Her whole life, Louise Mather thought she slept well. She just couldn’t understand why she felt so exhausted all the time. “I used to put the kids to bed and then go to bed at the same time myself,” says Mather, who is based in Cheshire, UK.
“I used to cancel a lot of social engagements – I might be going to the theatre after work and find I was too tired to go.”
It was only when she remarried 10 years ago, just after turning 50, that her husband Geoff pinpointed the problem. He was being disturbed at night by Mather snoring, and, more worryingly, gasping for air.
This concerned him enough that he would find himself waiting for her to start breathing again before he could get back to sleep.
After the couple went together to talk to a doctor, tests carried out by a sleep clinic confirmed that Mather suffered from ‘moderate’ sleep apnoea, which, in her case, had probably been lifelong.
The condition was causing her to stop breathing 19 times an hour, for a minute each time.
“I was very shocked,” Mather says. “But some things about my life started to make sense.” Mather now connects her sleep disturbances to a host of other health issues that troubled her over the years. And her story is not uncommon.
In fact, worldwide, sleep apnoea is remarkably widespread – as many as one in eight people likely have it. New research, published in 2026, says that in the UK and the US this figure is more like one in five, costing both countries billions in lost productivity.
Figures are expected to climb as populations get older, and obesity – with which sleep apnoea is intimately associated – continues to rise.
It’s not that sleep apnoea is hard to diagnose. It’s more of an awareness issue, according to sleep apnoea expert Prof Atul Malhotra, from the University of California San Diego.
In 2019, Malhotra’s research showed that there were a likely 10 times more cases of sleep apnoea globally than previously estimated – at one billion, rather than 100 million.
Yet, most people with the disorder remain unaware they have it – in the UK, as many as 80 per cent of sleep apnoea cases are undiagnosed. Experts have referred to sleep apnoea as a “silent epidemic”.
In particular, the stereotypical older male with obesity may pass their symptoms off as plain old snoring. But as Malhotra puts it, “Snoring isn’t funny and it may be a sign of sleep apnoea or some more serious condition.”
What’s more, those who don’t fit the stereotype – like Mather – may find that other symptoms, such as fatigue, get overlooked because they don’t necessarily scream sleep apnoea. Some people with sleep apnoea don’t even snore.
What’s worse, sleep apnoea is linked to a number of serious health problems.
So how can you tell if you have it? And how can you take action if you do?
The secret behind the snores
If you’ve heard of sleep apnoea, you probably associate it with snoring. But the association isn’t so strong that they always go together; in fact, you can have snoring without sleep apnoea or sleep apnoea without snoring.
Really, what’s happening is that people are repeatedly stopping breathing at night.
Sometimes this sounds like snoring, while for others it’s more like long pauses between breaths, choking, gasping or snorting. Often, a partner will be able to hear something is wrong, as in Mather’s case.
You can hear what someone with sleep apnoea sleeping might sound like by listening to the following audio clip:
Those with severe cases stop breathing over 30 times an hour. That’s at least every other minute, on average. Anything less than 15 breathing gaps an hour is classed as mild.
The breathless pauses usually happen because the muscles controlling breathing become too relaxed at night, causing ‘obstructive’ sleep apnoea. In some people, though, the messages between the brain and the muscles aren’t getting through – this is ‘central’ sleep apnoea.
Sleep apnoea often comes hand in hand with obesity because excess fat around the neck adds to pressure on airways, making them more likely to close during sleep, when the muscles relax.
Whichever cause, your brain is alerted to the problem and wakes you up (even if you don’t remember this happening), often with a quick gasp for air.
For some, the breathing pauses are quieter, making sleep apnoea harder to spot and therefore more dangerous. But then, other symptoms, like daytime sleepiness, may be telltale signs.
After all, these nightly intrusions often cause daytime headaches, mood swings and difficulty concentrating. Mostly, they cause daytime sleepiness – which, according to sleep apnoea expert Dr Chris Turnbull from the University of Oxford, is different to regular tiredness.
“There’s a medical distinction,” he explains. “Tiredness has any number of causes, and most of us will experience it from time to time. But sleepiness is actually an irresistible urge to fall asleep.
"So if people are finding they can’t stay awake during the daytime [at work], that is something which is more medically suggestive of a sleep disorder.”
The health impacts can also extend far beyond sleepiness. Mather believes sleep apnoea played a role in her long-lasting depression that began postnatally, and anxiety, as well as in a previous diagnosis of type 2 diabetes.
While the connection between sleep apnoea and depression is still up for debate, diabetes is well-known to be linked – with some research showing that over half of people with type 2 diabetes have sleep apnoea. That’s partly because the dips in overnight oxygen levels impair sugar metabolism.
“Those dips are related to increased problems like heart attacks and stroke in the longer term,” Turnbull says, as they raise blood pressure and put strain on the heart.
In fact, those with sleep apnoea face a 71 per cent higher risk of heart disease and an 81 per cent higher risk of having a stroke compared to the general population.
If that’s not enough reason to take snoring, and sleepiness, more seriously, then the more immediate impact can be seen on the roads.
Left untreated, sleep apnoea can triple the risk of a traffic accident. In fact, EU legislation bars those with moderate or severe versions of the condition from driving until they deal with it.
Read more:
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- Scientists find best diet to stop loud snoring
- Here’s the best position to sleep in, according to a doctor
So you think you have sleep apnoea?
If you’re worried you have sleep apnoea, a great first step is to score your sleepiness. The Epworth Sleepiness Scale asks you about a range of situations where you might feel like dozing, such as driving or watching television. A score above 8 out of 24 indicates a potential sleep problem.
Next, go to your doctor, who can refer you to a sleep clinic for diagnosis. You’re very unlikely to have to stay overnight – most patients are sent away with a home testing kit, including a pulse oximeter (a finger clip that measures oxygen levels).
Testing kits can be cumbersome to sleep in. But some clinics are now turning to smaller and more wearable diagnostic devices, such as the AcuPebble® (a pebble-like sensor that sticks to patients’ necks) and NightOwlTM (a WiFi-enabled finger ring).
Within the next few years, it may even be possible to diagnose sleep apnoea based on data from your smartwatch. Ainhoa Osa-Sánchez’s team at the University of Deusto, in Spain, for example, is developing AI algorithms for analysing sleep data via non-medical devices like wristwatches.
Right now, as one of Osa-Sánchez’s recent studies highlights, state-of-the-art AI specifically for helping diagnose sleep problems is being incorporated into other devices too, like bracelets, patches and chest bands (though it’s not yet made it into clinics).
The technology could automate analysis normally carried out by skilled technicians and “drastically” shorten waiting lists for sleep apnoea screening, Osa-Sánchez says. “The benefit to the public healthcare system would be enormous.”
She notes that we can’t rely on the current generation of smartwatches for definitive diagnosis – but if your sleep data does make you suspicious, take the hint and follow up with a professional.
For Mather, it was a more standard kit (including finger, nose and chest sensors) that finally, in 2016, led to a diagnosis. And though that diagnosis was given “very gently” by a kind consultant, it still left her stunned.
“What? I’ve been stopping breathing my whole life?” she thought. “Why hasn’t this been picked up before?” In retrospect, Mather wonders if it was because she didn’t fit the stereotype – she wasn’t male or over 60, and she doesn’t have obesity.
As Malhotra notes, “Obesity is one factor, but it’s certainly not the whole story. There are many people who are lean who have sleep apnoea.” In fact, a recent study of nearly 13,000 US and Swiss patients found that over 23 per cent would be classed as normal or underweight.
Mather’s sleep apnoea was put down to her having ‘smaller upper airways’ – an anatomical difference that can contribute to the condition, but one that’s less obvious when someone walks into a doctor’s surgery.
After getting over her initial shock, Mather contacted UK charity the Sleep Apnoea Trust, where she received counselling and support from other sufferers. For her, this was as much an emotional journey, she says, as a source of practical advice and information.
Behind the mask
There’s more than one way to beat sleep apnoea, but the gold standard is Continuous Positive Airway Pressure (CPAP) delivered by a machine that sits next to your bed. The machine provides pressurised air via a mask that may look a little uncomfortable but is actually tolerated well by most patients.
Despite this, Turnbull says, CPAP often gets bad press.
Data from large French registries of CPAP users suggests about 48 per cent stop using their machine in the first three years – about 23 per cent within the first year. Still, Turnbull says, “that means half of people are using it pretty well.”
For Mather, her ‘dream machine’ has become part of the bedroom furniture. The idea of sleeping with a mask did initially make her feel anxious, but hospital staff put her at ease by explaining how it worked and showing her that it wouldn’t be stuck tight to her face.
“You lift it off – it’s a little bit like a hovercraft – and the ring around the outside fills with air,” she explains, “so it’s not something hard on your face.”
For those who can’t tolerate CPAP, there are still other options, including dental devices to hold the jaw forwards and the airways open. And, as a last resort, surgery to remodel the throat, mouth or nose to make it easier to breathe.
There are also tongue and throat exercises, but evidence that these work is more scant. Some regimens advise pressing the tongue to the palate or exhaling like you’re playing a didgeridoo. But while these weird workouts might not do much harm, they might not help your sleep apnoea either.
Mouth taping, a fad that’s doing the rounds on social media, is also not recommended.
Weight loss works
For those whose sleep apnoea is linked to obesity, research suggests losing weight can make a big difference.
In a 2024 study funded by pharma company Eli Lilly, Malhotra found that a 20 per cent reduction in body mass index (BMI) translated to a 57 per cent reduction in breathing pauses.
One solution, then, could be weight loss jabs, such as tirzepatide (otherwise known as Mounjaro), which Eli Lilly produces. That same year, Malhotra also led two clinical trials, again supported by the company, both hinting at the potential of weight loss drugs in sleep apnoea treatment.
In people with more severe sleep apnoea and obesity, tirzepatide reduced the number of times they stopped breathing at night by at least 20 times per hour.
As a result, tirzepatide became the first drug approved for sleep apnoea in the US. In the UK, tirzepatide is approved mainly for weight loss, but doctors may consider sleep apnoea as another reason for prescribing it.
That said, most of the benefits are thought to come from the weight loss, rather than directly from the drug.
Nevertheless, according to Malhotra, the drug is proving to be a game changer in his sleep clinics.
“Lots of patients say, ‘I’ve never felt so good’ or ‘I’ve never had so much energy’,” he says. Others simply disappear from his waiting list because their sleep problems seem to have been solved.
Meanwhile, a 2025 study by Chinese researchers suggests another weight loss drug, liraglutide (also known as Saxenda or Victoza), can also reduce breathing pauses, although by less.
This doesn’t necessarily mean any weight loss drug will do – trials making direct comparisons are still needed. And many patients don’t like the side effects.
Still, for sleep apnoea sufferers, there is certainly a growing range of treatment options. And, thanks to progress in hi-tech wearables, there may soon be new, more comfortable options to help patients track how well these treatments work.
As for Mather, she now gets seven or eight hours’ shuteye most nights and no longer has diabetes. She’s retired but has enough get-up-and-go to volunteer with the Sleep Apnoea Trust, where she is a Trustee and raises awareness of sleep apnoea by giving talks, including to medical students.
She’s even helping to set up patient volunteer groups to support overwhelmed sleep clinics.
This unexpected turnaround in her life means there’s never any hesitation about using her CPAP machine. “I still sometimes think, ‘I don’t want my husband to see me in my mask,’” she laughs. But it’s a small price to pay for a good night’s sleep.
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