Obstructive sleep apnoea (OSA)

Obstructive sleep apnoea (OSA) is a chronic breathing disorder.

If you have OSA, during sleep:

• your airway becomes partly or completely blocked
• you stop breathing for short periods
• you briefly wake up when your breathing stops, which restarts your breathing

You will often be unaware of this happening.

These breathing pauses, known as 'apnoeas', can happen many times per hour. The severity of OSA depends on how many apnoeas you experience:

• Mild OSA is 5 to 14 apnoeas per hour.
• Moderate OSA is 15 to 29 apnoeas per hour.
• Severe OSA is more than 30 apnoeas per hour.

OSA can affect children and adults. Having OSA can increase your risk of other health problems.

OSA can cause symptoms while you sleep, including:

• apnoeas (pauses in breathing during sleep)
• loud snoring (vibration of your throat during sleep)
• tossing and turning
• gasping or choking
• mouth breathing
• insomnia (difficulty falling asleep or staying asleep)
• heartburn

People with OSA may:

• feel unrefreshed and tired after sleep
• experience daytime sleepiness
• wake up with a dry mouth or a headache
• feel irritable during the day
• experience depression
• have problems with attention and memory

OSA can affect anyone. Your chance of having OSA is higher if you:

• are overweight or obese
• are male or a post-menopausal female
• have a thick neck
• have large adenoids (soft tissue at the top of your throat)
• have large tonsils or a large tongue
• have a family history of OSA
• have polycystic ovarian syndrome (PCOS)

Some lifestyle factors that can increase your risk of sleep apnoea include:

• drinking alcohol
• smoking or vaping

Children can also have OSA (Opens in new tab). The main cause of OSA in children is large tonsils or adenoids, which can partially block the breathing passage.

See your doctor if you have any symptoms of OSA.

You should also see your doctor if:

• you have difficulty concentrating during the day
• having poor sleep is affecting your daily activities
• you are worried about your sleep

To diagnose OSA, your doctor:

• will ask about your symptoms
• will examine you, including checking your nose and throat
• may check your blood pressure
• may use a questionnaire called the Epworth Sleepiness Scale to work out how sleepy you feel during the day

If you share a bedroom with someone, it's a good idea to take this person with you to the appointment. They can describe your sleep and whether it's noisy or disturbed.

You may need an overnight sleep study. This involves wearing a small device overnight to monitor your:

• breathing
• oxygen levels
• sleep patterns

Some clinics do sleep studies under supervision in a sleep laboratory. Another option for some people is a home sleep study.

Your doctor may be able to refer you for a sleep study, or you may need to see a specialist, such as a sleep physician (a doctor who specialises in sleep disorders).

Treatment for OSA aims to manage your symptoms and lower your chance of related health complications.

The type of treatment will depend on how severe your OSA is and your overall health.

Self-care measures

Self-care treatments for OSA include:

• losing weight, if you are overweight
• quitting smoking and vaping
• having good sleep habits, including a regular sleep pattern
• not sleeping on your back
• limiting your use of sleeping pills

Other treatments

Treatments are also available to help keep your airways open while you are sleeping. These include:

• an oral appliance — a device fitted by your dentist that helps keep your airway open while you sleep. Your doctor may recommend an oral appliance if you have mild or moderate OSA.
• continuous positive airway pressure (CPAP) — a pump that feeds pressurised air into a mask you wear at night. Your doctor may recommend CPAP if you have severe OSA.

Your doctor may also recommend a corticosteroid nasal spray.

Surgery

Your doctor may recommend surgery if:

• you have problems with your airway, such as large adenoids or tonsils
• other treatments, such as CPAP, have not worked or are not suitable for you

Surgery can remove some tissue in your airway which helps keep your airway open while you sleep.

Talk with your doctor about which treatment is right for you.

You can help reduce your chance of having OSA by:

• maintaining a healthy weight
• limiting your alcohol consumption
• not smoking or vaping

As well as making you tired, untreated OSA can increase your risk of health problems, such as:

• high blood pressure
• heart arrhythmias (when your heart beats abnormally)
• heart failure
• stroke
• chronic kidney disease
• diabetes
• dementia

If you have untreated OSA, you may also experience:

• poor memory
• lack of concentration
• moodiness and personality change
• depression

You have a higher risk of car accidents and workplace accidents if you have OSA.

Seeing your doctor early for diagnosis and treatment can help reduce your chance of complications from OSA.

Central sleep apnoea (CSA) is when your brain does not send the right signals to control your breathing during sleep, causing apnoeas. This is different to OSA, where apnoeas are caused by a blocked airway.

CSA is a less common type of sleep apnoea. About 1 in 10 people with sleep apnoea have CSA.

CSA can be caused by anything that affects your brain, such as:

• a stroke
• heart failure
• some medicines

The Sleep Health Foundation (Opens in new tab) page offers fact sheets on topics, such as:

• sleep apnoea (Opens in new tab)
• obstructive sleep apnoea (OSA) (Opens in new tab)
• treatment options for obstructive sleep apnoea (OSA) (Opens in new tab)
• central sleep apnoea (CSA) (Opens in new tab)
• CPAP suppliers in Australia (Opens in new tab)

The Australian Institute of Health and Welfare (Opens in new tab) page has more information on sleep-related disorders in Australia (Opens in new tab).

The Sydney Children's Hospital (Opens in new tab) has information about CPAP treatment (Opens in new tab) in a range of languages.

The Australasian Sleep Association (Opens in new tab) has consumer resources on issues affecting sleep (Opens in new tab).

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.