Sleep apnoea 

Introduction 

Snoring and sleep apnoea

An expert explains the difference between snoring and sleep apnoea, and people talk about the methods they've used to get a good night's sleep.

Media last reviewed: 18/03/2013

Next review due: 18/03/2015

Stages of sleep

Sleep can be divided into two categories:

  • rapid eye movement (REM) sleep usually occurs around 90 minutes after falling asleep; during REM sleep, brain activity increases and dreaming occurs; a number of periods of REM can occur during a night’s sleep (usually three to five episodes)
  • non-rapid eye movement (NREM) sleep is made up of four different stages (see below); one sleep cycle may consist of several stages of NREM sleep followed by a period of REM sleep.

There are four different stages of NREM sleep.

  • Stage 1 (drowsiness) may last 5 to 10 minutes, during which time your muscles relax and you may be easily disturbed. You may also feel as if you are falling, which causes a muscle contraction known as hypnic myoclonia or ‘sleep jerks’.
  • Stage 2 (light sleep) eye movements stop during this stage, your heart rate slows down and your body temperature decreases as your body prepares itself for deep sleep.
  • Stages 3 and 4 (deep sleep) these two stages are deep sleep. Stage 4 is more intense than stage 3. During these stages, your physical energy levels are restored and your immune system is strengthened. If woken, you may feel disorientated for a few minutes. Around 90 minutes into this sleep cycle you will begin to have REM sleep.

Obstructive sleep apnoea (OSA) is a condition that causes interrupted breathing during sleep.

There are two types of breathing interruption characteristic of OSA:

  • apnoea  the muscles and soft tissues in the throat relax and collapse sufficiently to cause a total blockage of the airway; it is called an apnoea when the airflow is blocked for 10 seconds or more
  • hypopnoea  a partial blockage of the airway that results in an airflow reduction of greater than 50% for 10 seconds or more

Sleep apnoea is associated with being overweight, and other risk factors. Read more about the causes of sleep apnoea.

Because of the episodes of hypopnoea that occur during OSA, doctors sometimes refer to the condition as 'obstructive sleep apnoea-hypopnoea syndrome'.

The term 'obstructive' distinguishes OSA from rarer forms of sleep apnoea, such as central sleep apnoea, which is caused by the brain 'forgetting' to breathe during sleep.

Sleep

Sleep is driven by natural brain activity. You need to have a certain amount of deep sleep for your body and mind to be fully refreshed. Having only limited episodes of deep sleep will leave you feeling very tired the next day.

In order to function properly, most adults need seven to eight hours of sleep. Around 15-25% of that time should be spent in the deepest phase of sleep, known as slow wave sleep.

What happens during OSA?

During the night, people with OSA may experience repeated episodes of apnoea and hypopnoea.

During an episode, lack of oxygen causes the person to come out of deep sleep and into a lighter state of sleep, or a brief period of wakefulness, in order to restore normal breathing. However, after falling back into deep sleep, further episodes of apnoea and hypopnoea can occur. Such events may occur more than once a minute throughout the night.

Most people with OSA snore loudly. Their breathing may be noisy and laboured and it is often interrupted by gasping and snorting with each episode of apnoea.

The repeated interruptions to sleep caused by OSA can make the person feel very tired during the day. A person with OSA will usually have no memory of breathlessness, so they are often unaware that they are not getting a proper night's sleep.

Read more about the symptoms of sleep apnoea.

How common is OSA?

OSA is a relatively common condition that affects more men than women. In the UK, it is estimated that around 4% of middle-aged men and 2% of middle-aged women have OSA.

The onset of OSA is most common in people aged 35 to 54 years old, although it can affect people of all ages, including children. The condition often goes undiagnosed. It is estimated that up to 5% of adults have undiagnosed OSA.

Studies have also shown that 60% of people over 65 years old have OSA.

Outlook

OSA is a treatable condition and there are a variety of treatment options to reduce the symptoms.

Lifestyle changes, such as losing excess weight, can often help mild cases of sleep apnoea to resolve. In more severe cases, the use of breathing apparatus while sleeping may be necessary.

Read more about how sleep apnoea is treated.

Left untreated, OSA can increase the risk of:

  • high blood pressure (hypertension)
  • heart attack
  • stroke
  • obesity
  • type 2 diabetes

Untreated OSA also increases a person’s risk of developing heart failure and irregular heartbeats, and it can lead to poor performance at work and at school.

Read more about the complications of sleep apnoea.

Page last reviewed: 26/06/2012

Next review due: 26/06/2014

Ratings

How helpful is this page?

Average rating

Based on 299 ratings

All ratings

Add your rating

Comments

The 12 comments posted are personal views. Any information they give has not been checked and may not be accurate.

kehena said on 08 December 2013

My friend who lives in Paris was diagnosed with this. He breathes for only 4 out of the 8 hours he is asleep apparently. He tried unsuccessfully the CPAP machine. but what has worked for him is an orthosis, which he only has to wear in bed. It pushes his jaw into a position that somehow stops the problem. He was monitored only this week and is now breathing completely normally.

Report this content as offensive or unsuitable

Staggie90 said on 08 September 2013

My boyfriend has this. And he is a typical candidate, overweight, double chin, 37, male, night sweats (which we've only realised was a symptom from this site), stops breathing at night, heavy snorer, can fall asleep standing up, while eating, while changing the babys bum, and never woke up feeling refreshed.
During his sleep test he was told he stops breathing from anywhere between 25-46 times and hour, for around 10-15 seconds every night (he was observed over 4 nights). Its in the severe category obviously.
He's been diagnosed for a couple of months now but still falls asleep during the day even when he's used the machine. So another trip back to the sleep clinic and he's found out that he needs a more intense machine because of the size of the back of his throat and the size of his tongue (apparenty this can cause sleep apneoa even if you're not overweight which I found interesting).
He's also been told smoking makes OSA worse so for those smokers it might be worth investing in some patches.
There was a young lady on here who said she thinks she has this but isn't in the usual criteria, my mum also suffers from what you decribed and she has been diagnosed with night panic attacks eventhough she doesn't get them during the day, it might be worth speaking to your doctor again.
Hope I've helped.

Report this content as offensive or unsuitable

Mary Summerley said on 20 May 2013

I've just been diagnosed with severe obstructive sleep apnoea and told I will have to use a CPAP machine. I'm quite apprehensive at the thought of having to have a mask strapped onto my head all night and every night. Any advice on how to adapt to it more easily?

Report this content as offensive or unsuitable

freedomlass said on 23 April 2013

I was diagnosed with Sleep Apneoa about 4 years ago I was always tired and my other half complained madly about my snoring, after an op on my nose and throat as things didn't really improve I was given a CPAP machine, it took some getting used to and being called Darth Vadar I use it constantly, I don't however generally feel much different I still feel tired a lot of the time and do not wake feeling refreshed as I was told I would do, my consultant does feel after further overnight tests that it is working as I do not snore no where near as much, yes I do still snore sometimes even with the mask on, I am slowly loosing weight too. I do not like the mask much as I can't get into a sleep position that I like as it gets in the way, it wakes me up with the air leaks into my eyes or sides of cheeks, even after adjustments it still happens, they say it fits me well but find the straps at the back of the head slide up and have to put my hair in a pony tail to stop it sliding off, when it happens the bar on the forehead also moves up, I get indents on my forhead and over my nose, as for the breathing I even find myself occasionally holding my breath even when awake, does it really work?

Report this content as offensive or unsuitable

Andy W Leeds said on 02 March 2013

O.S.A.

Before diagnosis
Chronic fatigue
Thunderous snorer
Breathing stopped
Wife apprehensive!

Dozed everywhere:
Mid sentence
At work
Or pub
Awoken frequently!

Driving risk
For family
Strangers, friends
Eventually expecting
Airbag ending!

Finally treated
Thanks doctors
CPAP dependence
Love, hate
Life resurrected!

Sleeping quality
Never snoring
Or stopping
Wife calmed
Feeling energised!

Driving safely
DVLC approved
Obese drivers
Very concerning
Carnage diagnosed?

Nasal mask
Forehead imprinted
Whirling fan
Hissing, leaking
Snotty masks!

Fifteen years
Loving CPAP
Thanks NHS
Marathon runner
Life's fantastic!


Report this content as offensive or unsuitable

Emilycharlotteh said on 10 February 2013

Hiya,

I am 17 and believe I may have sleep apnea.
I have spoken to doctors about my experiences and they have given me little help, simply telling me that I must be stressed and to go away or go to see a councillor..

I do not snore and I am actually under weight. However I suffer with sleep paralysis at least twice a week, feeling as if someone is sat on my chest, I struggle to breathe and move even though I am aware of what is happening to me. I also wake up every day with a very dry mouth. I also suffer with daily morning migraines and things have got so bad that I cannot go at least 7 hours without having a nap, I am physically drained and worn out and I don't really know what can be done about it as it is really affecting my life daily.

If anyone has any advice or information please let me know as I need to get through to a doctor and get them to take me seriously, as they have not done the last 4 times I have been to them.

Best,
Emily.

Report this content as offensive or unsuitable

AndrewD said on 17 July 2012

I was diagniosed with apnea a little more than a year ago. In the run-up I had been catching lots of colds, was constantly exhausted and falling asleep all over the place.

After being given a cpap machine I lay down to try it out with a nap and slept 10 hours awaking incredibly refreshed.

Its a nuisance but does the job with no need for drugs.

Having lived with apnea for a while now I realise that I have a heavy double chin that presses down on my throat and is likely the cause of the problem, but you need to be getting good rest to have the energy to lose the necessary weight,.

Cpap is an effective remedy while you work on the weight.

I got a very small mask that is effectively just a bulb that sits under the nose. I wodul recommend this to anyone as an alternative to the face or nose mask, if you find it uncomfortable.

Report this content as offensive or unsuitable

David McC said on 27 June 2012

I am a world-class snorer....or, I was until I was provided with a CPAP machine a week ago - snoring has been stopped in its' tracks. That's the (very!!) good news.....

I have had no problems whatsoever adapting to the full-face mask - but, I do awake feeling decidedly fuzzy-headed. It's a feeling that does not fully disappear for several hours after what would appear to have been a good night's sleep.

Do you have experience of this? Is this something caused by the CPAP machine possibly - or, just a coincidence? If it isn't a coincidence, how did you overcome the problem, and after how ,long?

Report this content as offensive or unsuitable

David McC said on 26 June 2012

I am a world-class snorer who has very recently been given a CPAP machine ( a week ago) as OSA was causing my blood oxygen levels to be described as being "dangerously low" and I was waking as many as 12 times per hour each night.....it has stopped my snoring in its' tracks (much to my wife's great relief!!). However - and, this may not be associated in any way whatsoever - I awake feeling very fuzzy-headed and somewhat weary. I am having no difficulties whatsoever adapting to the full-face mask, or to the CPAP machine, and appear to be getting a good nights' sleep. Is this a disassociated coincidence - or, has anyone else experienced these symptoms? If you have, what did you do about it - or, did they simply disappear in time?

Report this content as offensive or unsuitable

Suzidog said on 27 October 2011

How do I get tested for this. I wake up during the night choking. Only happens once during the night but it appears to be getting more common. I'm starting to worry about what could be causing it. The morning after my throat is sore but usually clears by midday. Reading the internet suggests this as a possible cause. I am a 31 year old male, over weight but not obese.

Report this content as offensive or unsuitable

southway1 said on 31 May 2011

i am getting treated for this condition from my local hospital, and have been having the utmost care from them i could not wish for any better treatment they are a 100%

Report this content as offensive or unsuitable

Sleep Apnea said on 05 November 2010

It would be interesting to read about central and complex sleep apnea. I know that CPAP can worsen the symptoms of sleep apnea. However, Adaptive Servo-Ventilation was designed to help the patient with central apnea events.

Remy

Report this content as offensive or unsuitable

'I fell asleep at work'

Dr Malcolm Stewart knew something wasn’t right when he fell asleep in front of a patient during a consultation

Snoring's hidden threat

Snoring can often be a symptom of a more serious sleeping disorder called sleep apnoea

Britain's sleepless nights

Trouble sleeping is the most widely reported psychological disorder in the UK

Find and choose services for Sleep apnoea