Ajax Harwood Clinic
Sleep apnoea
In obstructive sleep apnoea the muscles holding the throat open relax during sleep and the airway narrows or closes, so breathing repeatedly pauses. Each pause ends in a brief arousal that you almost never remember — which is why sleep can be badly fragmented all night and simply feel like not sleeping well.
Get help straight away if
These are uncommon, but they need same-day care — go to an emergency department, do not wait for an appointment.
- Falling asleep, or nearly falling asleep, while drivingStop driving and contact us. This is the one symptom that can kill someone else, and it is treatable — but it needs dealing with now rather than at the next appointment.
Contact us promptly if
Not an emergency, but worth being seen sooner rather than waiting it out.
- Someone has seen you stop breathing, gasp or choke in your sleep
- Waking with chest pain, or with your heart pounding irregularly
- Falling asleep during the day when you did not intend to — in meetings, watching television, mid-conversationDifferent from being tired. Sleepiness that overrides you is what we are looking for.
What usually happens
It is not a snoring problem. Snoring is the noise the narrowing makes, and plenty of people snore without apnoea — the thing that matters is the pauses, the drop in oxygen and the repeated arousals, none of which are audible as anything in particular.
You are the last person to know you have it. The arousals are too brief to reach memory, so people report sleeping straight through while their partner has been awake half the night counting the pauses. If someone shares your bed, their account is the single most useful piece of history.
The reason to treat it is not only how you feel. Untreated sleep apnoea raises blood pressure, contributes to atrial fibrillation and worsens diabetes control, and treating it can make blood pressure that has been stubborn for years finally move.
Weight matters but does not explain everyone. Plenty of people with sleep apnoea are not overweight — jaw and airway shape, nasal obstruction, alcohol and some medications all contribute — so it is worth testing rather than assuming.
The main treatment takes some getting used to and many people give up in the first weeks. Most problems with it are fixable — mask fit, pressure, dryness, claustrophobia — so a bad first fortnight is a reason to come back rather than to stop.
At your appointment
We will ask about daytime sleepiness in situations rather than in general, and about what your partner has noticed, because both are more informative than how tired you feel.
A sleep study, usually one you do at home, which records breathing and oxygen overnight. It is the only way to know whether this is apnoea and how severe.
We will look at blood pressure, heart rhythm and blood sugar at the same time, since these travel together.
If treatment is started, we will follow up early rather than at six months, because the first few weeks decide whether people stay with it.
Worth asking
- How severe is mine, and does that change the treatment?
- Am I safe to drive in the meantime?
- What can be done if I cannot tolerate the mask?
- Would treating this help my blood pressure?
Curious what your doctor is weighing up? The clinical tool we use for sleep apnoea is open to anyone — it is detailed and written for clinicians, and you are welcome to read it.
Open the clinician reference →General health information for Ajax Harwood Clinic patients and the public — not medical advice, and not a substitute for seeing your own doctor. In an emergency call 911.