Obstructive sleep apnoea is repeated collapse of the throat during sleep. Each time the airway closes, breathing stops or becomes shallow for 10 seconds or more, oxygen falls, and the brain briefly rouses you to reopen it. You seldom remember these arousals, but they can happen hundreds of times a night and leave sleep unrefreshing.
Severity is graded by the apnoea-hypopnoea index: 5 to 15 events an hour is mild, 15 to 30 moderate, above 30 severe. Untreated moderate or severe disease raises the risk of high blood pressure, atrial fibrillation, stroke and road accidents. Treatment works well, often within days, but it controls the condition rather than curing it.
Symptoms
- Loud, habitual snoring
- Pauses in breathing, gasping or choking noticed by a partner
- Waking unrefreshed, with a dry mouth or morning headache
- Daytime sleepiness, dozing when reading, watching television or driving
- Poor concentration, irritability or low mood
- Getting up to pass urine several times a night
- Reduced sex drive
- Blood pressure that is hard to control
Causes and risk factors
The throat is held open by muscles that relax in sleep. Anything that narrows it makes collapse more likely: excess weight, particularly a collar size over about 43 cm, a small or set-back lower jaw, large tonsils or tongue, and nasal blockage. Risk increases with age, in men, and in women after the menopause. Alcohol, sedatives and sleeping on your back worsen it. Hypothyroidism, acromegaly, Down syndrome and polycystic ovary syndrome are associated conditions. In children, large tonsils and adenoids are the usual cause. Central sleep apnoea, where the brain's drive to breathe pauses, is a different condition linked to heart failure and opioids.
How it is diagnosed
- Questionnaires: Epworth Sleepiness Scale and STOP-Bang estimate sleepiness and likelihood of apnoea.
- Home sleep apnoea test: A portable device worn for one night records airflow, breathing effort and oxygen. Adequate for most adults with a typical story.
- Polysomnography: A full overnight laboratory study adding brain waves, leg movements and sleep stages, used for complex cases or when home testing is inconclusive.
- Upper airway examination: An ENT assessment of nose, palate, tonsils, tongue base and jaw. Drug-induced sleep endoscopy may be used when surgery is considered.
- Health checks: Blood pressure, weight, glucose, lipids and thyroid function.
Treatment options
- CPAP: A bedside machine delivers gentle air pressure through a mask to splint the airway open. It is the standard treatment for moderate and severe disease and works only on the nights it is used.
- Weight reduction: Losing 10 percent of body weight can markedly lower the index. Bariatric surgery or GLP-1 medicines may be appropriate; tirzepatide is approved for apnoea with obesity in some countries.
- Mandibular advancement device: A custom dental splint that holds the lower jaw forward, for mild to moderate disease or CPAP intolerance.
- Positional therapy: Devices that keep you off your back when apnoea occurs mainly in that position.
- Surgery: Tonsillectomy, palate or tongue-base surgery, nasal surgery to aid CPAP use, or jaw advancement in selected anatomy. Results vary and a repeat sleep study is needed afterwards.
- Hypoglossal nerve stimulation: An implanted device that moves the tongue forward with each breath, for selected people who cannot use CPAP.
When it is urgent
Sleep apnoea itself is not an emergency, but stop driving and see a doctor quickly if you have fallen asleep at the wheel or had a near miss. Seek emergency care for chest pain, palpitations with faintness, stroke symptoms, or severe breathlessness. Tell any anaesthetist about known or suspected apnoea before surgery.
Travelling to Türkiye for treatment
Diagnosis travels well. An overnight study, ENT examination and a CPAP trial can be fitted into 3 or 4 days, and you can take a machine home, provided you have someone locally for mask problems, data review and supplies. Airway or jaw surgery needs about 7 to 14 days and a follow-up sleep study a few months later to check it worked. Bring your CPAP in hand luggage when you fly; airlines do not count it against your allowance.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
Frequently Asked Questions
Is snoring the same as sleep apnoea?
No. Many people snore without apnoea. Snoring together with witnessed pauses or daytime sleepiness warrants a test.
Will I need CPAP for ever?
For as long as the cause remains. Significant weight loss or successful surgery can reduce or remove the need, confirmed by a repeat study.
I cannot tolerate the mask. What now?
Most problems are solved with a different mask type, a humidifier or pressure adjustment. If not, a dental device or other options can be considered.
Can I keep my driving licence?
Rules vary by country. In general you must not drive while excessively sleepy, and you can drive once treatment controls your symptoms.