Snoring is common. Stopping breathing is not.
Most snoring is harmless noise. But when breathing repeatedly pauses through the night, the body never gets the rest it is lying down for — and the consequences show up in blood pressure, in blood sugar, and in how you feel at four in the afternoon. Assessed here in Jubilee Hills by a respiratory specialist rather than treated as a nuisance.
The thing itself
In obstructive sleep apnoea — spelled sleep apnea as often as not — the throat narrows and closes as the muscles relax in sleep. Breathing stops — for ten seconds, twenty, sometimes longer — until the brain rouses just enough to reopen the airway. You gasp, you resettle, and you remember none of it. This can happen dozens of times an hour, every hour, for years.
Because it is invisible to the person it happens to, it is nearly always a partner who notices first. The patient's own experience is simply that sleep does not work: eight hours in bed and still exhausted.
Any of these sound familiar
At night
Loud snoring, gasping or choking
Particularly if someone has told you that you stop breathing, or that they have lain awake listening and waiting for the next breath.
In the morning
Waking unrefreshed, with a headache or dry mouth
Sleep that does not restore. A headache on waking that clears over the first hour is a classic pattern.
Through the day
Sleepiness you cannot explain
Dozing off while reading, in meetings, watching television — or worst of all, at the wheel in traffic. This one is not just a symptom, it is a danger.
On the chart
Blood pressure that will not settle
Hypertension that needs three or more drugs to control is a recognised reason to look for sleep apnoea. So are atrial fibrillation and type 2 diabetes that behave oddly.
Alongside the lungs
Asthma or COPD that is worse at night
Sleep apnoea and COPD together — overlap syndrome — is harder on the body than either alone, and is a particular research interest of Dr. Radhika's.
In children
Snoring, mouth-breathing, restless sleep
In children this more often comes from large tonsils or adenoids, and it can show as poor concentration or behaviour at school rather than as sleepiness.
How it is assessed
It starts, as everything here does, with the history — yours and your partner's, because they saw what you did not. Sleepiness is scored formally rather than guessed at, and the examination looks at the things that narrow an airway: weight and neck size, the nose, the tonsils, the jaw.
A diagnosis of sleep apnoea needs a sleep study. It is not something that can be settled by history alone, however typical the story. The study records breathing, oxygen levels, heart rate and sleep through the night, and produces a number — the apnoea–hypopnoea index — describing how many times an hour breathing stopped or became shallow. That number, read alongside your symptoms, is what decides whether treatment is needed and how urgently. Where a study is needed, it is arranged.
Because the airway is one organ from nose to lung, this is assessed with the rest of your breathing rather than separately. Nasal allergy that blocks you at night, asthma that flares in the early hours, and sleep apnoea frequently travel together — and treating one while ignoring another is why some patients never quite get better.
What happens if it is positive
Sleep apnoea is one of the more treatable conditions in respiratory medicine. The difficulty is rarely finding a treatment that works — it is finding one you will actually keep using.
CPAP — a small machine delivering gently pressurised air through a mask — holds the airway open through the night. It is the most effective treatment there is for moderate and severe disease, and people who get on with it often describe the change in how they feel as the most dramatic of any treatment they have had. Getting on with it is the whole game: the mask must fit, the pressure must suit you, and the first few weeks need support rather than being left to manage alone.
Weight, alcohol and sleeping position matter more than people expect, and in mild disease can be enough on their own. Mandibular advancement devices — a dental appliance that holds the jaw forward — suit selected patients with mild to moderate disease, particularly those who cannot tolerate CPAP. Surgery has a narrower role in adults than is often assumed, though in children with large tonsils it is frequently the answer.
Untreated nasal allergy makes every one of these harder, which is the other reason this sits in an allergy and lung clinic rather than away from one.
A note from Dr. Radhika
Sleep-disordered breathing was part of my training and remains part of my practice — my published work includes a study of the relationship between the apnoea–hypopnoea index and lung function in overlap syndrome, where sleep apnoea and COPD occur together.
The reason I keep raising it in a chest clinic is simple. A great many people being treated for daytime tiredness, for stubborn blood pressure, or for asthma that will not settle, have never once been asked how they sleep or whether they snore. It takes a minute to ask, and the answer changes the plan more often than you would think.
Dr. Radhika Sharma, MD (Respiratory Medicine) · Last reviewed September 2026. General information, not a substitute for consultation.