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What Is Sleep Apnoea?

The Greek word 'Apnoea' means 'Without Breath' which is where the name of the 'condition' called Sleep Apnoea (also spelt Apnea in some countries) is derived from.  Therefore, Sleep Apnoea means stopping breathing whilst sleeping!  People with Sleep Apnoea stop breathing or struggle to breathe regularly during sleep, and most are unaware of this.

Sleep Apnoea is a medical 'condition' which is only just being widely recognized in the UK.  However, it is a serious 'condition', due to the other medical conditions it exacerbates, causes and is linked to, such as:-

  •     Sleep Apnoea AwarenessHeart Attacks and other Cardiovascular Disorders
  •     Strokes
  •     High Blood Pressure
  •     Type 2 Diabetes
  •     Driving Accidents (through sleep deprivation)
  •     Obesity
  •     Anxiety and Depression
  •     Hypothyroidism
  •     ADHD
  •     Brain Confusion + Memory Problems
  •     Fibromyalgia
  •     Chronic Fatigue Syndrome (CFS)
  •     Dementia, particularly Alzheimers
  •     Floppy Eyelid Syndrome (FES)
  •     Glaucoma
  •     Asthma
  •     Erectile Dysfunction Syndrome
  •     Parkinsons
  •     Heartburn and Gastrointestinal Reflux
  •     Vitamin D and/or B12 Deficiency
  •     (New research is being undertaken constantly and many more links to other medical conditions are possible)

In most cases, a person with Obstructive Sleep Apnoea will be a snorer, and mostly (unbeknown to them) will stop breathing many times a night, ranging from:-





Mild Sleep Apnoea

15-30 Moderate Sleep Apnoea
30+     Severe Sleep Apnoea

*** AHI stands for Apnoea/Hypopnoea Index, which is the amount of times a person has an apnoea or hypopnoea PER HOUR!  Apnoeas are when a person totally stops breathing and hypopnoeas are partial lack of breathing events.

The apnoeas/hypopnoeas will happen whilst sleeping, and the brain (thankfully) sends messages to the body to start breathing again.  Unfortunately this cycle will repeat itself throughout the night.  The sufferer will often wake up feeling unrefreshed, but will not put this down to lack of sleep, as they are usually under the impression they have slept well, due to most people being unaware of what has been happening through the night.  Some people do wake up gasping or choking though.  It is normally the bed partner who may notice what is going on, and many have reported of hearing their bed partner snoring, followed by a silent pause when they suspect their partner has stopped breathing (which they have!).  The sufferer will then usually make a snorting, choking or gasping noise, and they will start breathing again, but the cycle will continue throughout the night.  It should also be pointed out that not everyone with sleep apnoea does snore.

During apnoea/hypopnoea events, this often causes oxygen levels to drop, carbon dioxide levels to raise and the heart becomes stressed, increasing both blood pressure and heart rate.  This obviously causes untold constant damage to the body, which is why it is important to treat sleep apnoea and any warning signs should not be ignored!

**Incidentally, Kath Hope of Hope2Sleep had no idea she stopped breathing at all during sleep, never woke up choking and yet her AHI (apnoea/hypopnoea index) was 30 which is just into the severe range.  Even her husband never spotted it!!

A person with undiagnosed sleep apnoea may present some or all of the following symptoms:-

  •     Daytime tiredness - often with the need for naps when circumstances permit.
  •     Snoring
  •     Sudden awakenings from sleep (but not always as many sufferers are unaware of waking up).
  •     Lack of concentration, poor work or school performance and possibly memory problems or confusion.
  •     Depression, anxiety or irritability.
  •     Morning headaches.
  •     Dry mouth and/or sore throat on waking.
  •     Decreased sex drive.
  •     They may already be a diabetic, have heart problems, have had a stroke/TIA or have hypothyroidism.
  •     They may already be on medication for high blood pressure.
  •     Many other symptoms can be present due to sleep deprivation.

Causes for Obstructive Sleep Apnoea

There are several different causes why a person has Obstructive Sleep Apnoea or how it can be made worse, as follows:-

  •     Nasal Blockage, due to deviated septum, narrow passages, congestion, allergies etc.
  •     Large Uvula.
  •     Large Neck Size
  •     Obesity.
  •     Overuse of Alcohol.
  •     Certain Medications, such as tranquillisers etc.
  •     Large Tonsils and/or Adenoids.
  •     Large Soft Palate.
  •     Receding Jaw.
  •     Large Tongue.
  •     Smoking.
  •     Family member with Sleep Apnoea, as there are hereditary factors due to craniofacial issues.

Causes for Central Sleep Apnoea

(Central Sleep Apnoea is where the brain 'forgets' to send messages to the muscles to breathe and snoring is not always a sign of this).  Sometimes there is no known cause.

Conditions which may be associated with central sleep apnea include the following:

  •     Congestive heart failure
  •     Hypothyroid Disease
  •     Kidney failure
  •     Damage to the brainstem caused by encephalitis, stroke, injury, or other factors
  •     Certain medications, eg Morphine etc
  •     Neurological diseases, such as Parkinson's, Alzheimer's and Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's disease)
  •     Cheynes Stokes Breathing, commonly associated with heart failure or stroke
  •     Idiopathic - no known cause

Mixed Sleep or Complex Sleep Apnoea

Put simply, this is a mixture of both Obstructive Sleep Apnoea and Central Sleep Apnoea and is more complicated to treat.  Sometimes Central Sleep Apnoea can become a problem when being treated for Obstructive Sleep Apnoea - often too high a CPAP pressure can actually cause central apnoeas.  

If You Suspect You May Have Sleep Apnoea, there are several routes to take and the most important advice is TAKE ACTION NOW!!

Action To Take

  • Book an appointment to discuss this with your GP, who should refer you to your local sleep clinic to arrange a Sleep Study.
  • Ask your bed partner to observe you sleeping.
  • If possible, record the sound of yourself sleeping, or even a video recording.
  • The Epworth Sleepiness Scale is normally the first thing you would be asked to fill in.  This will give you a good indication of whether you need further help after adding up your scores.  You could print out your results and take them to your GP.   Our advice would be to do all three!
  • You can also hire a Home Sleep Screening Screening Test from us to check for the likelihood of you having Sleep Apnoea if your GP needs convincing to refer to a sleep clinic, or even to help you decide yourself if you need to take action.

Sleep Apnoea also affects children (possibly at least 1 in 30).  Check out our dedicated page for Sleep Apnoea in Children.

Epworth Sleepiness Scale

Although not foolproof, this Epworth Sleepiness Scale is what your GP and/or a Sleep Clinic would ask you to fill in, as a screening tool to assess the likelihood of people suffering from undiagnosed Sleep Apnoea.

Please fill in this questionnaire as to how you feel most days in the following situations, as to the likelihood of you dozing off.  Even if you haven’t done some of these things recently, try estimating how they may have affected you.

Use the following scale to work out your scores:-

  • 0 = Would NEVER doze.
  • 1 = SLIGHT CHANCE of dozing.
  • 2 = MODERATE CHANCE of dozing.
  • 3 = HIGH CHANCE of dozing.

Epworth Sleepiness Scale

Sitting and reading


Watching television


Sitting inactive in a public place, (eg in a meeting or theatre)


As a passenger in a car for an hour without a break


Lying down to rest in the afternoon when circumstances permit


Sitting and talking to someone


Sitting quietly after lunch without alcohol


In a car, whilst stopped for a few minutes in traffic




To check the criteria your score meets, please click this link.


To download this Epworth Questionnaire to fill in and take to your GP, please click this link


ESS © MW Johns 1990-1997. Used under License.


The Questionnaire contact information and permission to use: Mapi Research Trust, Lyon, France



Treatment for Sleep Apnoea

  • CPAP (Continuous Positive Airway Pressure) where filtered air is delivered from a CPAP Machine via a hose/tube and into a Nasal or Full Face Mask, preventing the airways from collapsing.  There are different forms of CPAP machines, such as APAP, BiPAP and VPAP etc.,  but your sleep doctor will advise the most appropriate treatment for you.
  • Dental Appliances and Oral Devices can sometimes be a suitable option - especially in milder cases of of Obstructive Sleep Apnoea.
  • Surgery is sometimes a consideration, although at the time of publishing it is rare to get a complete cure, but surgery can help.   Children do have a good success rate for a cure from Sleep Apnoea by tonsillectomy and/or adenoidectomy, but the same high success rate is not evident in adults.
  • For Central Sleep Apnoea the most successful machines are BiPAP/BiLevel or Adaptive Servo-Ventilation (ASV).
  • Again, for milder cases sleeping position can help, as can refraining from alcohol within 3-4 hours of bedtime and nicotine.  Even ensuring you don't eat a large meal within these time periods can help.  Weight loss can also improve the severity of Sleep Apnoea, and in a small minority even cure it.

Self Help

  • For your own sake and other innocent prospective victims, please DO NOT drive a vehicle when tired.  The DVLA has strict rules on this and they have produced a leaflet you can download by clicking the following link 'Tiredness Can Kill.'
  • Try to lose some weight.  Even losing as little as 10% of the body weight can reduce the amount of apnoeas and often reduce the level of CPAP pressure.  Many diagnosed sleep apnoea sufferers have reported how much easier it is to lose weight once they are on successful treatment.
  • Try not to drink alcohol or eat within at least 3-4 hours of going to bed.
  • Stop smoking.
  • Try not to sleep on your back, and if possible, elevate the head of the bed by 4-6 inches.
  • Ensure your nasal airways are free from congestion.


According to the 'British Lung Foundation,' "it is estimated that about 110,000 people in the UK suffer from Sleep Apnoea/Hypopnoea.  Prevalence is higher in men than women and higher in those who are overweight.  It affects an esimated 4% of males and 2% of females in the UK, although it is thought to be considerably higher in specific groups and occupations, such as long-distance lorry drivers and shift workers, where the consequences can be fatal or lead to serious injury if left undiagnosed and untreated.  It is also esimated that only 1 in 10 patients with the syndrome have so far been diagnosed and treated.  The rate of treatment in the UK is lower than most other developed countries."

According to the 'American Sleep Apnea Association,' "Sleep Apnea (Apnoea) is as common as adult diabetes, and affects more than 12 million Americans.  However, because of the lack of awareness by the public and even some healthcare professionals, the vast majority remain undiagnosed and, therefore, untreated - despite the fact that this serious disorder can have significant consequences."

Approximately 1 in 30 children are also sufferers of Sleep Apnoea, and unfortunately these children get branded with bad behaviour, learning problems and ADHD instead. 

Sleep Apnoea (Apnea) is a serious condition, due to its links with other life threatening illnesses.  Not only will you lower your risks of these other medical conditions, but you should start to feel so much better in yourself when you are on successful treatment.