Sleep apnoea and sleep breathing disorders

Repeated pauses or shallow breathing during sleep can disturb rest and affect daytime alertness. A sleep assessment helps identify the cause and choose appropriate treatment.

 

What symptoms should I look for?

Loud snoring, witnessed breathing pauses, choking or gasping during sleep, morning headaches and unrefreshing sleep can suggest obstructive sleep apnoea (OSA). Some people notice daytime sleepiness, poor concentration or mood changes. A partner’s observations can be helpful.

 

Different types of breathing problem

In OSA, the upper airway repeatedly narrows or closes during sleep. Obesity hypoventilation syndrome (OHS) is different: a person living with obesity does not breathe deeply enough, causing raised carbon dioxide while awake, after other causes have been excluded. OSA and OHS can occur together. Central sleep apnoea and other causes of respiratory failure need their own specialist assessment.

 

How is it investigated?

Your clinician asks about symptoms, medicines, health conditions and how sleepiness affects work or driving. A home respiratory sleep study can record breathing, oxygen levels and other signals. If the result does not explain persistent symptoms, further testing may be needed. Suspected OHS also needs assessment of blood gases; overnight carbon dioxide monitoring may help. An oxygen reading alone cannot diagnose every sleep breathing disorder.

 

Treatment and follow-up

Regular sleep habits, reducing alcohol, stopping smoking and support with weight management can help. CPAP delivers air through a mask to keep the airway open. Selected patients may benefit from a mandibular advancement device or other treatment after assessment. OHS may require CPAP or non-invasive ventilation, depending on the pattern of breathing disturbance and response. Mask comfort, device use and symptom improvement should be reviewed; contact the sleep team if treatment is difficult to tolerate.

 

Our usual NHS pathway for CPAP

Most patients needing CPAP transfer to NHS care. Their GP usually refers them to their local NHS sleep clinic. We can provide our assessment and sleep-study results to support the referral. The NHS sleep service confirms the treatment plan, supplies equipment and arranges ongoing monitoring and support.

Sleep studies and other investigations | Conditions and treatment pathways

 

Sleepiness and safety

Do not drive when sleepy. If sleepiness affects, or is likely to affect, driving, stop driving and seek prompt advice about treatment and the applicable DVLA rules. Tell the clinic if you drive professionally or have a safety-critical job. Call 999 for severe breathing difficulty, blue or grey lips, collapse or new marked confusion.

 

Sources and further information

NHS: sleep apnoea
NICE NG202: sleep apnoea and obesity hypoventilation
Sleep Apnoea Trust: patient support
Sleep Apnoea Trust: driving guidance

General information for adults; assessment and treatment are tailored to you.