Tired of obstructive sleep apnoea?

Posted 9 April 2018 in Men's Health, Womens health

Alarm clock. Picture courtesy of pexels.comDo you often feel on waking that you haven’t had a good night’s sleep, despite going to bed early enough? Do you feel tired and catch yourself yawning throughout the day, although you seemingly slept for a reasonable time the night before? Or do you find you wake several times in the night, sometimes with a ‘snort’? You may be experiencing a condition known as obstructive sleep apnoea (OSA).

What is OSA?

OSA is a condition characterised by interrupted breathing while sleeping. The word ‘apnoea’ means absence of breathing and occurs when the muscles of the throat relax and the tissues slump to such an extent that the airway closes up. An episode of halted breathing is medically defined as apnoea if it lasts for at least ten seconds. Another type of breathing impairment associated with OSA is hypopnoea, meaning reduced breathing, which is when the airway is only partially obstructed by the relaxation of muscles and slumping of tissues in the throat, and functions at half capacity or less for at least ten seconds. (1)

What are the symptoms of OSA?

If you sleep alone, it is usually easier for OSA to go unnoticed, as the most obvious telltale signs occur during deep sleep. However, you may find that you wake up several times during the night, disrupting your sleep. Waking may be accompanied by a snorting or gasping sound as the brain tells the body to come out of deep sleep in response to the lack of oxygen in the blood, enabling a sudden, sharp intake of breath. You may also notice that you wake up in a sweat. (1, 2)

Another symptom is tiredness and sleepiness during the day. You may struggle to concentrate, leading to more mistakes at work. You may yawn excessively, or find yourself nodding off during quiet or dull parts of the day. If you wake several times at night you will be able to trace the tiredness back to this, but the brain sometimes tells the body to switch from deep to lighter sleep, rather than fully waking, to restore normal breathing. Deep sleep is more restful for the body, so fewer hours of deep sleep per night will increase tiredness during the day. (1, 2)

The deep sleep symptoms are often identified by another person, such as a partner, friend or relative, when you sleep in their presence. They may tell you that you snore loudly, or that it sounds like you’re struggling to take clear and complete breaths. Crucially, they can identify your episodes of apnoea, telling you that you stopped breathing for a prolonged period of time. (1)

Why does OSA happen?

Although most people experience some relaxation and slumping of the throat’s tissues and muscles during sleep, they can usually continue to breathe normally. Certain risk factors increase a person’s chance of developing OSA. (1)

Being overweight or obese is a major risk factor as excess weight carried on the neck can push the airway narrower or shut completely, and make it harder for the muscles to resist the slumping and keep the airway open. Men are at greater risk than women, again mainly due to the fact that they are more inclined to carry excess weight on the neck. This risk is more pronounced with a collar size of 17 inches or greater. (1)

Over the age of 40, risk of OSA increases for both men and women, then again for women after they reach the menopause. (1)

Natural variations in the structure of the airway or nasal cavity can be responsible for OSA. Such variations include a narrower airway than normal, enlarged tonsils or tongue, a receding jaw, a deviated nasal septum, nasal polyps and enlarged adenoids in children. OSA can also run in families. (1)

External factors such as drinking alcohol before bed, smoking and taking sedatives including sleeping tablets and anxiety medication can also make OSA more likely. (1)

Can OSA be treated?

If you think or someone else thinks you may have OSA, visit your GP. They will rule out any other causes of your symptoms and can refer you to a sleep centre for a firm diagnosis. (1)

Once you are diagnosed with OSA, your GP will advise you to make lifestyle changes if needed, or maintain your current healthy lifestyle. Losing weight, stopping smoking or reducing alcohol intake may be all that is needed to reverse OSA. Other changes such as sleeping on your side instead of your back, keeping your mouth closed and your nasal passages clear should also help. There are various aids available to facilitate directing air through the nose instead of the mouth, such as chin straps, mouth guards, mandibular advancement devices (MADs), nasal strips and saline nasal sprays. If you find you often wake up lying on your back, pillows can be purchased which are designed to prevent you from rolling from your side onto your back while you sleep. (1, 2)

If your OSA is not relieved by these changes, it may be worth considering a week’s trial of a continuous positive airway pressure (CPAP) device. This device pumps air through a mask into your airway to stop it from closing throughout the night. The trial is expensive at £100, but if it is successful you may be put on an NHS waiting list for a free CPAP of your own. CPAPs are also available to buy. Click here for more information. (1, 2)

If a variation in structure of the airway is the cause, surgery can be performed to correct this. (1)

Can OSA cause any other problems?

If not treated, OSA will continue to cause constant tiredness, poor concentration and irritability, negatively affecting your quality of life. Furthermore, it may lead to other health problems including high blood pressure, heart attacks and strokes, changes in heart rhythm, and even type 2 diabetes. (1)

If you receive a diagnosis of OSA and you drive, you’re legally obliged to inform the DVLA, as is the case with all conditions which may impair your driving. It’s possible that you’ll be asked not to drive until your symptoms are under control. (1)

Visit the Sleep Apnoea Trust website for further support.


  1. NHS Choices. Obstructive sleep apnoea [cited 28 March 2018]. Available at: https://www.nhs.uk/conditions/obstructive-sleep-apnoea/
  2. The Guardian. Seven ways to… prevent snoring [cited 28 March 2018]. Available at: https://www.theguardian.com/lifeandstyle/2018/mar/26/seven-ways-to-prevent-snoring

Author: Gabby Gallagher MPharm

Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 09/04/18

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