preventing breathing

Overview

Apnea is a medical term for a pause in breathing that lasts at least 10 seconds. The most common type is sleep apnea, where a person repeatedly stops breathing during sleep. This can lower oxygen levels in the body and disrupt sleep, making you feel tired and putting strain on your heart and brain.

Yes, sleep apnea is very common. Experts believe around 1 in 5 adults has at least mild sleep apnea, and it can also affect children.

Sleep apnea can affect anyone, but it is more likely in people who are overweight, older, male, or have a family history. Central sleep apnea, where the brain fails to send the right signals to breathe, is less common and often linked to heart failure, stroke, or certain brain conditions.

Symptoms

Common symptoms

• Loud snoring, often with long pauses and then a gasp or choke
• Waking up suddenly with a feeling of gasping or choking
• Excessive daytime sleepiness, even after a full night's sleep
• Morning headache or dry mouth
• Difficulty concentrating or remembering things
• Irritability, mood changes, or depression

Symptoms in children

• Snoring or noisy breathing during sleep
• Restless sleep and frequent waking
• Bedwetting, especially if they were previously dry at night
• Mouth breathing or a dry mouth in the morning
• Daytime behavioral problems, such as hyperactivity or inattention
• Poor performance at school

Symptoms in older adults

• Memory problems or confusion
• Balance problems and falls
• Worsening heart failure or high blood pressure
• Daytime fatigue that limits daily activities
• Waking up often at night

Causes

Main causes

• Obstructive sleep apnea: muscles at the back of the throat relax too much during sleep, blocking the airway
• Central sleep apnea: the brain doesn't send proper signals to the muscles that control breathing
• Mixed apnea: a combination of obstructive and central apnea, often seen in infants or people with certain medical conditions

Risk factors

• Overweight or obesity, especially with extra fat around the neck
• A narrow airway, large tonsils, or a recessed jaw
• Smoking or drinking alcohol, especially before bed
• Using sedative medications or sleeping pills
• Heart failure, kidney failure, or a previous stroke
• Being male, though risk rises for women after menopause
• Being over age 40
• A family history of sleep apnea

When to see a doctor

See a doctor urgently if:

• You, or someone else, see that you stop breathing during sleep for long periods (20 seconds or more)
• You feel very sleepy during the day and are at risk of falling asleep while driving or working
• A child has symptoms that are getting worse or affecting their school day

Book a routine appointment if:

• You snore loudly and often wake up gasping or choking
• You feel unrefreshed after a full night's sleep and tired during the day
• Your partner is concerned about your breathing during sleep
• You have high blood pressure, type 2 diabetes, or heart disease and also have any sleep apnea symptoms

Diagnosis

Your doctor will ask about your sleep history, how you feel during the day, and any health conditions. They will also examine your mouth, nose, and neck. If they suspect apnea, they'll refer you for a sleep study.

Tests that may be done

• Sleep history questionnaire and symptom diary
• Physical exam, including measuring your neck and checking blood pressure
• Overnight sleep study (polysomnography) at a sleep centre or with a home monitoring device

What to expect at your appointment

A sleep study is painless. You'll be monitored for breathing, oxygen levels, heart rate, and brain waves while you sleep. If you do a home study, you'll wear a small device overnight. Results are usually available within a couple of weeks.

Treatment

Treatment depends on the type and severity of apnea. For obstructive sleep apnea, the most common and effective treatment is continuous positive airway pressure (CPAP), which keeps your airway open with gentle air pressure. Lifestyle changes also play a key role. Central sleep apnea is treated by addressing the underlying cause, such as heart failure or adjusting medications.

Self-care at home

• Lose weight if you are overweight – even a 5% reduction can make a big difference
• Sleep on your side instead of your back
• Avoid alcohol, heavy meals, and sleeping pills before bed
• Quit smoking if you smoke
• Keep a consistent sleep schedule and make your bedroom calm and dark

Medical treatments

Your doctor may prescribe a CPAP machine, which delivers a steady stream of air through a mask to keep your airway open. Other options include custom-fitted mouth appliances, nasal valves, or an implanted device that stimulates the nerves that control breathing. Medications are being researched, but none are currently approved specifically for apnea. Always talk to your healthcare provider about the options that are right for you.

When is surgery considered?

Surgery may be considered if your apnea is caused by enlarged tonsils, a blocked nose, or a jaw problem, and if other treatments haven't worked. A specialist will discuss the possible benefits and risks with you. Surgery is rarely the first choice but can help certain people.

Living with this condition

Using CPAP regularly can improve your energy, mood, and concentration. It may take a week or two to get used to. If your mask feels uncomfortable, ask your equipment provider to adjust it. Staying consistent is the key to seeing results.

Lifestyle tips

• Set a fixed bedtime and wake-up time, even on weekends
• Create a relaxing bedtime routine, like reading or gentle stretching
• Keep your bedroom quiet, dark, and slightly cool
• Avoid screens for at least 30 minutes before bed
• Exercise regularly, but not too close to bedtime

Diet and exercise

A balanced diet and regular physical activity can help you maintain a healthy weight and strengthen your upper airway muscles. Losing just 5–10% of your body weight, if needed, can reduce the severity of sleep apnea. Aim for moderate exercise like brisk walking or swimming for at least 150 minutes per week.

Mental health and emotional wellbeing

Living with untreated apnea can make you feel irritable, anxious, or low. Poor sleep affects your emotions and ability to cope. Treating apnea usually improves these symptoms. If you still feel down or anxious, talk to your doctor – there are effective treatments for mental health problems too.

Prevention

You can lower your risk of obstructive sleep apnea by staying at a healthy weight, avoiding alcohol before bed, not smoking, and treating nasal congestion. However, some risk factors like your anatomy or a family history can't be changed. Central sleep apnea is less preventable because it's often linked to other medical conditions.

Vaccines

There is no vaccine that prevents apnea. However, staying up to date with regular vaccines, like flu and pneumonia vaccines, can help you avoid infections that can temporarily make breathing problems worse.

Screening programmes

There is no routine screening for apnea in the general public. If you have symptoms or risk factors, your doctor may recommend a sleep study. Some health systems offer questionnaires to help spot potential cases.

Complications

If left untreated

• High blood pressure, heart attack, or irregular heartbeat
• Type 2 diabetes
• Stroke
• Daytime drowsiness that raises your risk of car crashes or work accidents
• Memory problems and difficulty concentrating

Long-term outlook

With the right treatment, most people feel more energetic, think more clearly, and lower their risk of serious health problems. Some people improve enough with lifestyle changes that they no longer need a CPAP machine. Even for those who need ongoing treatment, adapting is easier than you might think – and the benefits are well worth it. Your healthcare team will help you find a plan that works for you.

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