How to Fix Sleep Apnoea: Treatments & Tips

How to fix sleep apnoea is a question that affects millions of people in the UK, many of whom remain undiagnosed for years. Sleep apnoea causes breathing to repeatedly stop and start during sleep, leading to poor rest, daytime exhaustion, and longer-term health risks if left untreated. The good news is that effective treatments exist, from CPAP therapy and mandibular advancement devices to targeted lifestyle changes such as weight management and positional adjustments. This guide explains how sleep apnoea is diagnosed, what the main treatment options are, and when to seek help from your GP or an NHS sleep service.

What is sleep apnoea and how do you know if you have it?

Sleep apnoea is characterised by repeated breathing pauses during sleep, with OSA being the most common type. Diagnosis in the UK is confirmed via a sleep study, and NICE supports home sleep testing for adults with high clinical suspicion.

Sleep apnoea is a condition in which breathing repeatedly stops and starts during sleep, often without the person being aware of it. The most common form is obstructive sleep apnoea (OSA), where the muscles at the back of the throat relax and partially or fully block the airway.^[1][2] Central sleep apnoea, where the brain fails to send the correct signals to the breathing muscles, is less common and typically requires specialist evaluation, as its management differs from OSA. A third type, complex sleep apnoea, combines features of both.

The most frequently reported symptoms include:

• Loud, persistent snoring

• Witnessed pauses in breathing (often noticed by a partner)

• Waking with a dry mouth or headache

• Excessive daytime sleepiness, even after a full night in bed

• Difficulty concentrating or mood changes

Because many of these symptoms occur during sleep, people often remain undiagnosed for years. If a partner or family member has noticed that you stop breathing during the night, this is a particularly important sign to take seriously.

Severity is graded using the apnoea-hypopnoea index (AHI), which counts the number of breathing interruptions per hour of sleep. As a general guide, an AHI below 5 is considered normal in adults, 5 to 14 is mild, 15 to 29 is moderate, and 30 or above is severe, though individual sleep services may apply slightly different thresholds.^[2][3]

Diagnosis in the UK is typically confirmed through a sleep study, which may be carried out at home using a portable monitoring device or in a specialist sleep clinic. The NHS uses the Epworth Sleepiness Scale as a simple questionnaire to help assess daytime sleepiness before referral.^[1][2] NICE guidance (NG202) supports the use of home sleep testing for adults with a high clinical suspicion of OSA, making the diagnostic pathway more accessible than it once was.^[2][5] If central sleep apnoea is suspected, specialist referral is recommended, as additional investigation is usually required.

What are the main treatments for sleep apnoea in the UK?

CPAP is the NICE-recommended first-line treatment for moderate to severe OSA, with mandibular advancement devices, positional therapy, and weight management as additional options. Surgery is reserved for carefully selected cases with a clear anatomical cause.

Sleep apnoea can be effectively managed through a range of treatments, and the right approach depends on the severity of the condition and any underlying contributing factors. For mild to moderate OSA, lifestyle changes alone may produce meaningful improvement. For moderate to severe OSA, NICE (NG202) recommends continuous positive airway pressure (CPAP) therapy as the first-line treatment, and this is widely available through NHS sleep services.

Other recognised treatment options include:

• Mandibular advancement devices (MADs): Custom-fitted dental splints that hold the lower jaw slightly forward to keep the airway open. NICE recommends these as an alternative for people who cannot tolerate CPAP or who have mild to moderate OSA.^[4]

• Positional therapy: For people whose apnoea occurs mainly when sleeping on their back, devices or techniques that encourage side-sleeping can reduce episodes significantly.

• Surgery: Procedures such as uvulopalatopharyngoplasty (UPPP) or tonsillectomy may be considered in carefully selected cases where there is a clear anatomical cause and non-surgical options have not been effective or tolerated. Surgical options are generally reserved for specialist assessment and are not routinely recommended for most adults with OSA; NICE interventional procedures guidance should be consulted for specific procedures.

• Weight management: Where excess weight is a contributing factor, clinically supported weight loss can reduce the severity of OSA considerably.

Central sleep apnoea is managed differently from OSA. If central sleep apnoea is identified or suspected, a specialist sleep service will determine the most appropriate treatment, which may differ substantially from the OSA pathway described above.

Bolt Pharmacy is a GPhC-registered UK online pharmacy offering online weight-management consultations, with prescriber review and pharmacist support. Weight-management medicines are only prescribed where clinically appropriate following a consultation. This may be relevant for people whose sleep apnoea is linked to excess weight. Treatment decisions should always be made in discussion with a qualified clinician who can assess individual circumstances.

Can lifestyle changes really help fix sleep apnoea?

Lifestyle changes, particularly weight loss, can reduce OSA severity and may resolve mild cases entirely, but are rarely sufficient alone for moderate to severe disease. Avoiding alcohol, stopping smoking, and sleeping on your side are all evidence-supported measures.

Lifestyle changes can genuinely reduce the severity of sleep apnoea, and in mild cases they may resolve it entirely, though they are rarely sufficient on their own for moderate to severe disease. The evidence base for several modifications is well established, and NHS sleep services routinely incorporate lifestyle advice alongside clinical treatments.

Weight loss is the most impactful lifestyle intervention for OSA in people who are overweight or living with obesity. Excess weight, particularly around the neck and upper airway, increases the likelihood of airway collapse during sleep. Studies have shown that meaningful weight reduction can lower the AHI, which is the measure used to grade severity. NICE NG202 supports weight management as part of the overall treatment plan for OSA.

Other evidence-supported changes include:

• Avoiding alcohol, especially in the evening, as alcohol relaxes the throat muscles and worsens airway obstruction^[1][3]

• Stopping smoking, which causes airway inflammation and increases mucus production; NHS Stop Smoking services can provide support^[1][3]

• Sleeping on your side rather than your back, which reduces the tendency for the tongue and soft palate to fall backwards

• Maintaining a regular sleep schedule to improve overall sleep quality

• Treating nasal congestion, whether allergic or structural, as nasal obstruction increases the effort required to breathe during sleep

Sedating medicines, including some prescribed drugs such as opioids and benzodiazepines, can worsen OSA by relaxing the upper airway muscles.^[8][16] Do not stop or alter any prescribed medicine without first speaking to your GP or prescriber.

It is important to understand that lifestyle changes work best as part of a broader management plan rather than as a replacement for clinical treatment in moderate to severe cases. If symptoms persist despite these adjustments, further assessment and treatment remain necessary.

How does CPAP therapy work and is it right for you?

CPAP delivers pressurised air through a mask to act as a pneumatic splint, keeping the airway open and eliminating apnoea episodes. Consistent nightly use improves daytime alertness, lowers blood pressure, and reduces cardiovascular risk.

CPAP (continuous positive airway pressure) therapy works by delivering a steady stream of pressurised air through a mask worn over the nose or mouth during sleep, which acts as a pneumatic splint to keep the upper airway open and prevent the collapses that cause apnoea episodes. It is the most extensively studied treatment for moderate to severe OSA and is recommended by NICE (NG202) as the primary intervention for this group.

When used consistently, CPAP can:

• Eliminate or significantly reduce apnoea episodes

• Improve daytime alertness and concentration

• Lower blood pressure, which is often elevated in people with untreated OSA^[9][10]

• Reduce the risk of cardiovascular complications associated with long-term untreated sleep apnoea^[7][9]

CPAP machines are available through NHS sleep clinics following a confirmed diagnosis. The device is set to a pressure calibrated to the individual's needs, and modern machines are compact, quiet, and often include humidifiers to improve comfort. A range of mask styles, including nasal pillows, nasal masks, and full-face masks, are available to suit different preferences.

NHS sleep services typically offer follow-up appointments to review mask fit, check device data, and adjust pressure settings. Consistent nightly use is important to gain the full benefit; most services will review adherence and troubleshoot difficulties at follow-up. Equipment such as masks and tubing requires regular cleaning and periodic replacement, and your sleep service can advise on this.

Some people find CPAP difficult to tolerate initially, particularly due to mask discomfort, claustrophobia, or difficulty exhaling against the pressure. Auto-titrating CPAP (APAP) devices, which adjust pressure automatically throughout the night, are increasingly used and may improve comfort.^[12] If CPAP is not tolerated after a genuine trial, a mandibular advancement device or other alternatives should be discussed with your sleep specialist.

When should you see your GP about sleep apnoea?

See your GP if you or a partner have noticed breathing pauses during sleep, or if daytime sleepiness is affecting your ability to drive or work safely. Diagnosed OSA with excessive daytime sleepiness requires DVLA notification and cessation of driving until controlled.

You should see your GP about sleep apnoea if you or someone close to you has noticed repeated pauses in your breathing during sleep, or if you are experiencing persistent daytime sleepiness that is affecting your ability to work, drive, or carry out daily activities safely.

Untreated OSA is associated with an increased risk of road traffic accidents.^[13][14] If you have been diagnosed with OSA that causes excessive daytime sleepiness, you must stop driving and notify the DVLA (or DVA in Northern Ireland).^[15] You may resume driving once your symptoms are effectively controlled and you are adhering to treatment, in line with GOV.UK DVLA guidance on sleep apnoea and driving. If you are unsure whether your symptoms affect your fitness to drive, speak to your GP before getting behind the wheel.

Contact your GP promptly if you experience:

• Witnessed apnoeas (pauses in breathing observed by another person)

• Severe daytime sleepiness that is not explained by other causes

• Morning headaches occurring regularly

• Waking frequently at night, particularly with a sensation of choking or gasping

• Mood changes, poor memory, or difficulty concentrating that are affecting daily life

Your GP can complete an initial assessment, including the Epworth Sleepiness Scale, and refer you to an NHS sleep service if OSA is suspected. You do not need to wait until symptoms become severe before seeking advice.

If you experience chest pain, a racing heartbeat, or breathlessness at rest, contact NHS 111 for urgent advice, or call 999 if you believe you are having a medical emergency. These symptoms may indicate a separate cardiovascular condition that requires prompt assessment.

Suspected side effects from any medicines used in the management of related conditions, such as those prescribed for weight management, can be reported to the MHRA via the Yellow Card scheme at yellowcard.mhra.gov.uk.

Scientific References

1. Sleep apnoea.
2. Obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s (NG202).
3. Obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome – rationale and impact (NG202).
4. Obstructive sleep apnoea/hypopnoea syndrome (NG202, Chapter 1).
5. Home-testing devices for diagnosing obstructive sleep apnoea hypopnoea syndrome (DG62).
6. Automated home testing devices for diagnosing obstructive sleep apnoea – topic description (HTG735).
7. Adherence to CPAP Treatment and the Risk of Recurrent Cardiovascular Events.
8. Effects of opioid, hypnotic and sedating medications on sleep-disordered breathing in adults with obstructive sleep apnoea.
9. Effects of Continuous Positive Airway Pressure on Surrogate, Intermediate, and Functional Cardiovascular Outcomes in Obstructive Sleep Apnea: An Umbrella Review of Systematic Reviews and Meta-Analyses.
10. Does treatment of nonsleepy OSA with CPAP therapy change CVD risk? A systematic review.
11. Continuous Positive Airway Pressure Versus Mandibular Advancement Devices Impact on Cardio-Metabolic Outcomes in Patients With Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.
12. The use of auto-titrating continuous positive airway pressure for treatment of adult obstructive sleep apnea.
13. Motorists warned about dangers of untreated obstructive sleep apnoea syndrome.
14. Nasal continuous positive airway pressure (nCPAP) treatment for obstructive sleep apnea, road traffic accidents and driving simulator performance: a meta-analysis.
15. Excessive sleepiness and driving.
16. Lorazepam 1 mg tablets – Summary of Product Characteristics.
17. GLP-1 receptor agonists for obstructive sleep apnea: a meta-analysis of randomized controlled trials.
18. Psychological interventions for weight management of patients with obstructive sleep apnea syndrome: A systematic review.

Frequently Asked Questions