Obstructive Sleep Apnea
Also known as OSA, Sleep apnoea
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is obstructive sleep apnea?
Obstructive sleep apnoea occurs when the upper airway repeatedly collapses during sleep, causing pauses in breathing, drops in oxygen and frequent brief arousals. The result is unrefreshing sleep and daytime sleepiness. It is strongly linked to hypertension, atrial fibrillation and road traffic accidents, and it remains substantially underdiagnosed.
Causes
- Relaxation of upper airway muscles during sleep
- Excess soft tissue around the neck
- Anatomical narrowing including large tonsils
- Retrognathia or a small jaw
- Nasal obstruction
- Alcohol and sedatives worsening muscle relaxation
Symptoms
- Loud snoring
- Witnessed pauses in breathing during sleep
- Gasping or choking arousals
- Excessive daytime sleepiness
- Morning headache and dry mouth
- Poor concentration and irritability
- Nocturia
- Reduced libido
Risk factors
- Obesity and large neck circumference
- Male sex
- Increasing age
- Menopause
- Family history
- Smoking and alcohol use
- Hypothyroidism
Diagnosis
- Epworth sleepiness scale and STOP BANG questionnaire
- Home sleep apnoea testing with overnight oximetry and airflow
- Full polysomnography in complex cases
- Apnoea hypopnoea index to grade severity
- Assessment of blood pressure and cardiovascular risk
Treatment
- Continuous positive airway pressure therapy as first line for moderate to severe disease
- Weight loss, which can substantially reduce severity
- Mandibular advancement device for mild to moderate disease
- Positional therapy for supine predominant apnoea
- Avoiding alcohol and sedatives before sleep
- Surgery in selected anatomical cases
- Driving advice until sleepiness is controlled
Self care
- Use CPAP every night, including naps, and persist through the adjustment period
- Work with your clinic on mask fit, which drives most tolerance problems
- Lose weight if overweight, which can substantially reduce severity
- Avoid alcohol and sedatives before bed
- Sleep on your side rather than your back
- Treat nasal congestion, which affects mask tolerance
- Do not drive when sleepy
When to see a doctor
Book an appointment if:
- Loud snoring with witnessed breathing pauses
- Daytime sleepiness affecting work or driving
- Morning headaches and unrefreshing sleep
- Difficulty tolerating CPAP
- Blood pressure hard to control
- Waking gasping or choking
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Maintain a healthy weight
- Avoid alcohol and sedatives at bedtime
- Treat nasal obstruction
- Sleep on your side if apnoea is positional
- Stop smoking, which increases airway inflammation
Outlook
Treatment is highly effective. CPAP resolves the breathing pauses immediately and most people report substantially better energy within weeks. Treating apnoea improves blood pressure control and reduces cardiovascular and accident risk. Weight loss can reduce severity considerably and occasionally resolves mild disease entirely.
Common questions
Does snoring always mean sleep apnoea?
No. Many people snore without apnoea. The concerning features are witnessed breathing pauses, gasping arousals and daytime sleepiness, which warrant formal testing.
Is CPAP uncomfortable to use?
It takes adjustment, and mask fit is the biggest factor in tolerance. Most people who persist through the first few weeks with proper support use it successfully and report substantial improvement in energy.
Why does it raise blood pressure?
Repeated oxygen drops and arousals activate the sympathetic nervous system through the night. Untreated apnoea is a recognised cause of resistant hypertension, which often improves with treatment.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.