Sleep Apnea Symptoms

Sleep apnea symptoms are easy to identify once the physiological effects and how they present are understood.

Obstructive Sleep Apnea (OSA) is a serious medical disorder where a sufferers’ breathing repeatedly stops and starts while asleep, disrupting their natural sleep cycle.

OSA is known to increase morbidity (likelihood of ill health) and mortality (likelihood of dying), with over 80% of sufferers being undiagnosed.

If you snore loudly and feel tired each morning or throughout the day (even after 8+ hours in bed), it is highly likely a latent obstructive sleep apnea (OSA) condition is the cause.

Patients with untreated OSA may have one or more of the following symptoms. The more symptoms you identify with, the more serious a potential sleep-disordered condition may be.

If you can relate to more than two of the following symptoms, check your Sleep Apnea Risk Profile for more information and recommendations. Or call us on 1300 246 637 for a free chat with a sleep health expert. We’re here to help.

Persistent Loud Snoring

Snoring is a primary tell-tale symptom of sleep apnea. However, not everyone who snores needs to see a sleep specialist. Dr Robert Owens of the Sleep Disorders Research Program at Brigham asserts "Most people who snore don't have obstructive sleep apnea, but most people who have sleep apnea snore."1

In Australia, it is estimated that 1 in 5 adults who snore have sleep apnea, with 1 in 3 of those suffering from severe obstructive sleep apnea (OSA)2 where apnea events can occur hundreds of times a night and last upward of >40 seconds at a time unknown to the sufferer. Therefore, like snoring, sleep apnea is commonly first witnessed by a bed partner, family members or friends such as while on vacation or work trips.

However, if you don't have a bed partner, other tell-tale symptoms include waking tired each morning, morning headaches or excessive daytime sleepiness3 to name only a few. (Keep reading to learn more about other sleep apnea related symptoms).

If you suspect that you snore loudly and persistently, talk to a sleep health expert or your doctor immediately. Especially if a bed partner, family member or friend mentions that you stop breathing periodically while asleep.

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Waking Tiredness

Waking to feel tired or unrested even though you have just spent the last 8+ hours in bed is a common symptom and red flag indicator of sleep apnea.

Each time an apnea event (cessation of breathing while asleep) occurs, the brain registers excessive carbon dioxide in your system, which causes the sympathetic nervous system to wake you briefly to resume breathing and restore oxygen flow.4 These brief awakenings, known as micro-arousals, disrupt your sleep cycle, reducing your sleep quality and general wellbeing.

Most OSA sufferers do not consciously experience micro-arousals who immediately fall back to sleep after an apnea event. The bed partner or family members often witness an apnea event when breathing ceases, then resumes suddenly with a cough and a gasp.

A level 1 sleep study or level 2 sleep study (polysomnogram) can accurately record the number and duration of apnea events and blood oxygen level decline during sleep, allowing an accurate diagnosis of a sufferers' potential OSA condition. Only then can appropriate treatment recommendations be prescribed to address that individual's condition, helping them to sleep normally (less than five events in an evening) while regaining health, wellbeing and vitality.

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Excessive Daytime Sleepiness

Obstructive Sleep Apnea (OSA) is a particularly significant cause of excessive daytime sleepiness5, which is a condition that leaves the sufferer feeling poorly rested after sleep with the overwhelming need to take an afternoon or daily naps regularly. 

However, many sufferers don't make the connection between excessive daytime sleepiness and sleep apnea.

Since apnea events lead to sleep disruptions while the sufferer sleeps, their quality of sleep is impacted more than the quantity. In particular, deep sleep (NREM) and rapid eye movement sleep (REM) are the sleep stages most affected, causing the most significant degree of daytime sleepiness.

"If [the sufferer] have had apnea for a long time, they may have developed compensatory mechanisms (such as sugary food, caffeine, or energy drinks to avoid an afternoon crash) and not realize how tired they are all the time"6 asserts Dr Nancy M. Holekamp, Vitreoretinal Surgeon and Associate Professor of Clinical Ophthalmology and Visual Sciences at Washington University, St. Louis.

Individuals with excessive daytime sleepiness risk increasing their chances of being involved in motor vehicle and job-related accidents and have poorer health than non-sufferers.7

Moderate daytime sleepiness (such as the desire to take an afternoon nap) doesn't necessarily mean you have sleep apnea. However, people with severe OSA are likely to doze off in the middle of meals or even during conversations.

Dr J Pagel states, "the evaluation and management of excessive daytime sleepiness are based on the identification and treatment of underlying conditions, particularly obstructive sleep apnea."8 This is especially important if you're living alone and not sharing sleeping space with someone else that would otherwise notice the apparent signs.

Complete your online Sleep Apnea Risk Profile to learn more about your potential OSA condition and how to improve your sleep health and wellbeing.

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Morning Headaches

Morning headaches for sleep apnea sufferers are caused by significant changes within the bloodstream as a result of airway obstruction and increased carbon dioxide in the system due to apnea events during sleep.

Sleep apnea headaches are usually on both sides of the head rather than just one side. Unlike some other types of headaches, sleep apnea headaches are not accompanied by nausea or sensitivity to light and sound.9

As the sufferer awakens, breathing returns to normal with the lungs moving air in and out of the lungs returning carbon dioxide levels to normal. The sleep apnea headache usually resolves within thirty minutes of awakening.

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Waking Choking or Gasping

Waking to choking or gasping for air is typically caused by an apnea event where the sufferer has stopped breathing momentarily due to a collapsed airway. The sufferers' sympathetic nervous system jolts them briefly to awaken so they can resume breathing.10

Waking while choking is consciously experienced by some OSA sufferers but not all. Most OSA sufferers are completely unaware that they have woken and immediately fall back to sleep once breathing resumes.

Furthermore, many people with OSA sleep with their mouths open, as they struggle to breathe, resulting in a dry mouth or a sore throat upon awakening the next morning.

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Trouble Concentrating

When an individual fails to get the recommended amount of sleep, concentration, coordination, memory, and mood suffer. Several studies have shown that without adequate restorative sleep, brainpower is reduced. Obstructive Sleep Apnea (OSA) typically leads to deficits in executive functions, attention, and memory.11

The average adult aged between 18-64 years requires 7-9 hours of sleep per night. It is important that this age group not receive less than six hours or more than ten hours of sleep in a night for good sleep health and wellbeing.12

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Slow Metabolism

Poor sleep quality is one of the major causes of slow metabolism. Other influencing factors include genetics, hormones, age, exercise, diet or medications.13

Metabolism refers to the body's chemical processes that regulate the body's most basic functions, such as breathing, blood circulation, digestion, and building/repairing cells. Each person's metabolism is unique to them.14

A slow metabolic rate burns fewer calories to perform the body's functions than a fast metabolic rate, which is why people with fast metabolism tend not to gain weight easily.

Research studies suggest that sleep deprivation can cause a sluggish metabolic rate due to the body saving energy as a result of loss of or poor quality sleep. Prolonged periods of sleep deprivation has been shown to slow the average metabolic process by as much as 8% over a five-week period.15

The three key ways to boost your metabolism are by getting good restorative sleep, understanding your hormones and making sure you are eating enough food.  If your metabolism is slow due to any of these factors, fixing the underlying cause will obviously help with weight control and improved sleep quality.16

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Pre or Type 2 Diabetes

Studies suggest that diabetes and sleep apnea are strongly associated with one another. Clinical research shows as many as 48% of people diagnosed with type 2 diabetes have also been diagnosed with sleep apnea.17

Even more striking, researchers believe that 86% of obese type 2 diabetic patients suffer from sleep apnea.18 Although these statistics don’t necessarily prove that diabetes causes sleep apnea (or vice versa), it’s clear that there’s a real medical connection here.

Sleeping problems are common as a result of unchecked diabetes, as the sufferer may need to urinate more frequently during the night. Whenever blood glucose levels rise, the kidneys attempt to eliminate any additional sugar by increasing urination, requiring the sufferer to get up more frequently to use the bathroom, further disrupting their natural sleep cycle.19

Compounding further, the average person with type 2 diabetes is typically overweight, which restricts the airway, reducing oxygen intake while asleep.19

If type 2 diabetes is a problem you experience, you may want to consider paying close attention to the risk factors of sleep apnea.

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According to medical experts, Nocturia, which displays as frequent nighttime urination, has links to Obstructive Sleep Apnea (OSA).

Mary Umlauf, a professor and noted nocturia researcher, said, "many healthcare providers and ordinary people think of Nocturia as a urological or gynecological problem. They don't understand that sleep apnea can cause the body to produce too much urine at night." She adds, "People who wake up to urinate shouldn't assume that "it's my prostate," or "I'm just old," she said.20

Dr Barry Krakow at the Sleep & Human Health Institute in Albuquerque, N.M. asserts, "I see patients all the time who think they're waking up to urinate because they have prostate trouble or a small bladder. About 80 percent of the time, we discover that apnea is the cause of their problem.20

Dr Vishesh Kapur, Medical Director of the Sleep Institute at the University of Washington in Seattle, has noted that Nocturia tends to occur when obstructive sleep apnea is really extreme. "When a sufferers' breathing is disrupted, it puts pressure on the heart. This, in turn, affects a hormone that normally controls urine production in the kidneys.21

Studies suggests that a common treatment for sleep apnea - positive airway pressure (PAP) therapy - can reduce symptoms of Nocturia, thereby improving sleep and preventing debilitating falls among elderly people who get out of bed at night to use the bathroom.20

If you are experiencing the effects of Nocturia, complete your Sleep Apnea Risk Profile to learn whether OSA may be a factor. Or call us today on 1300 246 637 for a cost and obligation-free chat with a sleep health expert. Otherwise, please consult your doctor immediately.

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Low Libido

Researchers examining the relationship between libido (sex drive) and Obstructive Sleep Apnea (OSA) discovered that male patients who struggle with OSA produce lower testosterone levels, leading to reduced sex drive and sexual activity, according to medical researchers at the Technion-Israel Institute of Technology.22

Furthermore, people who suffer from untreated sleep disorders can experience poor moods, mental health issues, not to mention exhaustion - robbing both partners of the desire to be intimate and the ability to have sex.

"Poor sleep may make us more selfish as we prioritize our own needs over our partner's," said Amie Gordon, lead investigator and psychologist at the University of California. Research data evaluating poor sleep and its impact on marital relationships suggest that interrupted sleep leaves couples less attuned to the needs and sensitivities of their partners.23

A practical way to remedy a poor libido can be as simple as understanding your Sleep Apnea Risk Profile and following expert advice to improve sleep quality.

"Therapeutic intervention of sleep apnea could become a recommended remedy for certain forms of sexual dysfunction," offers Prof. Rephael Luboshitzky, an endocrinologist at the Technion-Israel Institute of Technology. "It is our hope that in the future, by correcting nighttime breathing patterns, we will be able to stimulate hormone production and thereby raise libidos." 22

Having gratitude and showing that you appreciate your significant other by saying “thank you” when they do something nice will go a long way too.

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GERD (Chronic Acid Reflux)

Recent studies estimate 60 percent of people with Obstructive Sleep Apnea (OSA) have chronic acid reflux, also known as gastroesophageal reflux disease (GERD).24 GERD occurs when the lower esophageal sphincter remains open, allowing gastric acid to backflow into the esophagus.

GERD's typical signs consist of chest pain, heartburn, a sour taste in the mouth, and halitosis (bad breath). Nevertheless, it is possible to have GERD and not experience symptoms at all.25

During an apnea event, the respiratory effort of the diaphragm pulling to inspire creates a negative pressure in the chest. This negative pressure can be significant and leads to turning the esophagus into a straw pulling stomach contents up through the esophagus and throat, creating the acid burning of gastric reflux in the chest and throat.26

Researchers studying the association between GERD and OSA, while evaluating the effect of CPAP on GERD symptoms, concluded that CPAP therapy has a good role in treating both OSA and GERD symptoms.24

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Bruxism (Teeth Grinding)

Sleep bruxism involves repetitive jaw-muscle activity during sleep, often characterised by teeth (brux) grinding or clenching.27 Tooth grinding itself is not abnormal but what characterises sleep bruxism is the frequency and intensity of grinding.28

Although it is still unclear whether there is causation or only correlation, studies show that many sufferers have both obstructive sleep apnea (OSA) and sleep bruxism, with OSA being one of the main risk factors for sleep bruxism.27

Studies suggest that OSA causes sleep bruxism due to the physiological threats caused by pauses in breath (apnea event). When the respiratory tract constricts, the mouth muscles (associated with chewing) assist in reopening the airway to resume breathing.

Another hypothesis is that jaw movement aids in lubricating the back of the throat, which can dry from laboured breathing due to OSA. Nevertheless, studies suggest that sleep bruxism helps the body to protect itself from the adverse health effects of OSA.27

A study conducted with a patient who suffered from both severe OSA and sleep bruxism found that while using CPAP overnight, ‘most breathing abnormalities were eliminated and a complete eradication of the tooth grinding events was observed.’29

The results of this study suggest that when sleep bruxism is related to apnea/hypopneas, the successful treatment of these breathing abnormalities may eliminate sleep bruxism.29

If you knowingly suffer from sleep bruxism (some sufferers are unaware because sleep bruxism typically occurs during sleep), check your Sleep Apnea Risk Profile here to learn more about a potential OSA condition. Or call us on 1300 246 637 for a cost and obligation-free chat with a friendly sleep health expert. We’re here to help.

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Cardiovascular Disease

Multiple health risk factors, i.e. heart disease, hypertension, diabetes or stroke, have an accumulative effect on cardiovascular disease. The more risk factors a person has the higher the risk of developing cardiovascular disease.30

Several behaviours increase the degree of each risk factor, including an unhealthy diet, not getting enough physical activity, drinking too much alcohol and smoking.31

Untreated obstructive sleep apnea (OSA) is also a behaviour that significantly increases risk factors associated with cardiovascular disease.32 In fact, OSA is found in 47% to 83% of people with cardiovascular disease, 35% of people with hypertension, and 12% to 53% of people with heart failure, atrial fibrillation (a heart rhythm abnormality), and stroke.33

Insufficient or poor-quality sleep due to conditions like OSA denies the cardiovascular system vital healing time, increasing the incidence of risk factors such as heart disease, hypertension and stroke.31

Sleep expert Dr Phyllis Zee asserts, "good-quality sleep decreases the work of your heart as blood pressure and heart rate go down at night."34 

It's important to watch for cardiovascular symptoms and discuss any concerns with your doctor.

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High Blood Pressure

High blood pressure (hypertension) is strongly connected to obstructive sleep apnea (OSA). Research studies indicate as much as 50% of individuals struggling with high blood pressure (BP) also suffer from OSA.35

When an apnea event occurs, the upper airway constricts, causing blood oxygen levels to drop. This triggers the heart to work harder (raising BP) to pump oxygenated blood through the body.36 With time, raised BP can deteriorate your heart, blood vessels, kidneys and other parts of your body37, eventually leading to serious health problems such as cardiovascular disease.38

Research studies indicate that treating OSA can significantly improve health for those struggling with high blood pressure. One research study, led by Dr Claudia Korcarz of the University of Wisconsin's Atherosclerosis Imaging Research Program, studied the effect CPAP (continuous positive airway pressure) has on hypertension. The results revealed CPAP treatment drastically decreased high blood pressure in adults with OSA.36

The good news is that hypertension is extremely treatable by engaging in simple lifestyle changes such as following a healthy diet plan, getting 7-9 hours of quality sleep per night, and regular exercise. If your BP does not respond to lifestyle changes (or medication in some cases), undergoing a sleep test to check for an undiagnosed OSA condition is essential.36

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OSA is a common but under-recognised risk factor for stroke. OSA doubles the threat of stroke for middle-aged and older males and increases the stroke threat in middle-aged and older females.39 It is believed that men with OSA may have a higher risk of stroke because they develop OSA at a younger age than women.

When an apnea event occurs, the sufferers' airway constricts, causing oxygen levels to fall. Brain receptors are triggered that send messages to the blood vessels to increase oxygen to the heart and brain. The boost in blood circulation increases pressure on the capillary walls.39 Over time, this can lead to uncontrolled high blood pressure and a heart condition called atrial fibrillation (A-fib). Both are known cardiovascular risk factors, increasing the chances of a heart attack or stroke.40 

The threat of stroke is relative to the severity of an OSA condition. One study discovered men with moderate to severe OSA were three times more likely to have a stroke than those men suffering from mild OSA or without OSA.39

Dr Danny R. Rose Jr., a neurologist with Norton Neuroscience Institute, insists "if you or a loved one has issues with excessive daytime sleepiness, snores loudly or gasps for air during the night, you should be screened by a health care provider for sleep apnea."39

Determining the origin of your daytime sleepiness, waking tiredness and other OSA symptoms begins with understanding your Sleep Apnea Risk Profile. Our unique scientifically validated online quiz will quickly assess your potential OSA condition and provide recommendations relative to your particular results, cost and obligation-free. 

Or contact us on 1300 246 637 for a chat with a friendly sleep expert for sound reliable advice.

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  2. Types, Causes and Symptoms of Sleep Disorders. Parliament of Australia. (2021).
  3. Obstructive sleep apnea basics. Cleveland Clinic journal of medicine, 86(9 Suppl 1), 2–9. Rundo J. V. (2019).
  4. Brinkman J E; Toro F; Sharma S. (2021).
  5. PAGEL J.F.  MD, MS. (2009). Mar 1;79(5):391-396.
  6. Obstructive Sleep Apnea and the Eye: The Ophthalmologist’s Role. Stuart A. Contributing Writer. (2013).
  7. Excessive Daytime Sleepiness. Pagel J F. (2009).
  8. Clues You Might Have Obstructive Sleep Apnea. Allen A. (Archived).
  9. Sleep Apnea Headaches. Pacheco D. Medically Reviewed by Dr. Nilong Vyas. (2021).
  10. Why Do I Wake Up Gasping for Air?  Gotter A. Medically reviewed by Elaine K. Luo, M.D. (2019).
  11. Cognitive deficits in adults with obstructive sleep apnea compared to children and adolescents. Krysta K. Bratek B. Zawada K. Stepańczak R. (2016).
  12. How Much Sleep Do You Really Need? (2011)
  13. 8 Lifestyle Habits That Maybe Secretly Slowing Your Metabolism. Parsons L. (2021).
  14. Do I Have A Fast Or Slow Metabolism? McFarland S. (2016).
  15. How to lose weight with a slow metabolism.  Klamer H, RD.
  16. What Causes a Slow metabolism and How Do You Fix It?  Shellabarger B. (2016).
  17. Prevalence of sleep apnea in a population of adults with type 2 diabetes mellitus. Endocr Pract. 2007 Jul-Aug;13(4):355-62. Einhorn D, Stewart DA, Erman MK, Gordon N, Philis-Tsimikas A, Casal E.
  18. Obstructive sleep apnea among obese patients with type 2 diabetes. Diabetes Care. 2009 Jun;32(6):1017-9. doi: 10.2337/dc08-1776. Epub 2009 Mar 11. Foster GD, Sanders MH, Millman R, Zammit G, Borradaile KE, Newman AB, Wadden TA, Kelley D, Wing RR, Sunyer FX, Darcey V, Kuna ST; Sleep AHEAD Research Group.
  19. How Does Diabetes Affect Sleep? Purdie J. Medically reviewed by Lisa Hodgson, RDN, CDN, CDCES, FADCES, Nutrition. (2021).
  20. Sleep Apnea May Cause Nighttime Urination. (2009).
  21. Clues You Might Have Obstructive Sleep Apnea. Reviewed by Ratini M. DO, MS. (2014).
  22. Sleep Apnea Linked To Decreased Libido, According To New Study. ScienceDaily. American Society For Technion - Israel Institute Of Technology. (2002).
  23. Poor sleep can leave romantic partners feeling unappreciated. Anwar Y. (2013).
  24. Frequency of obstructive sleep apnea (OSA) in patients with gastroesophageal reflux disease (GERD) and the effect of nasal continuous positive airway pressure. Shaker A. Magdy M. (2016).
  25. GERD and Sleep Apnea: Which Causes the Other?
  26. Why Do I Wake Up Gasping for Air? Gotter A. Medically reviewed by Elaine K. Luo, M.D. (2019).
  27. The Link Between Sleep Apnea and Teeth Grinding. Suni E. Medically Reviewed by DeBanto J. (2020).
  28. Bruxism. Blanchet P. (2010).
  29. Sleep bruxism related to obstructive sleep apnea: the effect of continuous positive airway pressure. Oksenberg A. Arons E. (2002).
  30. Heart, stroke and vascular disease—Australian facts, AIHW, Australian Government, accessed 2021.
  31. Sleep Apnea and Heart Disease. Newsom R Medically reviewed by Truong K. (2021)
  32. Obstructive sleep apnea and cardiovascular disease: evidence and underlying mechanisms. Jean Louis G, Zizi F., Brown D B., G Ogedegbe G., Borer J S. and McFarlane S. (2009).
  33. How sleep apnea affects the heart. Harvard Medical School. Harvard Health Publishing. (2013).
  34. How Your Sleep Affects Your Heart. Boufis C. Medically Reviewed by Michael J. Breus, PhD. (2011).
  35. Sleep Apnea and Hypertension: Interactions and Implications for Management. Kapa S., Fatima H. Kuniyoshi S, and Somers V K. (2008).
  36. The Connection Between Sleep Apnea and High Blood Pressure. Sleep Center of Middle Tennessee. (2021).
  37. High Blood Pressure. American College of Cardiology. (2021).
  38. High Blood Pressure (Hypertension). Mayo Clinic. (2021).
  39. The Sleep Apnea and Stroke Connection. Martin DS. (2020).
  40. What Is Mild Obstructive Sleep Apnea? Barhum L. Medically reviewed by Michael Menna, DO. (2021).

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Great experience - Excellent communication and personal and professional service.


I didn't know I really had sleep apnea and was surprised when the sleep test and report showed how badly my sleep was being affected.


Great to deal with, very in depth and good explanations. Happy to help you work it all out!



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