Obstructive sleep apnoea (OSA) is a condition in which the airway narrows or closes repeatedly during sleep, stopping your breathing for ten seconds or more at a time. Each time it happens, your oxygen level dips and your brain briefly rouses you to reopen the airway. This can happen dozens or hundreds of times a night without you being aware of it, which is why people with sleep apnoea often sleep for eight hours and wake exhausted.
It is common, affecting around one in ten adults to some degree, and most people who have it do not know. It is also very treatable.
Why it matters
Beyond the tiredness, which affects concentration, mood and driving, untreated sleep apnoea puts strain on the heart and blood vessels. It is linked to high blood pressure, heart disease, stroke, type 2 diabetes and depression. Treating it improves energy and mood within weeks and reduces those longer-term risks. If you drive, the DVLA requires that moderate or severe sleep apnoea with daytime sleepiness is declared and treated.
Who is at risk
Anyone can have sleep apnoea, but it is more common with extra weight around the neck, a small or set-back lower jaw, large tonsils, nasal obstruction, in men, and from middle age. Alcohol and sedatives make it worse. Teeth grinding is often found alongside it, as the jaw clenches to help keep the airway open.
How we assess it
The Sleep, TMJ and Bruxism Assessment looks at your airway, jaw, bite and signs of grinding, and takes a careful history of your sleep and daytime symptoms. If sleep apnoea seems likely we arrange an at-home sleep study: a small device worn overnight that records breathing, oxygen levels and sleep position, with a personalised report that tells us whether you have sleep apnoea and how severe it is. You will not need to spend a night in a sleep lab.
Treatment
For mild to moderate sleep apnoea, a custom-made mandibular advancement appliance is an effective and well-tolerated treatment. Worn at night, it holds the lower jaw slightly forward and keeps the airway open. Many patients who cannot get on with CPAP machines do well with an appliance. For moderate to severe sleep apnoea, CPAP remains the first-line treatment, and we will refer you to a sleep specialist. Weight loss, sleeping on your side, and avoiding alcohol in the evening all help whichever route you take.
