Symptoms
- Loud snoring — the cardinal symptom
- Witnessed apnoeas (breathing stops — partner often notices first)
- Choking or gasping during sleep
- Excessive daytime sleepiness (Epworth Scale >10 is clinically significant)
- Morning headaches (from nocturnal hypercapnia)
- Unrefreshing sleep despite adequate duration
- Nocturia (frequent night urination)
- Cognitive problems: poor concentration, memory, irritability
- Depression and mood disturbance
Diagnosis
| Test | Setting | What It Measures |
|---|---|---|
| Home sleep test (oximetry + airflow) | Home | Oxygen dips, breathing patterns — sufficient for most OSA |
| Polysomnography (PSG) | Sleep lab | Full EEG, EMG, EOG, ECG, oximetry — gold standard |
| AHI (apnoea-hypopnoea index) | Result interpretation | <5 normal; 5–15 mild OSA; 15–30 moderate; >30 severe OSA |
Epworth Sleepiness ScaleScore yourself on likelihood of dozing in 8 situations (0–3 each, max 24). ESS ≥10 = excessive daytime sleepiness. ESS ≥16 = severe — avoid driving until assessed. Available free online.
OSA and Driving
In the UK, you MUST inform the DVLA if you have OSA causing excessive daytime sleepiness. Driving with untreated OSA causing sleepiness is a criminal offence and carries the same liability as drink-driving.
What causes sleep apnoea?
Relaxation of pharyngeal muscles during sleep causes airway collapse. Risk factors: obesity (especially central/neck fat), male sex, age over 40, large neck circumference (>40 cm women; >43 cm men), retrognathia, alcohol before bed.
How does CPAP work?
CPAP (continuous positive airway pressure) delivers pressurised air through a nasal or full-face mask to keep the upper airway open during sleep. It eliminates apnoeas in >90% of people when used correctly.
Can weight loss cure sleep apnoea?
Yes — in many cases. A 10–15% weight loss can significantly reduce or eliminate OSA. However, CPAP should be used while losing weight as untreated OSA impairs the metabolic changes needed for weight loss.
What if I can't tolerate CPAP?
Alternatives: mandibular advancement device (dental splint — effective in mild-moderate OSA), positional therapy (for positional OSA), upper airway surgery (uvulopalatopharyngoplasty — selected cases), or bariatric surgery if morbidly obese.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.