Obstructive sleep apnoea (OSA) is a serious sleep disorder where the upper airway repeatedly collapses during sleep, causing breathing to stop for ten seconds or longer. These episodes reduce blood oxygen levels, fragment sleep, and significantly increase the risk of heart disease, stroke, high blood pressure, and daytime fatigue. OSA affects approximately 10% of Australian adults and requires specialist assessment and treatment.
Many people with OSA are unaware they have it. The condition is often first noticed by a bed partner who witnesses pauses in breathing. Key symptoms include:
OSA occurs when the muscles that support the soft tissues of the throat relax excessively during sleep, allowing the airway to narrow or close completely. Several factors increase the risk:
Anatomical factors: Enlarged tonsils and adenoids (especially in children), a large tongue base, a long or floppy soft palate, a deviated nasal septum, retrognathia (receding jaw), and a thick neck circumference all contribute to airway narrowing.
Body habitus: Obesity is the strongest modifiable risk factor. Fat deposits around the upper airway and neck increase external pressure on the airway during sleep. Even modest weight loss can significantly improve OSA severity.
Other factors: Age (risk increases over 40), male sex, family history, alcohol and sedative use, smoking, and nasal congestion all contribute. OSA can also develop or worsen during pregnancy.
At Central Sydney ENT, our surgeons follow a structured diagnostic pathway for suspected sleep apnoea:
A detailed history covers sleep quality, snoring pattern, witnessed apnoeas, Epworth Sleepiness Scale score, and cardiovascular risk factors. Clinical examination includes assessment of the nose, oral cavity, oropharynx, and neck. Flexible nasendoscopy allows direct visualisation of the upper airway to identify the level and degree of obstruction.
A sleep study (polysomnography) is essential for diagnosis. This may be conducted in a sleep laboratory or at home with a portable monitoring device. The study measures the Apnoea-Hypopnoea Index (AHI), which classifies OSA as mild (5-15 events/hour), moderate (15-30), or severe (over 30). The AHI guides treatment decisions.
Continuous positive airway pressure (CPAP) is the gold-standard treatment for moderate to severe OSA. A mask worn during sleep delivers pressurised air to keep the airway open. CPAP is highly effective but requires nightly use, and some patients find it difficult to tolerate.
For mild to moderate OSA or for patients who cannot tolerate CPAP, a custom-fitted dental device (mandibular advancement splint) repositions the lower jaw forward to open the airway during sleep.
Surgical treatment targets the specific anatomical cause of obstruction. Options include:
Weight loss, avoiding alcohol and sedatives before bed, sleeping on your side, and regular exercise can all improve OSA symptoms. These are often recommended alongside medical or surgical treatment.
You should seek specialist assessment if you experience loud snoring with witnessed breathing pauses, excessive daytime sleepiness, or if your GP suspects sleep apnoea. Untreated OSA carries serious cardiovascular risks and impairs quality of life. Early diagnosis and treatment can significantly reduce these risks.
Central Sydney ENT has six FRACS-qualified ENT surgeons across seven Sydney locations in Burwood, Campbelltown, Gregory Hills, Ultimo, Drummoyne, Hunters Hill, and Miranda.
All six of our ENT surgeons assess and manage obstructive sleep apnoea:
Ask your GP for a referral to Central Sydney ENT, or call our reception team directly.