Sleep apnoea

Separate obstruction from reduced breathing drive

Obstructive sleep apnoea involves repeated narrowing or collapse of the upper airway during sleep. Central sleep apnoea involves insufficient breathing drive. Snoring alone cannot distinguish them, and being lean does not exclude obstruction. Assessment may require an appropriate sleep study.

Describe the effects on daily life

Tell the clinician about witnessed pauses, waking with gasping and daytime sleepiness. If sleepiness affects driving or safety-sensitive work, avoid taking risks while drowsy and discuss safe arrangements promptly. Wearable or phone alerts may provide clues but cannot establish or exclude the diagnosis on their own.

Match treatment to the cause

Continuous positive airway pressure (CPAP) uses air pressure to keep the airway open during sleep. Some people may be suited to oral devices or other treatments. Weight, alcohol, smoking and sleep position also warrant discussion. No single treatment or sleeping position suits everyone.

Resolve barriers to using treatment

Mask leaks, dryness or difficulty keeping the device on can undermine treatment. Bring records of device use, discomfort and daytime symptoms to follow-up so the team can adjust the equipment or plan. Receiving a machine is not the endpoint; symptom improvement and remaining breathing events need review.

Questions for your clinician

• Which sleep test do I need, and what are its limitations?
• Which part of my condition does this treatment address?
• How should leaks, dryness or persistent daytime sleepiness be reviewed?

Explore the underlying science

• 51 · Sleep stages and regulation
• 55 · Snoring, sleep apnoea and daytime sleepiness
• 56 · Light, shift work, jet lag and sleep

Sources

• NHLBI: Sleep apnoea
• NHLBI: Sleep apnoea treatment
• NHLBI: Living with sleep apnoea