Sleep apnoea symptoms are easy to miss, because the main ones happen while you're asleep. This guide covers the signs in adults, at night and during the day, how sleep apnoea differs from ordinary snoring, how the NHS tests for it, and what to do next. It's based on NHS, NICE and Asthma + Lung UK guidance.
What sleep apnoea is, in one paragraph
Obstructive sleep apnoea (OSA) is when the airway in your throat narrows or closes during sleep as the muscles relax, so your breathing repeatedly drops (a hypopnoea) or stops (an apnoea). Each time, your brain pulls you out of deep sleep just enough to start breathing again. On a sleep study, NICE defines an apnoea as a complete pause in breathing lasting 10 seconds or more. Asthma + Lung UK says OSA affects about 1 in 20 people, and the Sleep Apnoea Trust cites estimates that up to 4 million adults in the UK have moderate or severe OSA. You usually have no memory of the interruptions, so you may not know you have it.
Sleep apnoea symptoms at night
The NHS lists these as the main signs while you sleep:
- Breathing that stops and starts.
- Gasping, snorting or choking noises.
- Waking up a lot during the night.
- Loud snoring.
NHS inform, the Scottish NHS site, adds noisy or laboured breathing, night sweats, and waking often to pee. Because you're asleep when it happens, a partner, friend or relative is often the first to notice. If you share a bed, ask whether they've ever heard you stop breathing.
Sleep apnoea symptoms during the day
- feeling very tired or sleepy during the day
- waking up unrefreshed
- finding it hard to concentrate, or forgetting things
- mood swings
- a headache when you wake up
Not everyone with sleep apnoea feels sleepy. NICE tells clinicians not to rely on a sleepiness score alone when deciding whether to refer, because some people with OSA don't have excessive daytime sleepiness. The NICE committee says broken sleep, insomnia and fatigue should also be recognised as possible signs, including in people who aren't sleepy.
Sleep apnoea symptoms in adults: who is more likely to have it
Asthma + Lung UK lists these risk factors:
- being very overweight
- being older (usually over 60) or male
- a large neck (over 40.6cm, which is 16 inches)
- a narrow airway, or a set-back lower jaw or chin
- large tonsils or adenoids
- family members with sleep apnoea
- smoking, drinking alcohol, or sleeping on your back
- the later stages of pregnancy
- other conditions, including COPD, asthma and Down's syndrome
NICE also asks doctors to be aware that OSA is more common in people with treatment-resistant high blood pressure, type 2 diabetes, atrial fibrillation, a previous stroke, heart failure, polycystic ovary syndrome or an underactive thyroid. And the Sleep Apnoea Trust says that, although the person most at risk was once thought to be an overweight, middle-aged man, younger and slimmer men, women and children are increasingly being diagnosed too.
Snoring vs sleep apnoea: how to tell the difference
Snoring is the sound of relaxed tissue in your mouth, throat or nose vibrating as you breathe. The NHS says it's common and usually not caused by anything serious. Sleep apnoea is when that same relaxed airway closes or nearly closes, so breathing is interrupted. Snoring is one of its signs, but it's the other signs that separate the two.
| Snoring on its own | Possible sleep apnoea | |
|---|---|---|
| At night | Snoring, with regular breathing | Loud snoring with pauses in breathing, then a gasp, snort or choke |
| Your sleep | You sleep through | Waking a lot; waking unrefreshed |
| During the day | You feel fine | Very tired or sleepy, poor concentration, morning headaches, mood swings |
| What to do | Self-help first: sleep on your side, cut down on alcohol, lose weight if you need to | See your GP |
NICE tells doctors that one symptom, such as snoring, isn't enough on its own to investigate; two or more features together should prompt an assessment. That's guidance for doctors, not a reason to wait: the NHS says to see a GP if you have any of the main symptoms, such as breathing that stops and starts, gasping or choking noises, or always feeling very tired during the day.
Check your daytime sleepiness: the Epworth scale
NICE asks clinicians to use the Epworth Sleepiness Scale when they assess suspected sleep apnoea, and you can fill it in yourself before your appointment. It asks how likely you are to doze off in 8 everyday situations, such as sitting and reading, watching TV or lying down to rest during the day. Scores run from 0 to 24, and Asthma + Lung UK says a total of 11 or more might suggest you're unusually sleepy during the day.
Two caveats. The scale measures sleepiness, not sleep apnoea, so it can't tell you on its own whether you have it. And a low score doesn't rule it out, for the reason above. Take your score to your GP either way.
How the NHS tests for sleep apnoea
- See your GP. Bring someone who has seen your symptoms if you can. Your GP will ask about your sleep and may check your blood pressure or take a blood test to rule out other causes of tiredness, such as an underactive thyroid or anaemia.
- Questionnaires. Usually the Epworth scale, and sometimes the STOP-Bang questionnaire, which estimates your risk from your symptoms, your weight and your blood pressure.
- Referral to a sleep clinic. NICE asks sleep services to see some people faster: for example, people who drive for a living, work in jobs where alertness is critical for safety, are pregnant, have unstable heart problems or are about to have major surgery.
- A sleep study, usually at home. NICE recommends home respiratory polygraphy for suspected OSA. You take monitoring equipment home, such as an oxygen sensor on your finger and bands around your chest, and bring it back the next day. It records your breathing, oxygen level, heart rate, snoring and sleeping position. An overnight stay at the sleep centre is rare.
- Your result. Severity is based on the apnoea-hypopnoea index (AHI), the number of breathing pauses and drops per hour of sleep. The NHS uses mild for an AHI of 5 to 14, moderate for 15 to 30, and severe for over 30.
Why it's worth acting on the symptoms
The NHS says sleep apnoea needs treating because, left alone, it can lead to high blood pressure, stroke, type 2 diabetes and heart disease, depression or mood changes, and accidents caused by tiredness, including car crashes.
Driving. GOV.UK says you must tell the DVLA if you have confirmed moderate or severe OSA with excessive sleepiness, or any sleep condition, including suspected or confirmed mild OSA, that has caused excessive sleepiness for at least 3 months. You must not drive until the sleepiness is gone, or your symptoms are under control and you're following any treatment you need. You can be fined up to £1,000 for not telling the DVLA about a condition that affects your driving. If you're unsure, ask your doctor; the full rules are on GOV.UK.
Treatment. The NHS says losing weight, stopping smoking and drinking less alcohol can sometimes be enough. But many people need CPAP, a machine that gently pumps air into a mask while you sleep to stop the airway getting too narrow; it's free on the NHS if you need it. Other treatments the NHS says are sometimes used include a mandibular advancement device (a mouthpiece like a gum shield), surgery such as removing large tonsils, exercises for the mouth and facial muscles, and hypoglossal nerve stimulation, which uses an implanted device.
Quick answers to common questions
Does snoring mean I have sleep apnoea?
Not on its own. The NHS says snoring is usually not caused by anything serious. See your GP if lifestyle changes aren't helping, if your snoring has a big effect on you or your partner, or if you're sleepy in the day, stop breathing in your sleep, or gasp or choke at night.
Does snoring cause sleep apnoea?
The NHS describes the link the other way round: snoring is sometimes caused by sleep apnoea. Both involve the airway relaxing and narrowing during sleep. In snoring, the tissues vibrate; in sleep apnoea, the airway closes or nearly closes, and breathing is interrupted.
Do women get sleep apnoea?
Yes. The Sleep Apnoea Trust says women are increasingly being diagnosed, Asthma + Lung UK lists the later stages of pregnancy as a risk factor, and NICE lists polycystic ovary syndrome among the conditions where OSA is more common. The NICE committee also had concerns that the STOP-Bang questionnaire may be less accurate in women. Don't let "it's a man's condition" stop you seeing your GP.
Can an Apple Watch detect sleep apnoea?
Some recent Apple Watch models track breathing disturbances during sleep and can send a notification of possible sleep apnoea if these are elevated more often over a 30-day period. Apple says the feature looks for signs of moderate to severe sleep apnoea, isn't intended to replace talking to your doctor for a diagnosis, and isn't meant for under-18s or people already diagnosed. Treat a notification as a reason to see your GP, and see your GP anyway if you have the warning signs on this page.
Is sleep apnoea treated on the NHS?
Yes. Your GP can refer you to a specialist sleep clinic, and CPAP is free on the NHS if you need it. NHS inform notes that mouthpieces (mandibular advancement devices) aren't always available on the NHS, so some people pay for one privately through a dentist.
Where Respivea Pro fits
Respivea Pro is for snoring, not for sleep apnoea. It's a small, cordless device worn under the chin on an adhesive patch, and it uses gentle electrical stimulation of the muscles under the chin while you sleep, aimed at snoring. No mask, no mouthpiece, no machine; it charges in its own case, and each patch lasts up to 3 nights.
If you recognise the warning signs on this page (pauses in breathing, gasping or choking, real daytime sleepiness), see your GP first. A quieter night is not proof that your breathing is normal. If you've been prescribed CPAP, talk to your clinic before changing anything.
If you snore and none of those signs apply to you, Respivea Pro is £69 (was £139) with free UK delivery, a 4-month supply of patches (40) in the box and a lifetime device warranty. It usually arrives 7–10 days after dispatch (occasionally up to 12). The 100-night money-back guarantee asks you to use it 45 nights in a row first, then ask within 100 days of delivery; the refund goes back to your original payment method, and you don't need to send the device back.
Related: Can an anti-snoring device help sleep apnoea? · Maskless sleep apnoea devices in the UK
Respivea Pro is not a medical device and does not diagnose, treat or cure sleep apnoea. If you have been prescribed CPAP, talk to your clinic before changing anything.