Obstructive sleep apnoea (OSA) is one of the most common conditions I see in my practice — and one of the most underdiagnosed. Many people spend years feeling exhausted, foggy, and unwell without ever realising that the problem is happening while they sleep.
What Is Obstructive Sleep Apnoea?
OSA occurs when the muscles in the throat relax during sleep, allowing the soft tissue to partially or completely block the airway. This causes breathing to stop — sometimes for 10 seconds, sometimes for a minute or more — before the brain registers the drop in oxygen and rouses the body just enough to reopen the airway.
These events can happen dozens or even hundreds of times per night. Most people have no memory of them in the morning.
Common Symptoms
The classic symptom is loud snoring, often reported by a bed partner. But OSA is much more than snoring. Common symptoms include:
- Excessive daytime sleepiness — falling asleep during the day, struggling to concentrate
- Waking unrefreshed — despite sleeping a full night
- Morning headaches
- Frequent waking or insomnia
- Nocturia (needing to urinate overnight)
- Mood changes, irritability, or low mood
- Reduced libido
In children, OSA can also present differently — with behavioural problems, poor school performance, or mouth breathing.
Who Is at Risk?
OSA can affect anyone, but it is more common in:
- Men (though women’s risk increases significantly after menopause)
- People who are overweight or obese
- Those with a large neck circumference
- People with anatomical features such as a recessed jaw, large tonsils, or narrow airway
- Smokers and those with significant alcohol use
- Patients with hypothyroidism, acromegaly, or other metabolic conditions
How Is It Diagnosed?
A sleep study (also known as a polysomnogram) is required to diagnose OSA. There are two main types:
Home sleep (also know as ambulatory) study (Level 2 study): A portable device is worn overnight in your own bed. It measures basic brain activity, eye movements, oxygen levels, airflow, cardiac rhythm and respiratory effort. This is suitable for most patients with a straightforward presentation.
In-laboratory polysomnography (Level 1 study): A full overnight study conducted in a sleep laboratory, with more intensive monitoring of brain activity, eye movements, muscle tone, heart rhythm, oxygen levels, and breathing. This provides the most detailed information and is recommended for more complex cases or in certain clinical situations.
We provide the full suite of sleep diagnostic testing at our facility at South Brisbane.
Treatment Options
The good news is that OSA is very treatable. Options include:
CPAP therapy (Continuous Positive Airway Pressure) is the gold standard treatment for moderate to severe OSA. A machine delivers a gentle flow of air through a mask worn during sleep, keeping the airway open. Modern CPAP devices are quieter, smaller, and more comfortable than older machines — and most patients adapt to them well.
Mandibular advancement splints (MAS): Custom-fitted dental devices that hold the jaw slightly forward, widening the airway. These are an option for mild to moderate OSA or for patients who cannot tolerate CPAP.
Positional therapy: Some people have OSA predominantly when sleeping on their back. Position aids can help these patients.
Weight loss: For patients with obesity-related OSA, weight reduction can significantly reduce disease severity — sometimes to the point where CPAP is no longer required.
Surgery: In selected patients with specific anatomical abnormalities, surgical options may be considered.
Why Treatment Matters
Untreated OSA has consequences beyond feeling tired. It is associated with:
- Increased risk of cardiovascular disease, including hypertension, atrial fibrillation, and stroke
- Type 2 diabetes and metabolic syndrome
- Motor vehicle accidents due to impaired alertness
- Reduced quality of life, relationship strain, and occupational consequences
Effective treatment can reverse many of these risks and make a dramatic difference to how patients feel and function.
When to See a Specialist
If you or your partner have noticed loud snoring, witnessed breathing pauses during sleep, or you are experiencing significant daytime sleepiness — speak with your GP. A referral to a respiratory and sleep physician allows for proper assessment and, if OSA is confirmed, expert guidance on the most appropriate treatment.
If you have been referred and would like to make an appointment, please contact my rooms on 07 3123 5350.