Signs of Sleep Apnoea: What to Look For and When to See Your GP

Loud snoring, a partner who says you stop breathing, and mornings where no alarm seems loud enough. These are some of the signs of sleep apnoea, a common condition that most people who have it don't know about. This guide covers what obstructive sleep apnoea is, the signs to look for at night and during the day, who is most at risk, how it's diagnosed in Australia, why it makes waking up so hard, and when to see your GP.

The short answer: obstructive sleep apnoea is when your throat narrows or closes repeatedly during sleep, so your breathing stops and starts all night. The main signs are loud snoring, gasping or choking in your sleep, pauses in breathing that a partner notices, and being very sleepy during the day despite a full night in bed. Being overweight, male, middle-aged or older, drinking alcohol and having a thick neck all raise the risk. It's diagnosed with an overnight sleep study, which your GP can refer you for, and it can be treated. This guide is general information, not medical advice.

What sleep apnoea is

The Sleep Health Foundation describes obstructive sleep apnoea (OSA) as repeated episodes of narrowing or complete closure of the throat during sleep. Breathing can stop for 10 seconds up to a minute or more, and this can happen many times, even hundreds of times, overnight (source).

Each time it happens, your brain briefly rouses you to get breathing again. You usually don't remember these wake-ups. That's why many people with sleep apnoea think they slept fine, and can't work out why they feel wrecked.

Better Health Channel estimates that around 5% of Australians have sleep apnoea, and about 1 in 4 men over 30 have some degree of it (source).

Signs at night

You may not notice these yourself. A partner often does.

• Loud snoring. Healthdirect lists loud snoring and pauses in breathing that other people may notice as the two main signs (source).
• Gasping, choking or snorting as breathing restarts.
• Pauses in breathing. The Sleep Health Foundation notes that some partners try to stay awake to make sure the person starts breathing again.
• Tossing and turning and waking often during the night.
• Getting up to go to the toilet more than once a night.
• Waking with a dry mouth or a headache.

If you sleep alone, you may have no idea any of this is happening. A voice recorder app or a sleep-sounds recording can give you a rough idea of how much you snore, but it can't diagnose anything.

Signs during the day

• Sleepiness that doesn't match your time in bed. Dozing off in meetings, in front of the TV, or at traffic lights.
• Waking unrefreshed, however long you slept.
• Morning headaches.
• Poor concentration and memory.
• Irritability, low mood or anxiety.
• Low libido.

The Sleep Health Foundation points out that the signs can differ between men and women. Men more often have loud snoring and high levels of daytime sleepiness. Women more often report trouble getting to sleep and poor mood, which means it can be missed.

What a partner might notice

What your partner sees or hears	What it may mean
Snoring that stops suddenly, then a gasp	A breathing pause ending
Long silences between snores	Pauses in breathing
Restless, kicking, sweating	Repeated brief arousals
You deny snoring at all	You don't wake fully, so you don't know

Healthdirect suggests taking the person you share a bedroom with to the GP appointment, because they can describe your sleep and whether it's noisy or disturbed. If you're the partner, see how to sleep next to a snorer for getting through the nights in the meantime.

Who is most at risk

Healthdirect and Better Health Channel list these risk factors:

• Being overweight or obese.
• Being male.
• Being middle-aged or older. Throat muscles relax more with age.
• A thick neck or a narrow airway, including an undershot jaw or large tonsils.
• Alcohol, especially in the evening, and some sedative medicines.
• Smoking.
• Nasal congestion.
• Family history.

You don't have to tick every box. Slim people and women get sleep apnoea too.

Why it makes waking up so hard

If your sleep is broken hundreds of times a night, you are not getting the deep, continuous sleep your brain needs. You wake up in a fog, the alarm feels brutal, and the sleepiness doesn't lift with coffee. The Sleep Health Foundation notes that broken night-time sleep leads to less alertness, slower reaction times and poorer concentration, and that people with untreated OSA are roughly two and a half times more likely to have a motor vehicle accident.

This is why sleeping through alarms can be a symptom rather than a habit. If you've worked through why can't I wake up to my alarm and still tired after 8 hours of sleep and nothing fits, sleep apnoea belongs on the list to rule out.

Better Health Channel also notes that in Victoria, serious medical conditions that affect your driving must be reported to VicRoads. Other states have similar rules.

How it's diagnosed in Australia

1. See your GP. They will ask about your symptoms and may examine your nose and throat. Bring your partner or their notes.
2. Referral for a sleep study. Healthdirect explains this can be done under supervision in a sleep laboratory or as a home sleep study. Either way, your breathing and oxygen levels are monitored while you sleep.
3. Results. Better Health Channel describes the grading: fewer than 5 breathing interruptions an hour is normal, 5 to 15 is mild, 15 to 30 is moderate, and more than 30 is severe.
4. Treatment. For mild OSA, the Sleep Health Foundation lists weight loss, less evening alcohol and not sleeping on your back. For moderate to severe OSA, the main options are a CPAP machine, which uses a small, quiet air pump and mask, or an oral appliance fitted by a specialist dentist. Surgery is considered when those don't work.

Treatment is a conversation with your doctor. There is no wristband, app or pillow that treats sleep apnoea.

When to see your GP

Healthdirect's advice is simple: see your doctor if you or someone close to you is concerned about possible obstructive sleep apnoea. Go sooner if you snore loudly and are sleepy during the day, if a partner has seen you stop breathing, if you've nodded off while driving, or if you have high blood pressure that is hard to control. This guide is general information, not medical advice.

Where the Sovune Nudge fits

We make the Sovune Nudge, a vibrating alarm wristband, so we're not neutral. It does not treat, diagnose or prevent sleep apnoea, and nothing in this guide should delay a GP visit. Where it can help is the household around a sleep problem:

• Silent. If your partner snores and you've moved to another room, or you're on a different schedule, it wakes you with a vibration on your wrist without a sound in the house.
• Each alarm vibrates for a full minute, building through three intensity levels. Useful on mornings when your sleep has been broken and you want something felt rather than heard.
• Three separate alarms, so a backup is already set.
• Set on the band itself. No app or phone needed.
• Up to 14 days of battery per charge.

It comes with a 30-day money-back guarantee.

Quick answers

What are the first signs of sleep apnoea? Loud snoring, gasping or pauses in breathing that someone else notices, and feeling sleepy during the day even after a full night in bed.

Can you have sleep apnoea without snoring? Yes, though it's less common. Daytime sleepiness, morning headaches and waking unrefreshed are signs on their own, especially in women.

How do I get tested for sleep apnoea in Australia? Start with your GP. They can refer you for an overnight sleep study, in a sleep lab or at home.

Does sleep apnoea explain sleeping through alarms? It can. Broken sleep all night leaves you deeply tired, so alarms don't register. If you've fixed your sleep habits and still can't wake, ask your GP.

For every type of silent alarm compared, see our complete guide to vibrating alarms in Australia.

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