Sleep apnoea

Also called Obstructive sleep apnoea, OSA

Breathing repeatedly stopping during sleep. Around 1.5 million UK adults, and most are undiagnosed.

What it is

Obstructive sleep apnoea affects an estimated 1.5 million adults in the UK, and around 85% of them have never been diagnosed.

The airway collapses repeatedly during sleep. Each time, oxygen falls, the brain rouses just enough to reopen the airway, and sleep fragments. This can happen hundreds of times a night without the person having any memory of it.

The consequences are serious and under-appreciated: it raises the risk of high blood pressure, atrial fibrillation, stroke and type 2 diabetes, and it multiplies the risk of a road traffic collision.

Signs you might notice

Loud snoring, with pauses, and then a gasp or snort. A partner is usually the one who notices.

Excessive daytime sleepiness: falling asleep watching television, in meetings, or, dangerously, while driving.

Waking with a headache and a dry mouth.

Poor concentration, irritability and low mood, which frequently get treated as depression.

Waking to pass urine several times a night, which surprises people.

It is commoner in Down's syndrome, and should be actively screened for there.

How it can affect day-to-day life

People adjust to feeling exhausted over years and stop recognising it as abnormal. Many describe the treated state as getting their life back, which tells you what the untreated state was costing.

CPAP is the treatment and it is effective. It is also a mask worn all night, and abandonment rates in the first month are high without support. Getting the mask fitting right is most of the battle.

Driving matters legally: excessive sleepiness affecting driving must be reported to the DVLA, and treated apnoea usually means driving continues.

Supporting someone well

Get a sleep study rather than guessing. Referral is straightforward and many services now use home testing.

Persist with CPAP through the first few weeks, and go back for mask refitting rather than giving up. Humidification helps with dryness.

Sleep on your side. In mild cases positional therapy alone helps considerably.

Weight loss helps where relevant, and so does reducing alcohol in the evening, which relaxes the airway.

In a service, notice it. Loud snoring with pauses in a supported person is a clinical observation worth recording and reporting, not background noise.

Where to get help

Ask a GP for a sleep clinic referral. Take the Epworth Sleepiness Scale score with you.

Asthma + Lung UK and the Sleep Apnoea Trust both provide support and practical CPAP advice.

Do not drive if you are sleepy at the wheel, and get assessed before it causes harm.