Last updated: October 2026
Sleep apnoea is when your breathing repeatedly stops and starts while you sleep, usually because your airway narrows or closes. Signs include loud snoring, gasping or choking at night and feeling very tired by day. It is treatable, often with lifestyle changes or a CPAP machine on the NHS, so see a GP if you notice symptoms.
Below: the symptoms, obstructive vs central sleep apnoea, causes, how it is tested in the UK, treatments, driving rules and when to get help.
What is sleep apnoea?
“Apnoea” means a pause in breathing. In sleep apnoea, the pauses happen again and again through the night. Each time, your brain briefly wakes you, or pulls you into lighter sleep, so you start breathing again. You usually don’t remember these awakenings, but they break up your sleep and can leave you exhausted the next day.
NICE describes the obstructive type as a condition where the upper airway narrows or closes when the muscles relax during sleep, causing under-breathing (hypopnoea) or stopped breathing (apnoea). That is why doctors often call it obstructive sleep apnoea/hypopnoea syndrome, or OSAHS.
Obstructive vs central sleep apnoea
| Obstructive sleep apnoea (OSA) | Central sleep apnoea (CSA) | |
|---|---|---|
| What happens | The throat narrows or closes, so air can’t get through even though you try to breathe | The brain briefly stops sending the signal to breathe |
| How common | By far the most common type | Much less common |
| Linked with | Excess weight, a large neck, alcohol, smoking, sleeping on your back, large tonsils | Heart failure, high altitude and long-term opioid use |
| Main treatment | Lifestyle changes, CPAP, mouth devices | Treating the underlying cause, plus specialist breathing support such as positive airway pressure |
Some people have a mix of both. The rest of this guide focuses on obstructive sleep apnoea, as it is the type most people mean when they talk about sleep apnoea.
Sleep apnoea symptoms
Many of the signs happen while you are asleep, so a partner or family member often notices them first. The NHS suggests taking someone who has seen your symptoms with you to the GP. A phone recording of your snoring and breathing can help too.
At night
- breathing that stops and starts
- gasping, snorting or choking noises
- loud snoring
- waking up a lot, or restless, broken sleep
- getting up to pee in the night
During the day
- feeling very tired or sleepy, even after a full night in bed (see why you wake up tired)
- difficulty concentrating, poor memory or brain fog
- mood swings or low mood
- a headache when you wake up
- nodding off when you sit still, such as watching TV or as a passenger
NICE tells doctors to assess for sleep apnoea when someone has two or more of these features: snoring, witnessed pauses in breathing, unrefreshing sleep, waking headaches, unexplained sleepiness or fatigue, waking to urinate, choking during sleep, broken sleep or insomnia, and problems with memory or thinking.
Not everyone with sleep apnoea feels sleepy. Some people mainly notice poor concentration or simply feel they never sleep well, which is easy to mistake for insomnia, stress or getting older. If you are always tired and you snore, it is worth asking about.
Sleep apnoea vs snoring
Snoring is very common and usually harmless. The NHS says it can sometimes be a sign of sleep apnoea, which can be serious if not treated. The difference is whether your breathing is actually interrupted.
| Simple snoring | Possible sleep apnoea |
|---|---|
| Steady, regular snoring | Loud snoring broken by silences, then a gasp, snort or choke |
| You wake up feeling reasonably rested | You wake up unrefreshed, often with a headache |
| No real daytime sleepiness | Very tired or sleepy during the day |
| Often eased by simple changes | Needs a proper assessment and sleep test |
If snoring is your only symptom, our guide on how to stop snoring covers what the NHS recommends. If you notice pauses, gasping or real daytime sleepiness, see a GP rather than trying gadgets. That includes mouth taping, which is not a fix for suspected sleep apnoea.
Causes and risk factors
Sleep apnoea happens when your airway becomes too narrow while you sleep. Anything that narrows the throat, or relaxes its muscles more than usual, raises the risk. The NHS lists these risk factors:
- being overweight or obese, which Asthma + Lung UK says is closely linked
- a large neck, as extra tissue presses on the airway
- older age, although children and young adults can get it too
- a family history of sleep apnoea
- drinking alcohol
- smoking
- large tonsils or adenoids
- sleeping on your back
- COPD (a long-term lung condition)
Alcohol, sleeping pills and sedatives
Alcohol relaxes the muscles that hold your throat open. A 2018 University of Nottingham review of 21 studies found that higher alcohol intake was linked with a 25% higher risk of sleep apnoea. The NHS also advises avoiding sleeping pills unless a doctor recommends them, as sedating medicines can relax the airway in the same way. If you take any prescribed medicine that makes you drowsy, don’t stop it on your own: ask your GP or pharmacist.
Women and the menopause
Sleep apnoea is more common in men, but the gap narrows after the menopause. In a large US population study, sleep apnoea was rare in premenopausal women, while postmenopausal women not taking HRT had a rate much closer to men’s, and the authors concluded menopause is a significant risk factor. Weight gain around this time adds to the risk (see menopause weight gain). If your sleep has changed in midlife, snoring, gasping or heavy daytime tiredness are worth mentioning to your GP alongside the more familiar perimenopause sleep problems such as night sweats.
Health conditions that often go with it
NICE says sleep apnoea is more common in people with obesity, type 2 diabetes, high blood pressure that is hard to control, atrial fibrillation and other heart rhythm problems, heart failure, a past stroke, moderate or severe asthma, polycystic ovary syndrome, an underactive thyroid and Down’s syndrome.
How common is sleep apnoea?
Very common, and mostly undiagnosed. A 2019 analysis in The Lancet Respiratory Medicine estimated that about 936 million adults aged 30 to 69 worldwide have mild to severe obstructive sleep apnoea, and about 425 million have moderate to severe sleep apnoea. Many people with it have never been tested, often because they put the tiredness down to busy lives.
In children, Great Ormond Street Hospital says it affects about 1 to 3 in every 100.
Is sleep apnoea dangerous?
It can be if it is not diagnosed and treated, which is why the NHS says it needs treatment. Repeated drops in breathing put strain on the body night after night. The NHS links untreated sleep apnoea with:
- high blood pressure
- a higher chance of stroke
- type 2 diabetes
- heart disease
- depression or mood changes
- a higher risk of serious accidents caused by tiredness, including car crashes
- difficulty concentrating at work or school
- strain on relationships, often from snoring and separate bedrooms (see sleep divorce)
The good news: once it is diagnosed, effective treatment is available on the NHS,. Long-term poor sleep has its own effects too, which we cover in sleep deprivation.
How to get a sleep apnoea test in the UK
The usual route is through your GP, who can refer you to an NHS sleep clinic. Take along anyone who has seen you sleep, or a recording of your snoring and breathing.
Step 1: questionnaires at the GP
- Epworth Sleepiness Scale. You rate how likely you are to doze off in 8 everyday situations, such as watching TV, sitting after lunch or stopped in traffic. Asthma + Lung UK says a total of 11 to 24 might suggest you are unusually sleepy during the day.
- STOP-Bang questionnaire. Eight yes or no questions: Snoring, Tiredness, Observed pauses, blood Pressure, BMI, Age, Neck size and Gender. A score of 0 to 2 suggests low risk of moderate to severe sleep apnoea, and 5 to 8 suggests high risk.
NICE recommends the Epworth scale and suggests considering STOP-Bang as well. Importantly, it says the Epworth score should not be used alone to decide on referral, because not everyone with sleep apnoea feels sleepy.
Step 2: a home sleep study
Most people are tested at home. NICE recommends home respiratory polygraphy, where you wear small sensors overnight that record your breathing, oxygen levels and heart rate, typically a finger clip, belts around the chest and tummy and a small tube under the nose. Where that isn’t available, a simpler home oximetry test (finger clip only) may be used. If results are unclear but symptoms are significant, you may have a more detailed study, sometimes as an overnight stay in hospital (polysomnography).
You may be seen more quickly if you drive for a living, have a safety-critical job, are pregnant, are due for major surgery or have unstable heart problems. Tell your GP if any of these apply.
Step 3: your result
The test counts how many times an hour your breathing stops or becomes very shallow. This is the apnoea-hypopnoea index (AHI).
| AHI (events per hour) | Severity |
|---|---|
| Under 5 | Normal |
| 5 to 14 | Mild |
| 15 to 30 | Moderate |
| Over 30 | Severe |
Private home tests are also sold in the UK. If you go private, choose one reported by a qualified sleep physician, and share the results with your GP so your care is joined up.
Sleep apnoea treatment: CPAP and other options
Treatment depends on how severe it is and how much it affects your daily life. NICE says lifestyle advice should be offered at every level of severity.
| Severity | What NICE recommends |
|---|---|
| Mild, with no symptoms affecting daily life | Lifestyle and sleep habit changes; treatment not usually needed |
| Mild, with symptoms affecting daily life | Lifestyle changes, and CPAP if they aren’t enough |
| Moderate or severe | CPAP plus lifestyle changes |
| Can’t use CPAP | A custom-fitted mouth device (mandibular advancement splint) for adults with healthy teeth and gums |
The sleep apnoea machine: CPAP
CPAP stands for continuous positive airway pressure. A quiet bedside machine gently pumps air through a mask over your nose, or nose and mouth, which keeps your airway open as you sleep. The NHS says you will be given one free if you need it, and that it works best when used every night. It can take time to get used to. If the mask leaks, your nose gets dry or it feels uncomfortable, tell your sleep clinic: different masks, humidifiers and settings are available.
Mouth devices (mandibular advancement devices)
These look like a gum shield and hold your lower jaw slightly forward to keep the airway more open. NICE recommends a customised or semi-customised one as an alternative for adults who can’t tolerate or don’t want CPAP, as long as their teeth and gums are healthy. They are usually fitted by a specially trained dentist. Ask your sleep clinic before buying one online. If you also clench or grind at night, mention it, as it can affect which device suits you (see teeth grinding).
Other options
- Positional devices that stop you rolling onto your back, which NICE says can be considered for mild or moderate sleep apnoea that mainly happens on your back.
- Surgery, such as removing large tonsils, for some people.
- Mouth and throat muscle exercises, which the NHS lists as another option.
- Hypoglossal nerve stimulation, an implant that sends small electrical signals to the nerve controlling the tongue, used for a small number of people.
Can sleep apnoea be cured?
For some people, yes, or it improves enough not to need a machine. For many others it is a long-term condition that is managed rather than cured, a bit like high blood pressure.
- Weight loss. Losing weight is one of the first things the NHS recommends, because excess weight is so closely linked to sleep apnoea, and it can improve it. Don’t stop CPAP on your own because you have lost weight: talk to your sleep clinic first.
- Sleeping position. Sleeping on your side can help when breathing pauses mainly happen on your back. Our guide to the best sleeping position has tips for staying on your side.
- Cutting down on alcohol and stopping smoking both help, according to the NHS and NICE.
- Surgery to remove large tonsils can help some adults, and Asthma + Lung UK says that in children, surgery combined with lifestyle changes can cure it.
Be wary of anything sold as a “cure” online, including pillows, sprays and supplements. They don’t replace a proper assessment.
Sleep apnoea and driving
Sleepiness at the wheel is dangerous, and there are clear rules. The government’s guidance on excessive sleepiness and driving says you must tell the DVLA if you have confirmed moderate or severe obstructive sleep apnoea syndrome with excessive sleepiness.
- Car or motorcycle licence: tell the DVLA online, or fill in form SL1.
- Bus, coach or lorry licence: fill in form SL1V.
- You must not drive until you are free from excessive sleepiness, or your symptoms are under control and you are following any treatment you need.
- You can be fined up to £1,000 if you don’t tell the DVLA about a medical condition that affects your driving.
Whatever your diagnosis, never drive if you feel sleepy. Pull over somewhere safe and rest. The rules focus on sleepiness, so once treatment has it under control you can usually drive again, subject to the DVLA.
Everyday habits that make a difference
Alongside medical treatment, the NHS and NICE recommend losing weight if you need to, drinking less alcohol, stopping smoking, avoiding sleeping pills unless a doctor recommends them and sleeping on your side. They also suggest:
- Exercising regularly.
- Keeping a regular sleep schedule and good sleep hygiene.
- Getting a blocked nose checked, as NICE advises assessing people with sleep apnoea and nasal congestion for rhinitis.
A note on supplements: no supplement treats or prevents sleep apnoea, including ours. If you use any sleep aid, from herbal teas to natural sleep supplements, mention it to your GP or sleep clinic, and don’t use one to mask daytime tiredness that might have a medical cause.
Sleep apnoea in children
Children can get obstructive sleep apnoea too, most often because of enlarged tonsils or adenoids. Great Ormond Street Hospital lists these signs:
- snoring, often with pauses or gasps
- restless sleep, unusual sleeping positions or brief waking
- daytime sleepiness, or trouble concentrating that affects school
- waking tired or grumpy
- in younger children, hyperactivity or aggressive behaviour rather than sleepiness
- poor growth or weight gain
If you are worried, see your GP. A video of your child sleeping can help. Diagnosis is by an overnight sleep study, and the most common treatment is removing the tonsils and/or adenoids. Never give adult sleep products or supplements to children. Our products are for adults only.
When to see a GP
The NHS recommends seeing a GP if you or someone else notices:
- your breathing stops and starts while you sleep
- you make gasping, snorting or choking noises
- you always feel very tired during the day
Also see a GP if snoring is having a big impact on you or your partner, you nod off at the wheel or at work, or you wake with headaches. Other things can cause similar tiredness, such as low iron, an underactive thyroid or waking at 3am every night, so a check-up is worthwhile either way.
FAQs
Is it sleep apnoea or sleep apnea?
Both are correct. Sleep apnoea is the UK spelling and sleep apnea is the US spelling. They mean exactly the same condition.
How do I know if I have sleep apnoea?
Common signs are loud snoring, pauses in breathing, gasping or choking at night and feeling very tired in the day. Only a sleep study can confirm it, so see a GP, who may refer you for a test at home.
Can I get a sleep apnoea test at home?
Yes. Most NHS sleep tests are done at home: you wear small sensors overnight that record your breathing, oxygen levels and heart rate, then return them to the sleep clinic. Private home tests are also available.
Can you get a CPAP machine free on the NHS?
Yes. The NHS says you will be given a CPAP machine for free if you need one. You get one after a diagnosis from an NHS sleep clinic.
Can sleep apnoea go away if you lose weight?
Losing weight can improve sleep apnoea and is one of the first things the NHS recommends. Don’t stop CPAP without talking to your sleep clinic, who can advise whether you still need it.
Do I need to tell the DVLA about sleep apnoea?
You must tell the DVLA if you have confirmed moderate or severe obstructive sleep apnoea with excessive sleepiness. You must not drive until the sleepiness is under control.
Can supplements help sleep apnoea?
No supplement treats or prevents sleep apnoea. The proven options are lifestyle changes, CPAP, mouth devices and, for some people, surgery. Tell your GP or sleep clinic about any sleep aid you take.
Sources
- NHS. Sleep apnoea.
- NHS. Snoring.
- NICE (2021). Obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s (NG202).
- GOV.UK. Excessive sleepiness and driving.
- Asthma + Lung UK. How is OSA diagnosed? and Epworth Sleepiness Scale.
- Great Ormond Street Hospital. Obstructive sleep apnoea.
- Benjafield AV et al (2019). Estimation of the global prevalence and burden of obstructive sleep apnoea. Lancet Respiratory Medicine. PMID 31300334.
- Chung F et al (2016). STOP-Bang Questionnaire: a practical approach to screen for obstructive sleep apnea. Chest. PMID 26378880.
- Simou E et al (2018). Alcohol and the risk of sleep apnoea: a systematic review and meta-analysis. Sleep Medicine. PMID 29458744.
- Bixler EO et al (2001). Prevalence of sleep-disordered breathing in women: effects of gender. American Journal of Respiratory and Critical Care Medicine. PMID 11254512.
- Dempsey JA (2019). Central sleep apnea: misunderstood and mistreated! F1000Research. PMID 31297185.
This guide is general information, not medical advice. If you think you have sleep apnoea, see a GP. Evopure makes sleep supplements; none of them treats or prevents sleep apnoea.
