Sleep apnoea in Australia is one of the most underdiagnosed conditions in the country. An estimated 1.5 million Australians have it, but the majority remain undiagnosed, going about their lives feeling perpetually tired, struggling to concentrate, and assuming it is just the way things are.
It is not just the way things are. Sleep apnoea is a treatable medical condition, and managing it effectively can transform quality of life in ways that most people with undiagnosed sleep apnoea cannot fully appreciate until they experience it.
The Sleep Health Foundation of Australia identifies sleep apnoea as a significant public health issue and a major contributor to daytime sleepiness, workplace accidents, and long-term cardiovascular risk in Australia.
What Sleep Apnoea Actually Is
Sleep apnoea is a condition where breathing repeatedly stops and starts during sleep. These pauses in breathing, called apnoeas, can last from a few seconds to over a minute and can occur dozens or even hundreds of times per night.
The most common form is obstructive sleep apnoea, where the muscles at the back of the throat relax too much during sleep, causing the airway to partially or completely collapse.
When the airway blocks, oxygen levels drop, and the brain triggers a brief arousal to restore breathing. The person rarely wakes up fully but the sleep architecture is profoundly disrupted.
Central sleep apnoea is less common and involves the brain failing to send the right signals to the muscles that control breathing. Complex sleep apnoea is a combination of both types.
The Symptoms That Should Prompt a Conversation With Your GP
The challenge with sleep apnoea is that the most obvious symptom, repeated breathing pauses during the night, is something the affected person is unaware of. It is often a partner, family member, or housemate who first notices something is wrong.
Loud and persistent snoring is one of the most common associated symptoms, though not everyone who snores has sleep apnoea and not everyone with sleep apnoea snores. Witnessed apnoeas, where a bed partner observes breathing stopping and restarting, are a stronger indicator.
For the person with sleep apnoea, the most common experiences include waking with a dry mouth or sore throat, morning headaches, difficulty staying awake during the day regardless of how long they slept, poor concentration and memory, irritability and mood changes, and waking frequently during the night or waking feeling unrefreshed.
In children, the signs can present differently and may include mouth breathing, bedwetting, behavioural problems, and poor school performance.
Who Is at Higher Risk
Sleep apnoea can affect anyone, but certain factors increase the likelihood significantly.
Being overweight is one of the strongest risk factors because excess tissue around the throat narrows the airway. However, sleep apnoea also affects people of healthy weight, particularly those with a naturally narrow airway, large tonsils, or certain facial structures.
Men are diagnosed with sleep apnoea at higher rates than women, though women’s risk increases significantly after menopause.
Age is a factor, with prevalence rising after middle age. Smoking, alcohol consumption, and sedative use all relax throat muscles and worsen the condition.
A family history of sleep apnoea, nasal congestion, and having a large neck circumference are also recognised risk factors.
How Sleep Apnoea Is Diagnosed
Diagnosis requires a sleep study, which monitors your breathing, oxygen levels, heart rate, and sleep stages while you sleep. Sleep studies can be done at home using a portable monitoring device or in a hospital or sleep clinic as an overnight study.
Home sleep studies are more accessible and generally sufficient for diagnosing obstructive sleep apnoea in adults. In-laboratory studies are used for more complex cases or when home testing is inconclusive.
Your GP can arrange a referral to a sleep physician or respiratory physician who will determine the most appropriate type of study.
The severity of sleep apnoea is measured by the apnoea-hypopnoea index, which counts the number of breathing disruptions per hour of sleep. Mild sleep apnoea is defined as 5 to 15 events per hour, moderate as 15 to 30, and severe as more than 30.
What Treatment Involves
The most effective and widely used treatment for moderate to severe obstructive sleep apnoea is continuous positive airway pressure therapy, known as CPAP.
A CPAP machine delivers a continuous stream of pressurised air through a mask worn during sleep, keeping the airway open and preventing apnoeas.
CPAP is highly effective when used consistently, and most people who use it regularly report significant improvements in energy, mood, concentration, and overall quality of life.
The adjustment period can take a few weeks as people get used to wearing a mask during sleep, but modern machines are quieter and lighter than earlier generations.
For mild sleep apnoea or for people who cannot tolerate CPAP, other options include mandibular advancement splints, which are custom-fitted dental devices that reposition the jaw during sleep, positional therapy for those whose apnoea is worse when sleeping on their back, and in some cases surgical intervention.
Weight loss, where relevant, can significantly reduce the severity of sleep apnoea and in some cases resolve it.
The Australasian Sleep Association provides resources on sleep disorders and can assist with finding accredited sleep physicians and sleep clinics across Australia.
The Long-Term Risks of Leaving It Untreated
Untreated sleep apnoea does more than cause tiredness. The repeated drops in oxygen saturation and disrupted sleep place sustained stress on the cardiovascular system.
Long-term risks include high blood pressure, heart disease, irregular heart rhythm, type 2 diabetes, and an increased risk of stroke.
The impaired concentration and excessive daytime sleepiness associated with the condition also significantly increase the risk of motor vehicle and workplace accidents.
Conclusion
Sleep apnoea in Australia is a common and serious condition that responds extremely well to treatment. The barrier for most people is simply not knowing they have it. If you recognise the symptoms in yourself or someone you live with, a conversation with your GP is the first step.
A sleep study, a diagnosis, and the right treatment can mean the difference between years of exhausted, impaired functioning and waking up genuinely rested. Visit medicine.com.au for more health related guides.
FAQs
1. Is sleep apnoea covered by Medicare in Australia?
GP consultations and specialist referrals are covered by Medicare. Sleep studies conducted in a hospital or accredited sleep laboratory attract Medicare rebates, as do follow-up consultations with sleep physicians. Home sleep study costs vary by provider.
2. Can children have sleep apnoea in Australia?
Yes. Paediatric sleep apnoea is most commonly caused by enlarged tonsils and adenoids. Treatment in children often involves surgical removal of the tonsils and adenoids, which resolves the condition in the majority of cases.
3. Does losing weight cure sleep apnoea?
For some people, particularly those whose sleep apnoea is closely related to excess weight, significant weight loss can substantially reduce or resolve sleep apnoea. For others, structural factors mean it persists regardless of weight.
4. How do I know if a home sleep study is accurate enough for diagnosis?
Home sleep studies are validated for diagnosing obstructive sleep apnoea in adults without significant comorbidities. They measure airflow, respiratory effort, oxygen saturation, and sometimes heart rate.
For straightforward cases they are considered clinically reliable. Your sleep physician will determine whether a home test is appropriate for your situation.
5. Can I drive if I have untreated sleep apnoea in Australia?
This is an important legal and safety question. In Australia, drivers with untreated sleep apnoea that causes excessive daytime sleepiness have a legal obligation to report their condition to the relevant licensing authority and must not drive if their sleepiness poses a risk.