Sleep apnoea – the snoring that actually matters
Loud snoring with pauses in breathing is not just a nuisance. It raises blood pressure and stroke risk, and it is very treatable.
What separates it from ordinary snoring
In obstructive sleep apnoea the airway collapses repeatedly during sleep, stopping breathing for seconds at a time, dozens or hundreds of times a night. Each pause drops the blood oxygen and jolts the brain briefly awake — usually without the person remembering any of it.
- Loud snoring, usually with silences followed by a gasp or snort — most often reported by a partner rather than noticed by the person.
- Waking unrefreshed however many hours were spent in bed.
- Daytime sleepiness: nodding off watching television, in meetings, or at the wheel.
- Morning headaches and a dry mouth.
- Waking to pass urine repeatedly at night.
- Poor concentration, irritability and low mood.
Who gets it
- Being overweight, particularly with a larger neck circumference — the strongest single factor.
- Men more than women, though risk in women rises after menopause.
- Larger tonsils or adenoids, especially the cause in children.
- Jaw and airway shape, which is why slim people get it too.
- Alcohol in the evening, sedatives and sleeping tablets, all of which relax the airway.
- Smoking, and nasal blockage.
- An under-active thyroid.
Getting diagnosed and treated
- Mention it, ideally with whoever has heard the pauses. Partner reports are the most useful piece of information there is.
- A sleep study confirms it — in a lab or, increasingly, with a home device.
- CPAP is the main treatment: a mask delivering gentle air pressure that holds the airway open. It works extremely well, and most people who persist past the first fortnight describe it as transformative.
- A mandibular advancement device — a custom dental appliance — is an option for milder cases or those who cannot tolerate CPAP.
- Weight loss can significantly reduce or resolve it, and is worth pursuing alongside rather than instead of treatment.
- In children, removing enlarged tonsils and adenoids is often curative.
- Avoid alcohol in the evening, and sedatives or sleeping tablets unless a doctor has weighed the risk.
- Sleeping on your side rather than your back helps some people considerably.
- Treat nasal congestion, which makes everything harder.
Driving
Common questions
- I am not overweight. Can I still have it?
- Yes. Jaw and airway anatomy, large tonsils, nasal obstruction and, in women, menopause all contribute. Slim people with sleep apnoea are frequently dismissed and go undiagnosed for years.
- Is CPAP uncomfortable?
- The first week or two takes adjustment, and mask fit is the usual reason people give up — it is worth persisting and asking for a different mask rather than abandoning it. Most long-term users report sleep and daytime energy they had forgotten was possible.
- Will losing weight cure it?
- It can significantly improve or resolve it in people whose weight is the main driver, but it takes time and does not help everyone. Treat it now and pursue weight loss alongside, rather than deferring treatment.
Sources
- Primary Healthcare Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
- Adult Primary Care guideNational Department of Health, South Africa
Last reviewed 4 August 2026.