Health condition · Clinically reviewed
Sleep apnoea, the guide that answers what to do next.
A common and treatable cause of daytime tiredness, morning headaches and resistant high blood pressure. Here is how it is diagnosed and what treatment actually looks like.
Why trust this guide
- 01
Clinically reviewed
Written by our editorial team and reviewed by a registered UK clinician before publication.
- 02
Sourced from guidance
Every claim is checked against NICE, BTS or peer-reviewed sources you can see at the end.
- 03
Current for 2026
Reflects current UK guidance on home sleep studies, CPAP, mandibular advancement and lifestyle.
Key facts
Sleep apnoea at a glance.
The essentials, in plain English - what it is, how common it is, how it is diagnosed, and what treatment actually looks like in the UK.
-
What it is
Repeated pauses in breathing during sleep - the throat repeatedly narrows or closes, fragmenting sleep.
-
How common
Around 1.5 million UK adults - many undiagnosed. Common in men over 40 and post-menopausal women.
-
Main symptoms
Loud snoring, witnessed breathing pauses, waking gasping, daytime sleepiness, morning headache.
-
Diagnosis
A home sleep study measuring oxygen, airflow and effort overnight - or in-lab polysomnography.
-
First-line treatment
Lifestyle change + CPAP (for moderate-severe) or a mandibular advancement device (for milder cases).
-
Why it matters
Untreated OSA raises risk of high blood pressure, stroke, heart failure and atrial fibrillation.
Why this guide matters
A tiredness problem that is really a heart problem.
Sleep apnoea is under-diagnosed and over-tolerated. The three points below explain why it is worth taking seriously - and why treatment can be life-changing.
-
Fatigue that never lifts is a symptom, not a personality trait
Chronic daytime sleepiness deserves an actual test - not more coffee.
-
Untreated OSA damages the heart
It drives high blood pressure, atrial fibrillation, stroke and heart failure - all preventable.
-
Treatment is life-changing in weeks
Well-fitted CPAP can transform mood and energy within a fortnight.
How the diagnosis is made
From a partner’s nudge to a clear plan.
The steps a UK GP and sleep service will normally follow, in order - so you know what to expect and why.
Phase 1 · Recognising
Symptoms noticed and screened
Phase 2 · Confirming
Home or in-lab sleep study
Phase 3 · Managing
AHI-graded treatment plan
- 01
Recognising
A partner notices the signs
Loud snoring, breathing pauses, gasps, restless legs, or leaving the bed.
- 02
Recognising
Daytime symptoms tell the story
Persistent tiredness, morning headache, poor concentration, mood dip, falling asleep unintentionally.
- 03
Recognising
Epworth Sleepiness Scale
A simple 8-question score. A total above 10 raises suspicion.
- 04
Confirming
A home sleep study
A small device recorded at home overnight measures oxygen, airflow and breathing effort.
- 05
Confirming
In-lab polysomnography
A full overnight study when the home study is unclear or a complex sleep disorder is suspected.
- 06
Managing
AHI decides severity
The Apnoea-Hypopnoea Index (events per hour) grades OSA as mild, moderate or severe.
- 07
Managing
A treatment plan
Weight, position and alcohol first. CPAP for moderate-severe; MAD for mild-moderate; surgery in select cases.
Typical timeline: 4-12 weeks from GP visit to starting treatment.
Symptoms
What sleep apnoea actually feels like.
Some symptoms happen while you sleep, others during the day. If several of these ring true, ask for a sleep study.
-
Loud snoring
Loud enough to be heard through walls. Often the first thing a partner mentions.
-
Witnessed breathing pauses
A partner reports silences of 10+ seconds, then a gasp or snort.
-
Excessive daytime sleepiness
Falling asleep while reading, watching TV, driving - not just being tired.
-
Morning headaches
From nocturnal hypoxia and disrupted sleep - often improve with treatment.
-
Mood & concentration
Low mood, irritability and poor concentration are frequently underestimated features.
-
High blood pressure
Especially resistant to treatment - OSA is a very common driver.
-
Waking unrefreshed
Long sleep but never feeling rested - a hallmark of fragmented sleep.
-
Driving risk
Falling asleep at the wheel is a legal and medical emergency - report to DVLA if diagnosed.
Treatment
How sleep apnoea is treated in the UK.
The right combination depends on severity, anatomy and what you can stick with. Most people need more than one lever.
-
CPAP
A mask that keeps the airway open with positive pressure - first-line for moderate-severe OSA.
-
Mandibular advancement device (MAD)
A custom oral device that holds the jaw slightly forward - well tolerated for mild-moderate OSA.
-
Weight loss
The single most impactful change - a 10% weight loss reduces AHI by around 26%.
-
Positional therapy
Devices that discourage sleeping on your back can help if OSA is position-dependent.
-
Alcohol & sedative avoidance
Both relax airway muscles and worsen apnoeas - especially in the last few hours before bed.
-
Smoking cessation
Smoking increases upper-airway inflammation - stopping helps sleep and general health.
-
ENT assessment
For nasal obstruction, enlarged tonsils or adenoids - sometimes surgery has a role.
-
Weight-loss medication or surgery
Bariatric surgery and GLP-1 medications can meaningfully reduce OSA in people who qualify.
What this guide is based on
The sources behind every number on this page.
UK national guidance and specialist society standards, current at the time of last review.
Key references
Guidelines and standards we relied on.
A quiet reminder
This guide is for information, not medical advice.
Your GP knows your history and can tell you which parts apply to you. If in doubt, ask about a sleep study.
-
NICE. Obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome (NG202).
-
British Thoracic Society. Sleep-disordered breathing quality standards.
-
DVLA. Fitness to drive: sleep disorders guidance.
-
The Sleep Charity. Patient information on OSA.
Red flags
When sleep apnoea becomes urgent.
Most sleep apnoea is a slow burn. These are the situations that need faster attention - or that change how something else should be managed.
-
Falling asleep while driving
Immediate: do not drive. Report to DVLA once diagnosed. Falling asleep at the wheel is a legal issue as well as medical.
-
Loud gasping or choking arousals
Especially with witnessed pauses - deserves prompt sleep study.
-
Resistant high blood pressure
Needs three or more BP medications - OSA is a common hidden driver.
-
New atrial fibrillation
Untreated OSA raises AF risk and worsens outcomes - screen when new AF is diagnosed.
-
Chest pain during sleep
Any new nocturnal chest pain - urgent assessment.
-
Bed-partner concern of stopping breathing
A clear objective observation - do not brush off.
-
Very high BMI with any symptoms
Even mild symptoms with high BMI have a high pre-test probability.
-
Post-op planning
Surgery on someone with untreated OSA has higher anaesthetic risk - tell the team.
-
Excessive weight gain in a child snoring
Paediatric OSA is under-recognised - discuss with the GP.
Living with it
A long-term condition, but a very treatable one.
Four things that make the biggest difference day to day - CPAP, weight, alcohol and the DVLA question.
A quiet reminder
Adherence beats perfection.
Wearing CPAP most nights, most of the night, is what changes outcomes - not one heroic week that does not last.
- 01 CPAP
The first few weeks are the hardest
Getting the right mask and pressure takes iteration. Adherence pays off within days once it clicks.
- 02 Weight
Small losses, big effects
A 10% weight loss halves the AHI in many. Even modest change makes CPAP easier and reduces pressure.
- 03 Alcohol
It is the biggest single lever
Cutting evening alcohol has an immediate effect on the following night’s apnoeas.
- 04 Driving
Legal duty as well as medical
You must tell the DVLA if OSA is causing daytime sleepiness. Fitness to drive depends on symptoms and treatment.
Frequently asked
Everything we get asked about sleep apnoea.
Quick answers on diagnosis, CPAP, alternatives, driving and when to see a GP.
-
What is obstructive sleep apnoea?
Repeated pauses in breathing during sleep, caused by the throat narrowing or closing. It disrupts sleep and lowers overnight oxygen levels.
-
How is it diagnosed?
Usually with a home sleep study - a small device worn overnight that records oxygen, airflow and breathing effort. Some cases need in-lab polysomnography.
-
What is the AHI?
The Apnoea-Hypopnoea Index - the number of apnoeas and hypopnoeas per hour of sleep. Mild is 5-14, moderate 15-29, severe 30+.
-
Is CPAP hard to get used to?
The first weeks take iteration on mask type, pressure and humidification. Most people adapt within 4-6 weeks and feel dramatically better.
-
What is a mandibular advancement device?
A custom-made oral device worn at night that holds the lower jaw slightly forward, keeping the airway open. Useful for mild-moderate OSA when CPAP is not tolerated.
-
Does weight loss help?
Considerably. A 10% weight loss reduces AHI by around 26% on average, and can allow lower pressures or move you out of CPAP-eligible territory.
-
Do I have to tell the DVLA?
Yes if you have excessive daytime sleepiness affecting driving. Once treated and stable, you can usually continue to drive.
-
What is central sleep apnoea?
A different type where the brain fails to signal breathing muscles. Less common, more often associated with heart failure or opioid use. Diagnosed on polysomnography.
-
Can children have sleep apnoea?
Yes - often related to enlarged tonsils and adenoids. Presents as snoring, restless sleep, or behaviour problems in the day. Paediatric ENT assessment often helps.
-
When should I see a GP?
Loud snoring with any of: witnessed pauses, daytime sleepiness, morning headache, resistant high blood pressure, or new atrial fibrillation.