Understanding Sleep Apnoea Through Nick’s Experience
When Nick went camping in the summer with friends, he always set up his tent about 100 meters away from the group. “It became a bit of a tradition,” he reflects. From his teenage years, he used humor to navigate what he thought was just a nuisance: the “cacophony” of his snoring.
It wasn’t until 2019, at the age of 37, that he discovered it was more than just an annoyance. A doctor’s visit revealed an “alarming” blood pressure reading, despite his active lifestyle and healthy eating habits. He started piecing together other troubling signs he had been ignoring, like persistent, uncontrollable tiredness during the day, which led to groggy moments in meetings and on public transit.
When Nick, who prefers to use his first name only, underwent a sleep test, he saw a device next to the bed: a CPAP machine, which stands for Continuous Positive Airway Pressure. This device uses gentle pressure to keep the airways open while someone sleeps.
The technician informed him that the study was simply observational and that the machine was there just in case his condition worsened, which Nick found somewhat disappointing. He wanted to try it out before drifting off to sleep.
An hour later, the lights came on, along with the mask. The attendant explained that they didn’t even need microphones to listen in from their desk 30 paces away; they could hear everything clearly.
Nick was diagnosed with severe obstructive sleep apnoea, a condition where the throat muscles relax excessively during sleep, leading to periods of shallow breathing or complete breathing cessation.
“Snoring and sleep apnoea exist on a bit of a continuum,” notes Dr. Linda Schachter, a sleep and respiratory physician and member of the Sleep Health Foundation board. “Snoring is a partial obstruction, and as it worsens, you can develop sleep apnoea,” she adds.
Humans have sought practical solutions to snoring for centuries. Ancient Egyptian medical texts suggested thyme, while during the American War of Independence, cannonballs were sewn into the uniforms of snoring soldiers to keep them off their backs.
However, interest from the medical community in sleep apnoea is relatively recent, according to Peter Cistulli, a professor of sleep medicine at the University of Sydney. Early in his career, he remembers treating sleep apnoea as a rare disorder, with the only option being a tracheostomy to allow breathing to bypass the nose and mouth.
Nowadays, less invasive treatments exist, and advancements in sleep measurement technology, combined with increased awareness of sleep disorders, have led to a growing demand for sleep services. Cistulli, who is president-elect of the World Sleep Society, notes that while sleep medicine’s popularity has been growing slowly, there’s been a “rapid” increase in interest, partly fueled by consumer tech that monitors sleep.
Interestingly, Cistulli’s mentor, Prof. Colin Sullivan, invented the CPAP machine, which was first commercially sold by ResMed, an Australian company that has seen its value quadruple over the past decade.
Nick’s first experience with the CPAP mask during the sleep test allowed him to sleep for four hours. “The energy and clarity I felt waking up were beyond anything I could remember,” he says. This first glimpse of uninterrupted sleep marked a significant turning point for him.
Initially, CPAP machines were mainly prescribed for people with severe sleep apnoea. However, Dr. Schachter observes an increase in prescriptions for milder cases as the medical community becomes more aware of the condition and its symptoms.
The devices even have celebrity endorsements, with Amy Poehler and Jack Black praising CPAPs for significantly reducing snoring. Some users on Reddit claim these machines have even saved their marriages.
However, Dr. Donald Lee, a respiratory and sleep physician, cautions that some retailers, both pharmacies and online vendors, sometimes market CPAP machines like consumer gadgets.
Thanks to the rise of sleep-tracking wearables, “orthosomnia”—a term denoting anxiety over achieving a perfect night’s sleep—has become a concern, according to Cistulli.
While CPAP therapy is generally safe when set correctly, Schachter warns that if the pressure is too high, it may lead to discomfort, such as swallowing air and subsequent burping—or worse, it might disrupt sleep or interfere with breathing altogether.
“There’s often a misconception that snoring is benign,” says Cistulli.
Lee likens CPAP machines to a “vacuum cleaner turned backward,” which can feel uncomfortable and claustrophobic. He notes that people are motivated to use these cumbersome devices only when they genuinely feel better afterward.
Surprisingly, sleep apnoea isn’t just affecting the stereotypical profile of an overweight, middle-aged man who drinks often; Cistulli mentions an increasing number of younger individuals and women experiencing more subtle forms of the disorder.
Schachter emphasizes that women have historically been under-treated for sleep apnoea. They might be diagnosed with a milder condition based on fewer recorded breathing episodes, yet they often display more significant fatigue symptoms.
Moreover, there’s a growing acknowledgment of “upper airways resistance syndrome,” where symptoms do not fully meet the criteria for sleep apnoea but still disturb sleep and cause frequent awakenings, according to Schachter.
There’s a consensus among experts that snoring warrants medical attention. “To prevent sleep apnoea, we should probably address problematic snoring early on,” Cistulli believes.
Even if someone doesn’t have sleep apnoea but merely snores, Schachter suggests they still face potential health risks. Some studies have even indicated an association between snoring and stroke, although Lee suggests more comprehensive studies are needed to validate these connections.
Beyond health implications, snoring can impact relationships. If a partner’s sleep is disrupted by snoring, it certainly deserves attention, according to Schachter.
If a sleep test shows no sleep apnoea but only snoring, treatment with a CPAP would be uncommon unless the person experiences significant symptoms or has upper airways resistance syndrome. She notes that plenty of treatments exist beyond CPAP, including mouthguards, nasal dilators, and weight-loss solutions if applicable.
Such treatments often form the first line of defense for mild to moderate sleep apnoea, Lee adds. If anyone struggles with any aspects of their health, they should definitely consult their doctor.
Nick likens using a CPAP to finally getting glasses after years of gradually losing eyesight. Having relied on the CPAP for many years now, he considers it “not a big deal.”
“In a world of trade-offs, this is no contest,” he states. “Self-care is appealing.”
