Obstructive sleep apnoea: symptoms, testing and treatment

Obstructive sleep apnoea is a condition in which the upper airway repeatedly narrows or closes during sleep.

Breathing effort continues, but airflow is reduced until the airway opens again. This may briefly disturb sleep many times, leaving a person less refreshed even when they do not remember waking.

Loud snoring, pauses in breathing noticed by a bed partner, gasping, unrefreshing sleep and daytime sleepiness are common presentations of obstructive sleep apnoea. Morning headache, difficulty concentrating, memory changes, fatigue and night sweats can also occur. Snoring alone does not diagnose the condition.

During sleep, throat muscles naturally relax. In obstructive sleep apnoea, the airway may become too narrow for steady airflow. Airway shape, enlarged tonsils, nasal blockage, alcohol or sedating medicines near bedtime and sleeping position can contribute.

Symptoms may develop gradually and can fluctuate with changes in weight, nasal congestion, sleep schedule or alcohol use. Untreated disrupted breathing can leave sleep persistently unrefreshing and may affect alertness, mood and cardiovascular health. A new decline in alertness deserves timely review.

Obesity, a larger neck, family tendency, smoking and certain jaw or airway features can increase risk. It can occur in people of different body sizes, including children with enlarged tonsils. Menopause and advancing age may also change airway stability.

A clinician asks about sleep, snoring, medicines and daytime safety, then examines the nose, mouth and neck. A sleep study records breathing and related signals overnight at home or in a sleep setting. The results guide the type of treatment rather than relying on symptoms alone.

Positive airway pressure uses gentle air pressure through a mask to keep the airway open while asleep. Other options may include a dental device that positions the lower jaw forward, treating nasal obstruction, positional measures, weight management or surgery for selected airway problems. The right choice depends on test results, anatomy and what you can use consistently.

Mask discomfort, dryness or leaks can often be adjusted by the sleep team. Use equipment for every sleep period when prescribed, keep it clean as instructed and arrange review if tiredness continues. Avoid driving when you feel too sleepy to react safely.

Interrupted breathing can strain the cardiovascular system and may occur alongside high blood pressure. Daytime sleepiness can also increase the risk of errors and road accidents. Addressing poor sleep may improve energy and ability to take part in daily activities.

Keeping a regular sleep schedule, limiting alcohol close to bedtime, stopping smoking and managing nasal symptoms may help. Weight management may reduce airway narrowing for some people. These measures do not replace a sleep assessment when pauses in breathing or marked sleepiness are present.

Arrange an appointment for loud habitual snoring with witnessed pauses, choking at night or ongoing daytime sleepiness. Seek prompt medical advice if sleepiness makes driving or work unsafe. A primary care clinician can arrange assessment or refer to a sleep specialist.