder that causes breathing to repeatedly stop and start during sleep. According to Asthma and Lung UK, around 1.5 million UK adults have sleep apnoea – and a further 85% of cases remain undiagnosed.
If left untreated, sleep apnoea can be damaging for health. So, it’s important to get checked and take steps to manage the condition.
Here, we’ll cover everything you need to know about sleep apnoea, including symptoms, causes, and treatment.
What is sleep apnoea?
Sleep apnoea is a sleep disorder that causes breathing to repeatedly stop and start while you sleep. Due to interrupted breathing, sleep apnoea can deprive the body of oxygen, meaning it can be dangerous if left untreated.
There are three main types of sleep apnoea, the most common of which is obstructive sleep apnoea (OSA). We’ll cover these below.
Obstructive sleep apnoea (OSA)
Obstructive sleep apnoea happens when throat muscles relax and block airflow. According to the NHS, OSA can cause two types of breathing interruption…
- Apnoea – a total blockage of the airway for 10 seconds or more
- Hyponoea – a partial blockage of an airway that reduces airflow by more than 50% for 10 seconds or more.
People with OSA can experience apnoea and hypoapnoea throughout the night. In severe cases, episodes may occur every one or two minutes.
Symptoms typically include loud snoring and daytime fatigue. Obesity, large tonsils, and changes in hormone levels are all risk factors for OSA.
Central sleep apnoea (CSA)
Central sleep apnoea (CSA) happens when the brain stops sending signals to the body to tell it to breathe.
CSA can be caused by several health conditions that affect the brain’s ability to control airways and chest muscles – for example, stroke.
Complex sleep apnoea
Complex sleep apnoea is a combination of OSA and CSA. It’s also known as treatment-emergent central sleep apnoea because it occurs when OSA converts to CSA during treatment.
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What are the symptoms of sleep apnoea?
Though there are three different types of sleep apnoea, symptoms typically include…
- Breathing stopping and starting
- Restless sleep and waking up frequently during the night
- Loud snoring
- Making gasping, choking, or snorting noises
You may also experience other symptoms during the day, including…
- Feeling very tired
- Mood swings
- Difficulty concentrating
- Having a headache when you wake up
As a result of these symptoms, research has found that sleep apnoea can significantly impact quality of life. Take this study, which found that people with untreated OSA had a lower quality of life compared to the general population.
According to the NHS, if left untreated, sleep apnoea can lead to more serious health problems – including high blood pressure, stroke, type 2 diabetes, heart disease, depression, and fatal accidents. In this study, OSA was associated with a two times greater risk of stroke. Sleep apnoea can also strain relationships.
What can cause sleep apnoea?
Sleep apnoea is the result of airways narrowing during sleep, preventing normal breathing. Experts have identified several factors that can cause this narrowing and increase a person’s risk of sleep apnoea. This includes…
- Obesity
- Chronic obstructive pulmonary disease (COPD)
- Age – sleep apnoea is more common among mature adults
- Sleeping on your back
- Having large tonsils or adenoids
- Having other family members with sleep apnoea
- Smoking and drinking alcohol
- Having a large neck
How is sleep apnoea diagnosed?
If you suspect you may have sleep apnoea, it’s important to speak to your GP.
Before your appointment, if possible, the NHS recommends asking a partner, friend, or relative to watch while you’re asleep and look out for breathing pauses. It can also be helpful to take the Epworth Sleepiness Scale questionnaire, which asks how likely you’d be to doze off in certain situations. Your final score can help your GP to determine whether or not you have a sleep disorder.
During your appointment, your GP will ask you about your symptoms. They may also take your blood pressure and a blood sample to help rule out other conditions that may explain your tiredness – for example, anaemia.
If your GP suspects you may have sleep apnoea, they may refer you for a sleep assessment. This will examine your sleeping pattern and check whether or not you have a high number of breathing pauses throughout the night. Testing can be done at home or at a sleep centre.
The NHS has more information on how sleep apnoea is diagnosed on their website.
How is sleep apnoea treated?
Sleep apnoea can have a significant impact on quality of life and long-term health, so if you’re diagnosed, it’s important to get treatment.
Treatment for sleep apnoea depends on several factors, including the type of sleep apnoea you have and its severity. In some cases, the condition can be treated with lifestyle changes, such as quitting smoking and losing weight (which we’ll cover below). However, for most people, treatment will involve using a device called a CPAP machine.
CPAP machines gently pump air into a mask that you wear over your mouth or nose during sleep – helping to improve breathing by preventing airways from becoming too narrow.
Other treatments sometimes used for sleep apnoea include gum shield-like devices that hold airways open and surgery (for example, to remove large tonsils).
The NHS has more information on treatment for sleep apnoea on their website.
7 ways to manage sleep apnoea
Alongside professional treatment, there are several things you can do to help manage sleep apnoea. We’ll cover some of these below.
1. Maintain a healthy weight
Being overweight is a major risk factor for sleep apnoea, largely because extra tissue around the throat can obstruct airways during sleep. So, maintaining a healthy weight is one of the most effective ways to improve sleep apnoea.
Studies have linked weight loss in overweight individuals with improvements in the severity of sleep apnoea. Take this study, which found that, when people with mild OSA lost 10% of their baseline weight, the severity of their OSA symptoms reduced by more than 20%.
To get started, head over to the diet and nutrition and fitness and exercise sections of our website. Here, you’ll find everything from quick and healthy recipes to simple ways to increase your step count.
2. Add regular exercise to your routine
Aside from contributing to healthy weight maintenance, research has found that exercise may reduce sleep apnoea symptoms and improve sleep quality.
According to research, these benefits largely stem from the fact that exercise can improve cardiovascular fitness, increase the strength of muscles in airways, and may reduce fluid retention in the neck.
If you’re yet to find a form of exercise you enjoy, head over to the fitness and exercise section of our website for inspiration. Here, you’ll find everything from cycling and dancing to team sports.
3. Establish a consistent evening routine
While it won’t cure sleep apnoea, many people find that establishing a consistent evening routine can help to improve symptoms.
Sticking to a consistent sleep and wake time, including at the weekend, can help to train the body to feel tired at specific times, making it easier to fall and stay asleep. Adding relaxing activities, such as reading, gentle stretching, and taking a warm bath, into your nighttime routine can also help with winding down before bed.
Equally, it’s best to avoid stimulants like caffeine and screen time before bed, as these can increase alertness and disrupt sleep.
Check out our article, How to design the perfect bedroom for sleep, for more tips. You’ll find various other sleep-related articles in the sleep and fatigue section of our website – including ways to improve insomnia and foods and drinks that may improve sleep quality.
4. Consider sleeping on your side
According to the Sleep Foundation, sleeping on your side can help to reduce snoring and improve other symptoms of obstructive sleep apnoea.
In this study, side sleeping was found to significantly reduce breathing disruptions in both OSA and CSA. More specifically, this study found that sleeping on your right side may be the most effective position for reducing OSA – likely due to the direction of blood flow to and from the heart.
Meanwhile, sleeping on your back has been found to increase the risk of airway obstructions and can exacerbate sleep apnoea symptoms. That said, in any sleep position, experts recommend elevating your head and keeping your neck and spine in alignment.
To learn more, check out this guide to the best sleeping positions for sleep apnoea from the Sleep Foundation.
5. Quit smoking
Smoking is known to irritate airways, causing inflammation and swelling, which can obstruct breathing during sleep. For this reason, research suggests that quitting smoking can help to improve symptoms of sleep apnoea.
If you’d like support with stopping smoking, you might find our article, 7 tips for quitting smoking, useful.
6. Moderate your alcohol intake
Alcohol consumption has been found to increase the risk of sleep apnoea and worsen symptoms (in both OSA and CSA). Take this study, which concluded that alcohol may contribute to the development of OSA, as well as worsen symptoms and outcomes in those who already have the condition.
Among other things, alcohol can cause breathing to become shallower. And, by relaxing muscles in the nose, throat, and mouth, it can make it more difficult for air to flow smoothly. Alcohol has also been found to reduce the amount of time spent in REM sleep, which is the restorative stage of sleep – therefore impacting focus and alertness during the day.
For help reducing your alcohol intake, check out our guides on making healthier drink choices and dry January (which can be applied to any time of year!).
7. Avoid taking sleeping pills unless advised by your GP
If you have sleep apnoea, you may think sleeping pills will help your symptoms. However, according to the NHS, it’s important to avoid taking sleeping pills unless you’ve been specifically recommended by your doctor.
Research shows that sleeping pills can actually exacerbate symptoms by further relaxing throat muscles – leading to more severe sleep disruptions.
For further advice on taking sleeping pills, it’s important to speak to your GP.
Health checks for living well, longer
We all have different reasons for getting health checks – reassurance, motivation, curiosity.
With Bupa, you’ll find the health check that gives you the right knowledge for you. Because when you know what’s going on, you’re empowered to take action, and feel better.
Final thoughts…
If left untreated, sleep apnoea can have a significant impact on quality of life and long-term health. And, with an estimated 85% of people living undiagnosed with the condition, it’s important to speak to your GP if you’re experiencing symptoms.
For further reading, head over to the sleep and fatigue section of our website. Here, you’ll find information on everything from insomnia to other age-related sleep conditions.
Do you have any experience with sleep apnoea that you’d like to share? We’d be interested to hear from you in the comments below.
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