Sleep Apnoea: What Is It, What Are the Symptoms and How Is It Treated?

Do you regularly wake feeling as though you haven't had a good night's sleep, even when you've allowed yourself plenty of time in bed?

Perhaps you snore, wake with a dry mouth or headache, or you may find yourself struggling with concentration and energy during the day. Maybe someone has noticed that your breathing pauses, or that you gasp, choke or snort while you're asleep.

These can all be signs of sleep apnoea.

Sleep apnoea is a condition where breathing is repeatedly interrupted during sleep. The most common form is obstructive sleep apnoea (OSA), which happens when the upper airway becomes narrowed or blocked during sleep.

It is common, affecting as many as 10 million people across the UK. But many people don't realise they have OSA.

Recognising the signs matters because untreated sleep apnoea can affect much more than your sleep. It can contribute to daytime tiredness, concentration problems and driving risk, and is associated with conditions including high blood pressure, stroke and heart disease.

The good news is that sleep apnoea can be assessed and treated.

In this guide, we'll explain what sleep apnoea is, what the symptoms can look like, why it can be missed in women, how you're tested and what treatments are available.

We'll also look at an important part of the picture

Important: This article is designed to help you recognise possible signs of sleep apnoea. It cannot diagnose the condition. If you're concerned about your symptoms, speak to your GP.

What is Sleep Apnoea?

Sleep apnoea is when your breathing repeatedly stops or becomes significantly reduced while you're asleep.

The most common form is obstructive sleep apnoea (OSA).

During sleep, the muscles around the upper airway naturally relax. In someone with OSA, the airway can become narrowed or temporarily close. This interrupts normal breathing.

Your brain responds to the change by briefly arousing you enough to reopen the airway and start breathing normally again. These arousals can be so brief that you don't actually remember waking up.

This cycle can happen repeatedly throughout the night, fragmenting your sleep. In some people, it can also cause repeated drops in blood oxygen levels and changes in heart rate and blood pressure.

You may therefore spend a full night in bed but still wake feeling as though your sleep hasn't been restorative.

What is Obstructive Sleep Apnoea?

Obstructive sleep apnoea (OSA) happens when the upper airway becomes partially or completely blocked during sleep.

There are several factors that can increase the likelihood of OSA, including:

• carrying excess weight
• getting older
• having a larger neck circumference
• having a family history of sleep apnoea
• sleeping on your back
• drinking alcohol, particularly close to bedtime
• smoking
• having enlarged tonsils or adenoids
• certain anatomical features affecting the airway
• some medical conditions, including COPD and hypothyroidism.

However, sleep apnoea can affect people of different ages, body shapes and backgrounds. Being overweight can increase the risk, but it isn't a requirement for having the condition.

What about Central Sleep Apnoea?

There are other forms of sleep apnoea, including central sleep apnoea (CSA).

Unlike OSA, central sleep apnoea isn't caused by an obstruction in the upper airway. Instead, the brain temporarily fails to send the appropriate signals to the muscles responsible for breathing.

Central sleep apnoea has different causes and requires specialist medical assessment.

This article focuses primarily on obstructive sleep apnoea.

What are the Symptoms of Sleep Apnoea?

Sleep apnoea doesn't always present in the same way.

Some people experience the more recognisable signs, such as loud snoring or witnessed pauses in breathing. Others may simply feel that they never wake refreshed.

Possible symptoms include:

• loud or persistent snoring
• pauses in breathing noticed by someone else
• gasping, choking or snorting during sleep
• waking frequently during the night
• waking with a dry mouth
• morning headaches
• feeling unrefreshed after a full night's sleep
• daytime sleepiness or fatigue
• difficulty concentrating
• memory problems or "brain fog"
• irritability or changes in mood
• waking frequently to urinate during the night
• difficulty staying alert during the day.

You don't need to have all of these symptoms to have sleep apnoea.

And snoring doesn't automatically mean you have sleep apnoea. But not snoring loudly doesn't rule it out either.

If symptoms are persistent or are affecting your daytime life, it's worth discussing them with your GP.

Sleep Apnoea in Women: Why it can be Missed

Sleep apnoea is often thought of as a condition that mainly affects men who snore loudly.

That picture is too simplistic.

Women can experience many of the same symptoms as men, but they may also experience a broader range of symptoms that aren't immediately recognised as signs of sleep apnoea.

These can include:

• unrefreshing sleep
• frequent waking
• insomnia or difficulty falling asleep
• morning headaches
• fatigue
• difficulty concentrating
• memory problems
• anxiety or low mood
• night sweats
• waking to urinate
• restless or disturbed sleep.

A 2026 study of women with obstructive sleep apnoea found that women reported symptoms including unrefreshing sleep, nocturia, memory problems, difficulty concentrating, insomnia, anxiety, depression, night sweats and morning headaches more frequently than men in the study (1).

Sleep Apnoea and Menopause

The menopause transition is another reason sleep apnoea can be difficult to recognise in women.

The risk of OSA increases through and after menopause, while symptoms such as night sweats, disturbed sleep, fatigue, mood changes and difficulty concentrating can also be associated with menopause.

That means it's easy to assume that every disrupted night is simply part of the menopause.

It isn't necessarily.

Sleep problems during perimenopause or menopause can have several possible causes, including hormonal changes, stress, insomnia and sleep apnoea. Sometimes more than one factor can be involved.

If you're experiencing persistent unrefreshing sleep, repeated waking, snoring, choking or gasping at night, morning headaches, daytime fatigue or brain fog, tell your GP about the whole pattern of symptoms rather than assuming menopause explains everything.

How is Sleep Apnoea Diagnosed?

If you think you may have sleep apnoea, the first step is to speak to your GP.

Your GP will consider your symptoms, health history and other possible explanations for your tiredness or disrupted sleep. If sleep apnoea is suspected, you may be referred to a sleep service for further assessment.

What Happens During a Sleep Apnoea Test?

Many people can have their sleep assessed at home.

A home respiratory sleep test can monitor things such as breathing and heart rate while you sleep. In some circumstances, a more detailed sleep study may be needed.

The test looks for breathing interruptions and reductions in breathing during sleep.

One measurement you may hear about is the Apnoea-Hypopnoea Index (AHI).

This measures the average number of apnoeas and hypopnoeas you experience per hour of sleep. NICE defines:

• AHI 5–14: mild
• AHI 15–30: moderate
• AHI over 30: severe (2)

However, your AHI isn't the whole story.

Two people can have similar AHI scores but experience very different symptoms and effects on their everyday lives. Clinicians will consider the results alongside symptoms, daytime functioning, other health conditions and individual circumstances.

Can a Smartwatch Diagnose Sleep Apnoea?

Wearables and consumer sleep trackers can sometimes identify patterns that might make you curious about your breathing or oxygen levels during sleep.

However, they cannot diagnose sleep apnoea.

If a device raises concerns, use this as a reason to speak to a healthcare professional rather than treating the result as a diagnosis.

Equally, an apparently normal result from a consumer device shouldn't be used to rule out sleep apnoea if you're experiencing persistent symptoms.

What Happens After a Sleep Apnoea Diagnosis?

Being diagnosed with sleep apnoea doesn't mean that there is one treatment that everyone needs.

The most appropriate treatment depends on factors including:

• the type of sleep apnoea
• how severe it is
• your symptoms
• your overall health
• the cause of the airway obstruction
• whether your sleep apnoea is worse when sleeping on your back
• your preferences and ability to use the treatment consistently

This is why treatment should be discussed with your sleep or respiratory team rather than approached as a list of general sleep tips.

How is Obstructive Sleep Apnoea Treated?

There are several treatments for obstructive sleep apnoea.

1. CPAP

Continuous Positive Airway Pressure (CPAP) is one of the main treatments for obstructive sleep apnoea.

A CPAP machine delivers pressurised room air through a mask worn over the nose or nose and mouth. The pressure helps keep the airway open while you sleep, preventing it from repeatedly collapsing.

Importantly, CPAP does not normally pump oxygen into your airway. It uses pressurised air to keep the airway open.

NICE recommends fixed-level CPAP for adults with moderate or severe symptomatic OSAHS. It can also be offered to some people with mild OSA when symptoms are affecting quality of life or normal daytime activities (3).

CPAP can take some getting used to.

If you're struggling with a mask that doesn't fit properly, air leaks, dryness, nasal discomfort, pressure or claustrophobia, don't simply assume you have to put up with it.

Your sleep service can review the equipment and support you in finding an approach that works better for you. NICE recommends follow-up and access to support for people using CPAP.

2. Mandibular Advancement Splints

A mandibular advancement splint (MAS) is an oral device that holds the lower jaw slightly forwards while you sleep.

This can help increase the space in the upper airway and reduce obstruction.

A customised mandibular advancement splint may be considered for suitable people who cannot tolerate or do not want CPAP. NICE recommends that these devices are properly customised or semi-customised and clinically supervised, rather than treating generic anti-snoring mouthguards as equivalent treatment (4).

3. Positional Therapy

For some people, sleep apnoea is significantly worse when sleeping on their back.

If testing shows that your OSA is positional, a positional modifier may be considered to encourage side sleeping.

This isn't a universal solution. NICE recommends positional treatment mainly for selected people with mild or moderate positional OSA when other treatments aren't suitable or haven't been tolerated, and says it is unlikely to be effective for severe OSA (3).

4. Lifestyle changes

Lifestyle changes can be helpful for some people with OSA and may form part of an overall treatment plan.

These can include:

• maintaining a healthy weight where appropriate
• regular physical activity
• reducing alcohol, particularly close to bedtime
• stopping smoking
• avoiding sleeping tablets unless they're recommended by your doctor
• sleeping on your side if this helps your symptoms.

However, it's important not to reduce sleep apnoea to a lifestyle issue.

Someone doesn't need to lose weight before they deserve assessment or treatment.

And while exercise, healthy eating and good sleep habits can support overall health, they don't necessarily stop an airway from closing during sleep.

5. Myofunctional Therapy and Other Specialist Treatments

Exercises designed to strengthen the muscles of the tongue, mouth and upper airway may have a role for some people.

However, these should be viewed as a possible part of a wider treatment plan rather than a replacement for diagnosis or established treatments.

Other specialist approaches, including surgery or hypoglossal nerve stimulation, may be considered for selected patients when other treatments aren't suitable or haven't worked. NICE recommends these as specialist pathways rather than first-line options for everyone (5).

Sleep Apnoea & Heart Health: What's the Connection?

Sleep apnoea isn't simply a problem with snoring or feeling tired the next day.

There is also an important relationship between sleep apnoea and cardiovascular health.

When breathing is repeatedly interrupted, oxygen levels can fall and the body responds by activating its "fight or flight" response. This can cause changes in heart rate and blood pressure as the body works to restore normal breathing.

Over time, obstructive sleep apnoea is associated with cardiovascular conditions including:

• high blood pressure
• atrial fibrillation
• stroke
• heart disease
• other cardiovascular problems.

The British Heart Foundation (BHF) describes the relationship as complicated. Sleep apnoea and cardiovascular conditions share some risk factors, so an association doesn't necessarily mean that sleep apnoea directly caused an individual's heart condition.

Can Sleep Apnoea Cause High Blood Pressure?

Sleep apnoea can contribute to changes in blood pressure, and treating sleep apnoea can lower blood pressure in some people. However, BHF notes that this reduction isn't as effective as blood pressure medication.

Professor John Stradling, Emeritus Professor of Respiratory Medicine, with a specialism in sleep apnoea, at the University of Oxford, advises

“Treating sleep apnoea can bring down high blood pressure, but it is not as effective as blood pressure medication.”

So treating sleep apnoea shouldn't be seen as a replacement for other cardiovascular treatments prescribed by your doctor.

What About Atrial Fibrillation?

Atrial fibrillation (AF) is an irregular heart rhythm and another condition associated with sleep apnoea.

BHF notes that sleep apnoea can trigger episodes of AF in some people.

This is one reason it's particularly important to tell your GP if symptoms of possible sleep apnoea occur alongside existing heart or blood pressure problems.

For example, speak to your GP if you're experiencing symptoms of sleep apnoea and also have:

• difficult-to-control high blood pressure
• atrial fibrillation
• a previous stroke or transient ischaemic attack
• heart failure
• another diagnosed cardiovascular condition.

Does Treating Sleep Apnoea Prevent Heart Attacks or Strokes?

This is an important distinction.

While treating sleep apnoea can improve breathing during sleep, sleep quality and symptoms such as daytime sleepiness, it should not currently be presented as a proven way of preventing heart attacks or strokes.

BHF says that it has not been shown that treating sleep apnoea reduces cardiovascular problems, although treatment can lower high blood pressure in some people.

If you're concerned about your heart health, speak to your GP or healthcare team.

Sleep Apnoea, Sleep Quality and Your Bed

If you've been diagnosed with sleep apnoea, the right sleep environment can still make your night more comfortable.

But it's important to distinguish between supporting good sleep and treating sleep apnoea.

A mattress, pillow or bedroom environment cannot diagnose or treat an airway obstruction.

The right sleep setup can, however, help you feel comfortable and may make it easier to use your prescribed treatment consistently.

For example, you may want to consider:

• a mattress that provides the right level of support for you
• a comfortable pillow
• an adjustable bed that can help you achieve a comfortable, elevated sleep position more easily
• breathable bedding to help regulate temperature
• keeping the bedroom comfortably cool, dark and quiet
• making sure there is enough space for your CPAP equipment if you use it.

If you use a CPAP machine or other prescribed treatment, your sleep service should be your first point of contact for questions about how to use it effectively.

What Should You Do if You Think You Have Sleep Apnoea?

You don't need to work out whether you definitely have sleep apnoea before seeking help.

Instead, look at the wider pattern:

• Do you have enough opportunity to sleep but regularly wake feeling unrefreshed?
• Do you snore, gasp or choke during sleep?
• Has someone noticed pauses in your breathing?
• Do you regularly wake with headaches, a dry mouth or a need to urinate?
• Are you struggling with daytime energy, concentration or alertness?
• Do these symptoms persist or affect your everyday life?

If so, speak to your GP.

Your GP can consider whether sleep apnoea or another health condition could be contributing to your symptoms and, where appropriate, arrange further assessment.

A sleep coach can help someone recognise that their sleep pattern may need further investigation, but sleep apnoea is a medical condition and needs clinical assessment and treatment where appropriate.

Sleep Apnoea and Driving

Daytime sleepiness isn't just inconvenient. It can affect your ability to drive safely.

If you have excessive sleepiness that affects your ability to drive, you should not drive until your symptoms are under control.

There are also specific DVLA requirements for some people diagnosed with obstructive sleep apnoea, so check the current rules and discuss your situation with your healthcare professional.

Frequently Asked Questions about Sleep Apnoea

What are the main symptoms of sleep apnoea?

Common symptoms include loud snoring, pauses in breathing, gasping or choking during sleep, frequent waking, morning headaches, dry mouth, unrefreshing sleep, daytime sleepiness, fatigue and difficulty concentrating. Not everyone experiences all of these symptoms.

Can you have sleep apnoea without snoring?

Yes. Although snoring is a common symptom of obstructive sleep apnoea, not everyone with OSA snores loudly. Some people may instead experience unrefreshing sleep, fatigue, insomnia, headaches or difficulty concentrating.

Is sleep apnoea more common in men?

Sleep apnoea has traditionally been recognised more often in men, but it can affect anyone. Women can also experience OSA and may present with different or less obvious symptoms, which can contribute to underdiagnosis.

Can menopause cause sleep apnoea?

Menopause doesn't necessarily cause sleep apnoea, but the risk of OSA increases through and after menopause. Some symptoms of menopause and sleep apnoea overlap, so persistent snoring, unrefreshing sleep, morning headaches, fatigue, nocturia or breathing pauses should be discussed with your GP.

Can sleep apnoea affect your heart?

Sleep apnoea is associated with cardiovascular conditions including high blood pressure, atrial fibrillation, stroke and heart disease. The relationship is complex and doesn't mean that sleep apnoea directly causes every cardiovascular problem.

Can sleep apnoea cause high blood pressure?

Sleep apnoea can contribute to changes in blood pressure. Treating sleep apnoea can lower blood pressure in some people, although it isn't a substitute for prescribed blood pressure medication.

Can a smartwatch tell if I have sleep apnoea?

A smartwatch or sleep tracker may identify patterns that could prompt you to seek medical advice, but consumer devices cannot diagnose sleep apnoea. A clinical sleep assessment is needed.

Is there a cure for sleep apnoea?

There isn't one universal cure. Some people's OSA can improve substantially with changes such as weight management or other targeted treatment, while many people need ongoing treatment such as CPAP or a mandibular advancement splint. The appropriate approach depends on the individual.

Does sleeping on your side help sleep apnoea?

It can help some people, particularly if their sleep apnoea is worse when sleeping on their back. However, positional therapy isn't suitable as a standalone treatment for everyone, particularly people with severe OSA.

Can a mattress or pillow treat sleep apnoea?

No. A mattress or pillow cannot treat the underlying airway obstruction that causes obstructive sleep apnoea. The right sleep products can improve comfort and support, but diagnosed sleep apnoea should be treated according to advice from a healthcare professional.

The Takeaway: Recognise the Signs, Don't Self-Diagnose

Sleep apnoea is more than simply being a loud snorer.

It can show up as unrefreshing sleep, repeated waking, morning headaches, brain fog, fatigue, insomnia or daytime sleepiness. It can affect people of all body shapes and ages, and it can be missed in women when symptoms are attributed to menopause or everyday stress.

It also matters beyond sleep. Sleep apnoea is associated with cardiovascular conditions including high blood pressure and atrial fibrillation, making recognition and appropriate clinical assessment particularly important.

But there's no need to diagnose yourself from a checklist.

The most useful approach is simple:

1. Recognise the pattern.
2. Speak to your GP.
3. Get properly assessed.
4. Understand your results.
5. Then find the treatment that's appropriate and workable for you.

And if you've already been diagnosed with sleep apnoea, remember that treatment isn't necessarily one-size-fits-all. If something isn't working, speak to your sleep service rather than simply giving up.

Better sleep starts with understanding what's actually getting in the way.

Sources:

1. https://www.sleepmeeting.org/women-with-sleep-apnea-report-greater-symptom-burden-than-men/
2. https://www.nice.org.uk/guidance/ng202/chapter/terms-used-in-this-guideline
3. https://www.nice.org.uk/guidance/ng202/chapter/1-Obstructive-sleep-apnoeahypopnoea-syndrome
4. https://osaalliance.co.uk/mas-nice-guidlines
5. https://cks.nice.org.uk/topics/obstructive-sleep-apnoea-syndrome/management/management/
6. https://sleep-apnoea-trust.org/about-us/what-is-sleep-apnoea/