For many adults, quiet nights hide breathing glitches with daily costs.
Sleep apnoea can strike without the tell-tale drone. Repeated pauses in breathing disrupt oxygen, fracture sleep architecture, and strain the cardiovascular and cognitive systems. Many people wake unrefreshed, brush it off as stress, and carry on while risks mount. The absence of noise does not equal the absence of danger.
Why silent sleep apnoea hides in plain sight
Obstructive sleep apnoea involves brief, repeated collapses of the upper airway during sleep. Breathing stops or narrows for seconds, often many times per hour. Oxygen dips. The brain triggers micro‑arousals to reopen the airway. These tiny awakenings fracture deep sleep and REM cycles. The person often has no memory of them.
Without snoring, partners miss the signs. The sleeper hears no warning either. By morning, the damage shows as foggy thinking, irritability, and flat energy. Over months, blood pressure creeps up. Heart rhythm can wobble. Weight control becomes harder. For some, the first clue is a near‑miss at the wheel after a sudden wave of drowsiness.
No snoring does not rule out sleep apnoea. Daytime clues often tell the real story.
Nine overlooked signs to watch this week
Look for a cluster rather than one symptom in isolation. Patterns matter more than one bad night.
- Unstoppable daytime sleepiness, especially during meetings, at the wheel, or while watching TV.
- Morning headaches that lift within an hour of getting up.
- Dry mouth or a sore throat on waking, hinting at mouth breathing overnight.
- Repeated trips to the loo at night (nycturia), without bladder or prostate disease.
- Palpitations or night sweats with no clear trigger.
- Blood pressure that stays high despite medication adjustments.
- Memory lapses, slow focus, or short fuse during the day.
- Night‑time acid reflux or a sour taste that disturbs sleep.
- Jolting awake with a gasp, or a bed partner noticing pauses in your breathing even if you don’t snore.
What these clues may be telling you
| Sign | What it often signals | What you can try this week |
|---|---|---|
| Morning headaches | Overnight oxygen dips and restless sleep | Track frequency across 7 mornings; note sleep duration and quality |
| Daytime sleepiness | Fragmented sleep and reduced REM | Aim for a steady 7–9 hour window; log dozing episodes and triggers |
| Night‑time loo trips | Hormonal shifts during apnoeas increasing urine production | Count awakenings; reduce late fluids after dinner by modest amounts |
| Palpitations or sweats | Stress responses to repeated arousals | Note timing and co‑symptoms; reduce alcohol near bedtime |
| Reflux at night | Pressure swings in the chest during obstructed breaths | Elevate the head of the bed by 10–15 cm; avoid late heavy meals |
When to speak to your GP and what to expect
Book an appointment if several signs persist for two or more weeks. Seek help sooner if drowsiness hits while driving or operating machinery. Bring a sleep diary, a list of medicines, and any home blood pressure readings.
Your GP may use brief questionnaires about sleepiness and snoring history, then arrange a sleep study. Many people start with a home test that records breathing, oxygen levels, heart rate, and snoring. Some cases need a night in a sleep centre for full polysomnography, which also tracks brain waves and limb movements.
Making sense of the numbers
Results often include the apnoea–hypopnoea index (AHI): the number of breathing events per hour of sleep.
- Mild: 5–14 events per hour.
- Moderate: 15–29 events per hour.
- Severe: 30 or more events per hour.
Reports may list the oxygen desaturation index (ODI) and the lowest oxygen level reached. Lower nadirs and higher AHI/ODI signal greater strain on the heart and brain.
Treatment options that actually work
Therapy depends on anatomy, severity, and personal goals. Continuous positive airway pressure (CPAP) keeps the airway open with a gentle airflow. For many, it restores alertness within days and improves blood pressure control within weeks. Oral appliances that advance the lower jaw help where the airway is narrow behind the tongue, especially in mild to moderate disease. Targeted weight loss of 5–10% can cut AHI meaningfully in people with overweight. Nasal sprays help when congestion narrows the nose. Positional trainers reduce events in people whose apnoea worsens on their back.
Treatment lowers risks linked to hypertension, stroke, heart rhythm problems, and driving incidents. Better sleep sharpens thinking and lifts mood.
Who is at risk even without snoring
Risk spans body types and ages. A slim person with a small jaw can have a collapsing airway. Women may present with fatigue, mood changes, and insomnia more than dramatic snoring. Risk rises after menopause. Alcohol near bedtime and sedatives relax airway muscles. Nasal allergies and a blocked nose push people to mouth‑breathe, which worsens collapse. Family history matters. So do conditions like type 2 diabetes, hypothyroidism, and polycystic ovary syndrome.
What you can do tonight
- Keep a regular sleep window and target 7–9 hours in bed.
- Avoid alcohol and heavy meals in the three hours before bedtime.
- Sleep on your side; a simple pillow behind the back helps you stay off your back.
- Clear the nose with saline before bed if congestion is common.
- Move daily; even 20–30 minutes of brisk walking improves sleep depth across the week.
- Measure blood pressure at home for a fortnight, morning and evening, and share readings with your GP.
- Use a sleep diary. Note wake‑ups, toilet trips, headaches, and dozing episodes.
- Ask a partner to watch for pauses in breathing, gasps, or restlessness on two separate nights.
- Use audio recording if you sleep alone. Apps can capture breathing patterns, though they do not diagnose disease.
Extra context that helps you plan
Many people worry about living with equipment. Modern CPAP devices are quiet and compact. Fit matters more than pressure. A well‑fitted mask prevents leaks and boosts comfort. Most users need a few adjustments in the first month. Good humidification cuts dry mouth. Cleaning takes minutes. Jaw‑advancing devices need dental assessment to protect the bite and gums.
Driving safety deserves attention. If daytime sleepiness affects driving, pause driving and speak with your GP. Treatment that restores alertness reduces crash risk to near‑background levels. Some professions have specific fitness‑to‑drive rules, so clarify what applies to you.
Understanding the metrics helps you stay engaged. Ask for your AHI, ODI, oxygen nadir, and time below 90% oxygen. Track weight, waist size, and blood pressure alongside sleep data. Small gains stack up. A 5% weight drop, one extra hour of sleep, and side‑sleeping can turn a rough night into a good one while you progress toward definitive therapy.
