Sleep apnoea

Sleep apnoea means breathing keeps stopping or going shallow during sleep. In the common kind, obstructive sleep apnoea, the airway at the back of the throat keeps collapsing; oxygen drops, and sleep breaks up. Evidence: solid A rarer kind, central sleep apnoea, comes from the brain not sending the signal to breathe. Evidence: solid The usual signs are snoring, someone seeing you stop breathing, and sleepiness in the day. Evidence: solid Being a man, getting older and carrying extra weight all raise the risk. Evidence: solid

It's common and mostly missed. A 2019 estimate put it at about 936 million adults aged 30 to 69 worldwide who met the lab cut-off, 425 million of them moderate to severe. Many mild cases have no symptoms. Evidence: decent In a 1997 US study of working adults, about 82% of men with moderate to severe apnoea had never been diagnosed. Evidence: decent Left alone, it causes daytime sleepiness, raises the risk of road accidents and probably raises blood pressure. Links to heart attack, stroke and diabetes are there; that it causes them isn't proven. Evidence: decent

Where it gets oversold: quick fixes. In short trials of people whose apnoea is worse on their back, side-sleeping aids cut about seven breathing stops and dips an hour compared with nothing. A CPAP machine, which keeps the airway open with air pressure, cut about six more, and it's the standard treatment. Evidence: decent Snoring alone doesn't settle it either: sleep labs see habitual snorers with and without apnoea. Evidence: decent A questionnaire can't diagnose it. The US sleep doctors' guideline says that takes a sleep study, in a lab or with a proper home test. Evidence: solid

If you snore loudly with pauses someone has noticed, wake gasping, or you're sleepy in the day despite enough time in bed, see a doctor. Evidence: solid If you've nodded off while driving, tell the doctor that too. Don't diagnose yourself.