What is Sleep Apnoea?
Sleep apnoea occurs when breathing repeatedly stops and starts during sleep. (American Academy of Sleep Medicine, 2014). These interruptions can lead to fragmented sleep and reduced oxygen levels, affecting both physical and mental health.
There are two main types:
- Obstructive Sleep Apnoea (OSA): caused by collapse or blockage of the upper airway
- Central Sleep Apnoea (CSA): caused by reduced or absent signals from the brain to breathe
OSA is the most common form, accounting for the majority of cases (Benjafield et al., 2019).
Sleep apnoea can significantly impact quality of life, contributing to daytime fatigue, reduced concentration, and increased health risks if left untreated (Benjafield et al., 2019).
Why it happens
In obstructive sleep apnoea, the airway becomes partially or completely blocked during sleep due to relaxation of throat muscles. This leads to reduced airflow and oxygen levels.
The brain responds by briefly waking the individual to restore breathing. These awakenings are often not remembered but can occur many times per night, leading to poor sleep quality (American Academy of Sleep Medicine, 2014).
Causes and Risk Factors
Sleep apnoea is associated with several risk factors:
- Excess body weight
- Narrow airway anatomy
- Alcohol consumption
- Smoking
- Sleeping on the back
- Nasal congestion
Central sleep apnoea is more commonly associated with conditions such as heart failure, stroke, and neurological disorders (American Academy of Sleep Medicine, 2014).
Common Symptoms
Symptoms of sleep apnoea may include:
- Loud snoring
- Pauses in breathing during sleep (often noticed by others)
- Waking with dry mouth or sore throat
- Morning headaches
- Daytime fatigue
- Difficulty concentrating
- Irritability or low mood
- Nocturia (frequent urination at night)
Not everyone who snores has sleep apnoea, but persistent snoring should be assessed.
Health Effects
Untreated sleep apnoea is associated with increased risk of:
- High blood pressure
- Cardiovascular disease
- Stroke
- Type 2 diabetes
- Daytime sleepiness and accidents
These risks highlight the importance of proper diagnosis and management (Benjafield et al., 2019).
When to Seek Help
Medical assessment is important if there are:
- Loud snoring with witnessed breathing pauses
- Excessive daytime sleepiness
- Morning headaches
- Poor concentration
- Waking with choking or gasping
Diagnosis is typically confirmed through a sleep study (polysomnography) (American Academy of Sleep Medicine, 2014).
Treatment Options
Management depends on severity and underlying causes.
Lifestyle Strategies
- Weight management
- Reducing alcohol intake
- Smoking cessation
- Sleeping on the side
Medical Treatment
- CPAP (Continuous Positive Airway Pressure) is the gold standard treatment for moderate to severe OSA
- Oral appliances may be used in selected cases
- Surgery may be considered in specific situations
These treatments aim to maintain airway patency during sleep.
Can Acupuncture Help Sleep Apnoea?
Acupuncture has been explored as a supportive therapy for sleep apnoea, particularly for symptom management and sleep quality.
A systematic review and meta-analysis by Evidence-Based Complementary and Alternative Medicine (Li et al., 2019) suggested that acupuncture may improve sleep-related outcomes in patients with obstructive sleep apnoea. However, the authors noted variability in study quality and methodology.
Some randomised controlled trials, such as Liu et al. (2018), reported improvements in sleep parameters in patients receiving acupuncture compared with control groups. Earlier trials, including Liu et al. (2017), also suggested potential benefits.
However, it is important to interpret these findings cautiously:
- Many studies have small sample sizes
- Study designs vary
- Acupuncture does not replace standard treatments such as CPAP
Overall, current evidence suggests acupuncture may play a supportive role, but it is not a primary treatment for sleep apnoea.
Where Acupuncture May Fit in Sleep Apnoea Care
When considering sleep apnoea, it is helpful to separate the condition into two components.
The first is the mechanical airway issue, where airflow is reduced or blocked during sleep. This is why treatments such as CPAP remain the primary and most effective management, particularly in moderate to severe cases (American Academy of Sleep Medicine, 2014).
The second is the associated symptom layer, which may include poor sleep quality, frequent waking, fatigue, and increased stress or arousal. These factors can persist even when the airway is being managed.
Acupuncture is sometimes explored within this second layer as a supportive approach.
What research suggests
Research into acupuncture for obstructive sleep apnoea is still evolving.
A systematic review and meta-analysis by Li et al. (2019) reported that acupuncture was associated with improvements in sleep-related outcomes, including measures such as the apnoea–hypopnoea index and sleep quality. However, the authors noted variability in study quality and heterogeneity between trials.
Randomised controlled trials, such as Liu et al. (2018), have reported improvements in sleep parameters in patients receiving acupuncture compared with control groups. Earlier work by Liu et al. (2017) also demonstrated similar trends, suggesting potential benefits in symptom reduction.
Despite these findings, important limitations remain:
- sample sizes are often small
- study designs vary
- long-term outcomes are unclear
Because of this, current evidence supports acupuncture as a potential adjunct, rather than a primary treatment for sleep apnoea.
How this applies in practice
In clinical settings, acupuncture may be considered in patients who:
- are using CPAP but continue to experience poor sleep quality
- report difficulty settling into sleep
- experience stress, tension, or fatigue
- prefer additional non-pharmacological support
The aim is not to replace established treatments, but to support:
- sleep regulation
- reduction of hyperarousal
- overall sleep quality
This aligns with how acupuncture is typically integrated into broader care rather than used as a standalone intervention (Li et al., 2019; Liu et al., 2018).
Practical Tips for Better Sleep
Helpful strategies include:
- Maintaining a regular sleep schedule
- Avoiding alcohol before bedtime
- Sleeping on the side
- Managing weight where appropriate
- Creating a quiet, dark sleep environment
Important Notice
This information is provided for general educational purposes only and does not replace individual medical advice, diagnosis, or treatment. If you suspect sleep apnoea, please consult a qualified healthcare professional for assessment and appropriate management.
References
American Academy of Sleep Medicine. (2014). International classification of sleep disorders (3rd ed.).
Benjafield, A. V., Ayas, N. T., Eastwood, P. R., et al. (2019). Estimation of the global prevalence and burden of obstructive sleep apnoea. The Lancet Respiratory Medicine, 7(8), 687–698. https://doi.org/10.1016/S2213-2600(19)30198-5
Li, S., Peng, W., & Wang, X. (2019). Acupuncture for obstructive sleep apnoea: A systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2019, 6715306. https://doi.org/10.1155/2019/6715306
Liu, J., Wu, Y., Chen, R., et al. (2018). Acupuncture for moderate-to-severe obstructive sleep apnoea: A randomised controlled trial. Sleep Medicine, 47, 93–100. https://doi.org/10.1016/j.sleep.2018.04.014
Liu, Y., Wu, J., Wang, B., et al. (2017). Acupuncture for obstructive sleep apnoea: A randomised controlled trial. Respiratory Physiology & Neurobiology, 236, 41–47. https://doi.org/10.1016/j.resp.2016.11.005