If you are waking up tired every day, it generally means you are not getting enough restorative sleep. This could be due to a temporary issue that’s interfering you’re your sleep or an underlying health condition.
Common reasons for persistent tiredness and fatigue
Common causes of tiredness and fatigue include: insomnia; stress, depression or bereavement; hormonal changes such as menopause; or illnesses that make it hard to sleep at night (coughs, colds, flu and viruses, for example).
However, it could also be the result of an underlying health condition. If you’re experiencing persistent tiredness without an obvious cause, it could be time to seek medical advice. Tiredness and fatigue may be due to a condition like: diabetes (particularly if it’s accompanied by feeling thirsty and needing to wee a lot); overactive thyroid (which may also make you feel nervous, irritable or fidgety); anaemia (which can lead to low energy, pale skin and heart palpitations) or sleep apnoea (which causes you to wake repeatedly during the night).
When to seek medical advice
It’s important to get your symptoms checked if your symptoms are persistent or worsening, if they are affecting your quality of life or if you suspect you might have an underlying medical condition. Early evaluation can confirm, diagnose and guide the most appropriate treatment.
In this article we will be taking a closer look at sleep apnoea – what it is, how to identify the symptoms and when to seek medical advice.
What is sleep apnoea?
Sleep apnoea leads to normal breathing being repeatedly interrupted during sleep. People with the condition – which is often caused by some kind of obstruction in the airway – stop beathing for up to 20-30 seconds throughout the night. You may be unaware that you have sleep apnoea, but waking up tired every day or having morning headaches or poor concentration can be an indicator.
Types of sleep apnoea
Obstructive sleep apnoea occurs when the throat narrows, blocking the flow of air into the lungs. As the throat walls relax, they block the airway. This can cause loud snoring, choking or gasping. A drop in the oxygen levels in your blood triggers you to wake up briefly to breathe. You may not remember waking, but these constant interruptions to your sleep throughout the night prevent you from dropping into a deep sleep and leave you feeling constantly tired during the day. This is the most common form of sleep apnoea.
Central sleep apnoea is caused by the brain failing to send proper signals to the muscles that control the breathing due to issues with your respiratory control centre, which is linked to your central nervous system. Central sleep apnoea most often affects people with neuromuscular diseases like amyotrophic lateral sclerosis, as well as those with heart failure or other forms of heart, kidney or lung disease. People who’ve had a stroke are also at risk and it can be linked to hormone levels, ageing or opioid use.
Complex sleep apnoea is a combination of obstructive and central sleep apnoea. The condition begins as obstructive sleep apnoea but develops into central sleep apnoea during treatment for the former.
Symptoms of sleep apnoea
If you are always tired, it could be a sign of sleep apnoea. Other symptoms include:
- Loud and persistent snoring
- Jolting awake gasping or choking
- Waking up with a headache or dry throat
- Your partner telling you that you experience interruptions to your breathing when you are asleep
- Falling asleep during the day, having trouble concentrating or experiencing bouts of forgetfulness
- Feeling anxious or low
Not everyone with sleep apnoea will have all these symptoms and their severity can vary. If you have mild sleep apnoea, you typically experience 5-15 episodes of breathing interruption per hour. Moderate sleep apnoea causes 15-30 episodes per hour, while more than 30 episodes is categorised as severe.
Diagnosing sleep apnoea
During a diagnosis, your doctor or respiratory consultant will ask about your symptoms and health history. They may suggest wearing a breathing monitor while you are asleep to track your breathing patterns, heart rate and blood oxygen levels. Subsequently, you may be invited to a sleep clinic where you will be connected to sensors that assess brain, heart and lung activity as well as the movements of your arms and legs.
Treating sleep apnoea
A sleep apnoea mask worn over your face at night to deliver air directly into your airways. With a continuous positive airway pressure (CPAP) machine, the mask covers your nose and mouth and blows air directly into your airways. A bilevel positive airway pressure (BPAP) machine delivers a greater force as you inhale which works better for some people. With central sleep apnoea you may need a combination of extra oxygen while you sleep, alongside treatment for any underlying conditions.
Treatments for sleep apnoea will vary depending on what type you have and how severe it is. Possible treatments include:
An oral appliance is preferred by some people with sleep apnoea. These include a sleep mouth guard or tongue retaining device.
Devices to alter the way you sleep are sometimes used to encourage you to sleep on your side rather than your back which can help prevent airway obstruction.
Surgery for sleep apnoea
Surgical options for treating sleep apnoea include:
- Uvulopalatopharyngoplasty (UPPP) to remove excess tissue from the throat
- Genioglossus advancement to reposition the tongue muscle attachment
- Maxillomandibular advancement to reposition the jaw
If you are always tired and concerned that you might have sleep apnoea, contact us for advice about diagnosis and treatment.
Frequently Asked Questions
What causes sleep apnoea?
Anyone can be affected by sleep apnoea however you might be more prone to the condition if you are overweight or have a large neck circumference which can make your airways narrower. People are also at increased risk if they have a narrowed airway, enlarged tonsils or adenoids. Men are more likely to have the condition than women and it is more common in older people. Smoking, drinking alcohol and using sedatives or tranquilisers all increase your risk, as does nasal congestion or a family history of the condition. Sleep apnoea is associated with certain health conditions, including type 2 diabetes, Parkinson’s disease and PCOS.
Is sleep apnoea dangerous?
Sleep apnoea is associated with an increased risk of long-term health conditions that could shorten your lifespan. It causes persistent tiredness that puts you at increased risk of accidents and can seriously impact your quality of life.