What does this mean?
Breathing stopping for ten seconds or more during sleep is called an apnoea. The chest goes on making the effort, but no air passes because the soft tissues in the throat have come together. When the oxygen in the blood falls, the brain triggers a very brief awakening, the muscles tighten and the airway opens again. This cycle can repeat many times in a single night, and you usually remember none of it.
What separates this symptom from the others is that the information does not come from you. You notice snoring and daytime sleepiness for yourself; only someone who stays awake beside you can see a pause. The description is nearly always the same: the sound of snoring cuts off sharply, the chest keeps moving, and then the sound comes back with a deep gasp. This observation is the single most useful piece of information in breathing problems during sleep.
A witnessed pause strengthens the suspicion; it does not make the diagnosis. How many times the pauses repeat in a night, and how far the oxygen falls, can only be measured by a sleep study. No treatment, an oral appliance included, is planned before that measurement is made, because the same observation can correspond to anything from a mild picture to a severe one.
Breathing stopping during sleep is put down to different causes depending on the level at which the airway closes. The headings below are the conditions found most often behind a witnessed pause.
Likely causes
What helps at home?
- Ask the person who told you for detail: at what time of night the pauses happen, in which sleeping position, and how often. These notes are useful at the appointment.
- If you can, record a whole night with a simple voice recording app on your phone; the silent gaps become audible on the recording.
- If you take sleeping tablets, muscle relaxants or sedatives, do not stop them on your own decision; tell your doctor what you are taking, because these can make the pauses longer.
- Do not turn to devices sold without a sleep study; they can quieten the sound of snoring while the pauses continue, and delay the diagnosis.
- If the lips or the face are seen to turn blue during the pauses.
- If you wake at night with chest pain, palpitations or breathlessness.
- If you fall asleep during the day while driving or operating machinery.
- If your blood pressure has risen noticeably, or will not come down despite medication.
- If the pauses are seen in a child; breathing stopping during sleep is not an expected finding in a child.
Frequently asked questions
- Can I notice the pauses in my breathing myself?
- Most people do not, because the awakenings that reopen the airway are very short and do not reach the memory. What you may notice in yourself is waking up choking at night, a dry mouth in the morning and feeling unrested during the day. Reliable information still comes from a sleep study.
- Which department should I go to for a sleep study?
- Sleep studies are carried out in sleep laboratories attached to respiratory medicine, neurology or ear, nose and throat departments. A dentist can share the suspicion based on the findings inside your mouth and point you in the right direction; the diagnosis and the treatment decision belong to the sleep specialist.
- If pauses are found, which treatments are discussed?
- The option depends on the severity measured in the test. In mild and moderate cases an oral appliance may come up if the doctor considers it suitable; in more severe cases a pressurised air machine (CPAP) comes to the fore. Weight, sleeping position and clearing a blocked nose keep their importance at every level.
This content is for general information and does not replace an in-person examination. Symptoms overlap between conditions, and a diagnosis can only be made clinically.