Sleep apnoea is when your breathing stops and starts while you sleep. The main signs are breathing that stops and starts, gasping, snorting or choking noises, loud snoring, waking a lot, and feeling very tired in the day. See a GP if you have these signs. They may refer you to a sleep clinic for overnight tests. Many people need a CPAP machine on the NHS. Untreated sleep apnoea can leave you exhausted, which often makes arthritis pain and concentration feel worse. Do not take sleeping pills for this unless a doctor recommends them — the NHS says they can make sleep apnoea worse.
This page covers one job: recognising NHS sleep apnoea signs, knowing how referral works, and linking daytime tiredness to how pain feels. For positions, pillows and a wind-down routine, hand off early to our how to sleep with arthritis guide and arthritis and sleep problems checklist.
NHS signs to watch for
Symptoms mainly happen while you sleep:
- breathing that stops and starts
- gasping, snorting or choking noises
- waking up a lot
- loud snoring
In the day you may feel very tired, find it hard to concentrate, have mood swings, or wake with a headache. It can be hard to notice yourself. Ask a partner, carer or family member to listen for pauses and gasping. Bring them to the GP if you can.
See a GP — do not wait for a perfect sleep diary
The NHS says see a GP if you have the main signs: breathing that stops and starts, gasping or choking noises, or always feeling very tired in the day. Sleep apnoea can be serious if it is not diagnosed and treated. It has been linked to high blood pressure, a higher chance of stroke, type 2 diabetes, heart disease, mood changes and a higher chance of serious accidents from tiredness, including car accidents.
Before the appointment, note what others hear at night, how sleepy you feel driving or sitting still, morning headaches, and your arthritis medicines. Loud night pain or toilet trips can coexist with sleep apnoea — treat both. Our sleep and pain diary still helps the GP see the pattern.
Sleep clinic tests and treatment in plain words
If a GP thinks you might have sleep apnoea, they may refer you to a specialist sleep clinic. You may be given devices that check breathing and heartbeat overnight, usually at home, sometimes in the clinic. Severity is based on how often your breathing stops (the AHI score).
Mild sleep apnoea sometimes improves with lifestyle changes such as losing weight if you need to, stopping smoking, cutting alcohol (especially before bed) and sleeping on your side. Many people need a CPAP machine, which gently pumps air into a mask over your nose, or nose and mouth, while you sleep. The NHS provides CPAP free if you need it. It can feel strange at first; tell your team if the mask is uncomfortable. Other options sometimes used include a gum-shield-style device, surgery in selected cases, or mouth and face exercises — your sleep team decides.
Do not take sleeping pills unless a doctor recommends them. The NHS says they can make sleep apnoea worse. If night sedation is already part of your plan, ask for a review — see our sleeping tablets and falls guide.
Why this matters when you have arthritis
- Broken nights raise next-day pain sensitivity, fatigue and flare frustration — see our pain–sleep cycle guide
- Daytime sleepiness makes paced exercise, physio and cooking harder, which can shrink your activity range
- Night gasping plus stiff joints raises toilet-trip and fall risk; keep a night light and clear path
- Steroids can disturb sleep on their own; take them as your team advises (often morning) and never stop them yourself — see steroids and infection
- Weight, neck size, alcohol and sleeping on your back are linked to sleep apnoea; ask your team before big diet or exercise changes in a flare
Driving and sleepiness
You may need to tell the DVLA about your sleep apnoea. If sleep apnoea with excessive sleepiness has been confirmed, you must not drive until symptoms like feeling very tired are under control. Check the GOV.UK rules with your GP or sleep clinic. This is a safety rule, not a judgement.
While you wait for assessment
- Keep the wind-down and joint-support habits in our how-to-sleep guide and sleep positions guide
- Settle night pain with your usual plan; see the night pain toolkit
- Try side-sleeping if your joints allow; ask physio or OT about pillows that protect hips and shoulders
- Do not start pharmacy sleep aids to "knock yourself out" — they can worsen apnoea and falls risk
- If worry keeps you awake after pain settles, ask about CBT for insomnia (NICE has recommended Sleepio as an option) via your GP
When to get urgent help
- Call 999 for severe breathlessness, chest pain, sudden confusion or collapse
- Contact NHS 111 if you are unsure how urgently you need help
- See a GP promptly for loud snoring with pauses, gasping, or daytime sleepiness that affects driving or work
Frequently asked questions
Is snoring always sleep apnoea?
No. Many people snore without sleep apnoea. See a GP if snoring comes with breathing pauses, gasping or choking, or you are always very tired in the day.
Will CPAP hurt my arthritis or neck?
CPAP is about keeping your airway open. Mask fit and pillow height matter. Tell the sleep clinic if neck, jaw or shoulder arthritis makes a mask painful — they can adjust the interface.
Can arthritis medicines cause sleep apnoea?
Sleep apnoea has many causes. Some medicines and alcohol can worsen it. Never stop prescribed arthritis medicines yourself; ask your GP or pharmacist to review the whole list.
Sources and further reading
- NHS: Sleep apnoea
- NHS: Insomnia
- NHS: Falls
- GOV.UK: Sleep apnoea and driving
- NICE MTG70: Sleepio to treat insomnia and insomnia symptoms
Educational information for people in the United Kingdom — not a diagnosis or personal medical advice. Charity no. 1218461. Pending clinical review. Everyone's situation is different, so always follow the advice of your own GP, pharmacist or rheumatology team. If you feel very unwell, call 999 or go to A&E. For urgent advice, contact NHS 111.
Continue with related help
- How to sleep with arthritis — tonight's routine
- What keeps you awake — checklist including apnoea
- Poor sleep and arthritis pain — diary for the GP
- Sleeping tablets and falls — why sedation is risky
- Sleep positions — joint support
- Night pain toolkit — settle pain first
- Arthritis fatigue — when tiredness lasts
- Falls prevention — safer nights
- Flare-up guide — when nights worsen