Sleep apnoea living in older adults

Overview

Sleep apnoea is a condition where your breathing repeatedly stops and starts during sleep because your throat muscles relax too much, blocking your airway. This can disturb your sleep and lower oxygen levels in your blood.

Yes, sleep apnoea becomes more common as you get older, especially after age 60. However, many people do not realise they have it.

It affects both men and women, but is more common in men, people who are overweight, and those with a large neck circumference. Having a family history of sleep apnoea also raises your risk.

Symptoms

Common symptoms

• Loud snoring that may be noticed by your partner
• Gasping or choking sounds during sleep
• Waking up feeling tired, even after a full night’s sleep
• Morning headache
• Daytime sleepiness (feeling drowsy or falling asleep during quiet activities)

Symptoms in children

• This article is about older adults, so symptoms in children are not covered here.

Symptoms in older adults

• In older adults, daytime sleepiness may be less obvious and instead present as confusion, memory problems, or a fall.
• Waking often to urinate during the night (nocturia) can be a sign.
• Mood changes, such as irritability or depression, are also common.

Causes

Main causes

• The most common cause is obstructive sleep apnoea – the muscles in the back of your throat relax too much during sleep, blocking your airway.
• As you age, muscle tone naturally decreases, which can make the airway more prone to collapse.
• Excess weight, especially around the neck, puts extra pressure on the airway.

Risk factors

• Being overweight or obese
• Having a large neck circumference (over 40 cm / 16 inches)
• Smoking
• Drinking alcohol before bed
• Using sedatives or sleeping pills
• Family history of sleep apnoea
• Being male

When to see a doctor

See a doctor urgently if:

• If your partner witnesses you stop breathing repeatedly during sleep
• If you experience choking or gasping sounds that wake you up
• If daytime sleepiness is causing accidents or near-misses while driving

Book a routine appointment if:

• If you snore loudly and feel tired even after a full night’s sleep
• If you wake up with a dry mouth or headache regularly
• If you often feel irritable or have trouble concentrating

Diagnosis

A doctor will ask about your symptoms and may refer you to a sleep specialist. The most common test is a sleep study, which can be done at home or in a clinic.

Tests that may be done

• Home sleep test – you wear a device overnight to measure your breathing, oxygen levels, and heart rate.
• Polysomnography – a more detailed sleep study done in a sleep clinic, where sensors track your brain waves, breathing, and muscle activity.

What to expect at your appointment

If you have a sleep study, you will sleep as usual while the device records your breathing. The results are reviewed by a specialist, who will tell you if you have sleep apnoea and how severe it is. This usually takes a few days to a week.

Treatment

The goal of treatment is to keep your airway open during sleep so you can breathe normally. The most common treatment is a CPAP (continuous positive airway pressure) machine, which sends a gentle stream of air through a mask to keep your throat open. Lifestyle changes and other devices can also help.

Self-care at home

• Lose weight if you are overweight – even a 10% reduction can make a big difference.
• Sleep on your side instead of your back – you can use special pillows or a tennis ball sewn into the back of your pyjama top.
• Avoid alcohol and sleeping pills, especially in the evening.
• Treat nasal congestion with saline sprays or ask your doctor about allergy treatments.

Medical treatments

Doctors may prescribe a CPAP machine, which you use every night. Other options include oral appliances (like a mouthguard) that reposition your jaw or tongue, or positional therapy to keep you off your back. These are fitted by a dentist or sleep specialist. No specific drugs are used for obstructive sleep apnoea, but a doctor may treat related conditions like thyroid problems or allergies.

When is surgery considered?

Surgery is rarely the first option. It may be considered if you have a clear physical blockage that can be fixed (such as large tonsils or a narrow airway), and only after other treatments have not helped. Your doctor will discuss the risks and benefits with you.

Living with this condition

Using a CPAP machine every night can take some getting used to, but most people adjust within a few weeks. Keep the mask clean and replace parts as recommended. Make sure your bedroom is quiet and dark to help you sleep. If you travel, many CPAP machines are portable and can be taken on flights.

Lifestyle tips

• Keep a healthy weight through balanced eating and regular physical activity.
• Avoid heavy meals and caffeine close to bedtime.
• Limit screen time before bed and keep a consistent sleep schedule.
• Do not drive if you are feeling sleepy due to untreated sleep apnoea.

Diet and exercise

Aim for a balanced diet rich in fruits, vegetables, whole grains, and lean protein. Regular exercise (like walking, swimming, or cycling) helps with weight management and improves sleep quality. Even light activity can make a difference.

Mental health and emotional wellbeing

Sleep apnoea can cause frustration, anxiety, or low mood because of constant tiredness. It is common to feel irritable or find it hard to enjoy daily activities. Talk to your doctor or a counsellor if you are struggling. Remember, treating sleep apnoea often improves your mood and energy levels. If you are having thoughts of harming yourself, please call your local crisis helpline or go to an emergency department.

Prevention

You cannot always prevent sleep apnoea, especially as you age. However, maintaining a healthy weight, not smoking, limiting alcohol, and treating conditions like allergies or a blocked nose can lower your risk.

Screening programmes

Routine screening is not recommended unless you have symptoms. If you have risk factors (such as obesity or a family history), ask your doctor if you should be checked.

Complications

If left untreated

• High blood pressure (hypertension)
• Heart disease, including heart attack and irregular heartbeat
• Stroke
• Daytime sleepiness leading to road accidents or falls
• Worsening of diabetes or memory problems

Long-term outlook

With proper treatment, the great majority of older adults with sleep apnoea can lead full, active lives. Symptoms often improve quickly after starting CPAP or other therapies. The key is to get diagnosed and stick with your treatment plan.

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