Obstructive Sleep Apnoea
Your throat narrows or closes many times a night, pausing your breathing. Loud snoring, gasping and daytime sleepiness are the clues. A sleep study confirms it, often at home.
The sleep apnoea ladder
Mild sleep apnoea can start at the bottom. Moderate to severe usually goes straight to CPAP, with the lifestyle steps alongside. Medicare covers a sleep study if a screening questionnaire shows you’re at risk.
- Step 1 · Self-careWeight loss, less alcohol, no smokingIf you’re above a healthy weight, losing weight is the biggest lever you control.
- Works
- Each 10% of body weight lost cuts breathing pauses by about a quarter; sometimes cures it
- Cost
- Free (or the cost of support programs)
- How long
- Months; keep it up
- Watch for
- Alcohol within 3 hours of bed, sleeping tablets and opioids relax the throat and make it worse
The nightcap is doing your throat no favours.
- Step 2 · Self-careSleeping on your sideHelps if your apnoea happens mostly on your back. A positional device or backpack trick can keep you there.
- Works
- About 7 fewer breathing pauses an hour than no treatment in back-only apnoea; less than CPAP, and many stop using devices
- Cost
- Free, or about $50–300 for a device
- How long
- Every night
- Watch for
- Doesn’t help if your apnoea happens in every position
The old tennis-ball-in-the-pyjamas trick, now with a price tag.
- Step 3 · Allied healthCPAP (continuous positive airway pressure)A quiet machine blows air through a mask to keep your throat open. The most effective treatment for moderate to severe sleep apnoea.
- Works
- Stops breathing pauses in almost everyone while worn; daytime sleepiness improves and blood pressure drops a little (about 2–3 points)
- Cost
- About $1,000–3,000 to buy, or about $60–120 a month to hire. Masks about $150–300
- How long
- All night, every night, long term
- Watch for
- Dry mouth, mask leaks, sore nose. A well-fitted mask and humidifier fix most problems
It only works when it’s on your face, not in the cupboard.
- Step 4 · Allied healthMouth splint (mandibular advancement splint)A custom mouthguard from a dentist with sleep training that holds your lower jaw forward.
- Works
- Roughly halves breathing pauses in mild to moderate apnoea; less than CPAP, but people often use it more
- Cost
- About $1,500–3,000 for a custom splint; some private health cover
- How long
- Every night; check it works with a follow-up sleep study
- Watch for
- Jaw ache, drooling, tooth movement over years. Pharmacy ‘boil and bite’ devices work less well
The fallback for people who’d rather wear a mouthguard than a mask.
- Step 5 · PrescriptionTirzepatide injectionA weekly weight-loss injection approved in Australia for moderate to severe sleep apnoea in adults with obesity.
- Works
- Cut breathing pauses by about half to two-thirds over a year (dummy treatment about 5–6%), mainly through weight loss
- Cost
- Not PBS-subsidised for this: about $300–600 a month
- How long
- Weekly, long term; benefit fades if stopped
- Watch for
- Nausea, vomiting, diarrhoea, constipation. Not in pregnancy
Pricey and weekly, but it treats the weight and the breathing together.
- Step 6 · ProcedureSurgery or a nerve stimulator implantTonsil and adenoid removal is the main treatment for children with large tonsils. For adults: throat or jaw surgery, or a tongue-nerve stimulator, after sleep specialist review.
- Works
- Children: sleep study normal in about 8 in 10 after tonsil surgery vs 5 in 10 waiting. Adults: mixed results in selected people
- Cost
- Specialist and hospital fees vary widely; private cover helps
- How long
- Weeks of recovery
- Watch for
- Pain, bleeding, and results that may fade in adults
For the few, not the first try.
Save your money
Popular, heavily marketed or often asked about, but the evidence is weak or says no.
- Mouth tapingLittle evidence it helps, and it may be risky if your nose is blocked. A social media trend, not a treatment.
- Anti-snoring spraysNo good evidence they treat sleep apnoea. They may quieten the noise while the breathing pauses carry on.
- Nasal strips and dilatorsCan reduce snoring a little, but don’t treat sleep apnoea. Silence is not the same as oxygen.
- ‘Anti-snore’ pillowsNo good evidence beyond helping you sleep on your side, which a cheaper trick can do.
- Boil-and-bite mouthguardsLess effective and less comfortable than a custom splint from a dentist. Cheap now, wasted later.
What you can do
- Don’t drive when sleepy. Take a break every 2 hours on long trips, and pull over if you feel drowsy.
- Treat a blocked nose: it makes CPAP and sleep easier.
- Give CPAP a few weeks: most people need time to get used to it. Ask your provider about mask fit and a humidifier.
- Tell your driver licensing authority if sleep apnoea affects your driving. Most people can keep driving once treated.
See your GP if
- You snore loudly, stop breathing or gasp in your sleep, or wake unrefreshed
- You feel sleepy during the day, especially while driving
- You have high blood pressure that’s hard to control, heart rhythm problems or type 2 diabetes
- A child snores most nights, breathes through their mouth, or has trouble with behaviour or concentration
Stop driving and see your GP soon if you have nodded off at the wheel or had a crash or near miss from sleepiness. Call 000 for chest pain, severe breathlessness, or if someone can’t be woken.
Common questions
What are the signs of sleep apnoea?
Loud snoring, breathing pauses or gasping noticed by a partner, waking unrefreshed, morning headaches and daytime sleepiness.
How is sleep apnoea diagnosed?
With a sleep study, often done at home. Medicare covers the study if a screening questionnaire shows you are at risk.
Are there alternatives to CPAP?
A custom mouth splint from a dentist suits mild to moderate sleep apnoea. Weight loss, sleeping on your side and, for adults with obesity, tirzepatide injections can also help.
Can I drive with sleep apnoea?
Don’t drive when sleepy. Tell your driver licensing authority if sleep apnoea affects your driving. Most people can keep driving once treated.
Is sleep apnoea dangerous?
Untreated moderate to severe sleep apnoea raises the risk of high blood pressure, atrial fibrillation, stroke and car crashes from sleepiness. Treatment improves daytime sleepiness and lowers blood pressure a little, so it’s worth getting checked.
Can losing weight cure sleep apnoea?
It can greatly improve it. Losing about 10% of body weight reduces breathing pauses by roughly a quarter, and some people with mild sleep apnoea no longer need treatment. It may not fully fix it if jaw shape or airway size also play a part.
Does snoring always mean sleep apnoea?
No. Many people snore without sleep apnoea. Snoring with gasping, pauses in breathing, waking unrefreshed or daytime sleepiness makes sleep apnoea more likely and is worth discussing with your GP.
Helpful resources
- CPAP: making it work for you (Sleep Health Foundation)Practical tips for getting used to CPAP and sticking with it. Free.
- Certified CPAP supplier directoryAustralian CPAP suppliers that meet the Sleep Health Foundation’s code of practice. Free to search, Australia.
Evidence and more information
- Austroads: Assessing fitness to drive, sleep disorders
- AJGP: Management of obstructive sleep apnoea in primary care (2024)
- Sleep Health Foundation: TGA approves tirzepatide for OSA
- Healthdirect: Obstructive sleep apnoea
- Sleep Health Foundation: Obstructive sleep apnoea
- Cochrane: Positional therapy for obstructive sleep apnoea
- Malhotra et al, NEJM 2024: tirzepatide for sleep apnoea (SURMOUNT-OSA)
- Marcus et al, NEJM 2013: tonsil surgery for childhood sleep apnoea (CHAT)
- Peppard et al, JAMA 2000: weight change and sleep apnoea
maladywise.com/sleep-apnoea/