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Sleep apnoea guide
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CPAP practical guide
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What is sleep apnoea?

Obstructive sleep apnoea (OSA) is a condition where the muscles in your throat relax during sleep and temporarily block your airway. This causes you to stop breathing repeatedly — sometimes hundreds of times per night — often without you knowing.

Each pause can last 10–60 seconds. Your brain briefly wakes you to restart breathing, disrupting your sleep quality even if you don't remember waking. Over time, this leads to serious health consequences including high blood pressure, heart disease, stroke, type 2 diabetes, depression, and increased accident risk from daytime sleepiness.

OSA affects approximately 1 in 4 men and 1 in 10 women in Australia. Most are undiagnosed.

Signs and symptoms
🌙 At night

Loud, persistent snoring

Gasping, choking, or snorting during sleep

Breathing pauses witnessed by a partner

Restless sleep or frequent waking

Waking to urinate frequently (nocturia)

☀️ During the day

Waking unrefreshed despite enough hours

Excessive daytime sleepiness

Morning headaches

Difficulty concentrating or memory problems

Irritability or mood changes

Not everyone who snores has sleep apnoea, and not everyone with sleep apnoea snores. The key sign is the combination of snoring plus daytime tiredness or witnessed breathing pauses.

Risk factors
⚖️Overweight or obese — the single biggest risk factor. Excess tissue around the neck and throat narrows the airway. 👨Male sex — men are 2–3x more likely than women (risk equalises after menopause). 🎂Age over 50 — muscle tone decreases with age. 📏Large neck circumference — over 43cm (men) or 40cm (women). 👪Family history of sleep apnoea or snoring. 🍺Alcohol and sedatives — relax throat muscles, worsening obstruction. 🚬Smoking — increases inflammation and fluid retention in the upper airway. 👃Nasal congestion or anatomical factors (large tonsils, deviated septum, receding jaw).

Quick screening — could you have sleep apnoea?

Try one of these validated screening tools. They don't replace a sleep study, but they can help you decide whether to talk to your GP.

How is it diagnosed? The sleep study

The only way to confirm sleep apnoea is a sleep study (polysomnography). Your GP can refer you directly — you don't always need a specialist referral first.

🏠 Home sleep study

A portable device you take home. Measures breathing, oxygen, heart rate, and body position overnight. You return it the next day.

Cost: $150–350 out of pocket (after Medicare rebate). Some clinics bulk bill.

Best for: Suspected straightforward OSA in adults without complex conditions.

🏥 In-lab sleep study

Overnight at a sleep clinic. More sensors — also measures brain waves, eye movements, and leg movements. A technician monitors throughout.

Cost: $400–800+ out of pocket (after Medicare rebate). PHI hospital cover may help.

Best for: Complex cases, suspected central sleep apnoea, other sleep disorders, or if home study is inconclusive.

Results are reported as the Apnoea-Hypopnoea Index (AHI) — the number of breathing pauses per hour of sleep:

AHI Severity What it means
<5NormalFewer than 5 pauses per hour — no significant sleep apnoea
5–15MildMay not need CPAP — lifestyle changes and positional therapy may help
15–30ModerateCPAP recommended, especially if symptomatic or high cardiovascular risk
>30SevereCPAP strongly recommended — significant health and safety risks without treatment
Treatment options

CPAP (Continuous Positive Airway Pressure)

The first-line treatment for moderate-severe OSA. A small bedside machine delivers pressurised air through a mask worn over your nose (or nose and mouth) while you sleep. The air pressure holds your airway open.

What to expect: It takes most people 1–4 weeks to adjust. Start by wearing it for a few hours, then build up. Modern machines are quiet (under 30 decibels), have heated humidifiers to reduce dryness, and track your usage data. Your sleep clinic or GP can review the data to fine-tune your settings.

Cost: CPAP machines cost $800–2,500 to buy. Some sleep clinics offer rental or trial periods ($50–100/month). Masks ($100–250) need replacing every 6–12 months. Private health insurance extras cover may rebate part of the cost. There is no Medicare rebate for CPAP equipment.

Mandibular Advancement Device (MAD)

A custom-fitted mouthguard that holds your lower jaw forward during sleep, opening the airway. Made by a dentist with sleep medicine experience.

Best for: Mild-moderate OSA, or people who can't tolerate CPAP. Less effective than CPAP for severe OSA.

Cost: $1,500–3,000 for a custom device. Over-the-counter versions ($50–200) are less effective and not recommended long-term.

Lifestyle changes

Often the first step for mild OSA, and important alongside CPAP for all severities:

⚖️Weight loss — losing 10% of body weight can reduce AHI by 50% in some people. The most effective non-CPAP intervention. 🍺Reduce alcohol — avoid alcohol within 3–4 hours of bedtime. 💊Review sedating medications — benzodiazepines, opioids, and some antihistamines worsen OSA. Talk to your GP. 🛏️Sleep position — sleeping on your side instead of your back can reduce mild positional OSA. A positional therapy device or tennis ball technique may help. 🚬Stop smoking — reduces airway inflammation.

Medication — new option (added June 2025)

In June 2025 the TGA approved Mounjaro (tirzepatide) for "moderate to severe obstructive sleep apnoea in adults with obesity" — the first medicine registered in Australia specifically for OSA. It's a weekly injection that works indirectly: by reducing weight, it eases pressure on the chest, abdomen and throat that contributes to airway collapse during sleep. It is not a substitute for CPAP and is generally used alongside, not instead of, standard treatment unless your specialist advises otherwise.

Who it's for: the TGA approval is specifically for moderate-to-severe OSA — RACGP experts have noted that many people GPs see with OSA symptoms don't fall into that severity range, so this isn't a general-purpose sleep apnoea treatment. Confirming your OSA severity (via a sleep study) is part of establishing whether it's relevant to you.

Cost and access: not PBS-subsidised for this indication — private script only, reported from around $395/month and up depending on dose. See our Weight Management Explorer for the fuller per-dose cost breakdown (the same medicine, same pricing, as used for weight management).

We could not confirm from public sources whether a specific dose range applies to the OSA indication versus the weight-management indication, or the exact BMI cut-off used in the approval — ask your GP or check the current Product Information for specifics.

Surgery (selected cases)

Surgery is not first-line and is only considered when CPAP and MAD have failed or are not tolerated. Options include tonsillectomy (if tonsils are enlarged), UPPP (uvulopalatopharyngoplasty — trimming soft palate tissue), nasal surgery, or jaw advancement surgery. Results are variable. Discuss with an ENT surgeon or sleep specialist.

Yes — untreated moderate-severe OSA with excessive daytime sleepiness is not compatible with driving under Austroads Assessing Fitness to Drive guidelines.

Under Austroads guidelines, people with untreated moderate-severe OSA and excessive daytime sleepiness are required to report to their state transport authority. Your GP can advise on your specific obligations. Once treatment is established, driving may be permitted under a conditional licence subject to regular medical reviews — your GP and treating specialist will advise on your specific situation.

If you drive for work (heavy vehicle, taxi, bus), the requirements are stricter — typically requiring a specialist sleep physician assessment and documented CPAP compliance data.

Check your driver licence medical requirements →

Yes, in most cases. Your GP can order a home sleep study, interpret the results, prescribe CPAP, and manage ongoing follow-up. You don't always need to see a sleep specialist.

Your GP may refer you to a sleep specialist if: the diagnosis is unclear, you have complex or multiple sleep disorders, central sleep apnoea is suspected, you can't tolerate CPAP, or you need an in-lab study.

Many CPAP suppliers work directly with GPs and will set up your machine based on your GP's prescription.

Start slowly. Wear the mask while watching TV to get used to it. Then try the first few hours of sleep, building up to all night.

Try different masks. Nasal pillows, nasal masks, and full-face masks feel very different. If one doesn't work, try another. Most suppliers offer exchanges.

Use the humidifier. Heated humidification reduces dryness, nasal congestion, and mouth dryness — the most common complaints.

Use the ramp feature. Start at a low pressure that gradually increases as you fall asleep. Most machines have this built in.

Keep the mask clean. Wash the mask cushion daily with warm water and mild soap. Replace the mask every 6–12 months.

Persevere. Most people who stick with CPAP for 2–4 weeks report dramatically better sleep, more energy, and improved mood. The first few nights are the hardest.

Children can have sleep apnoea too — usually caused by enlarged tonsils and adenoids rather than obesity. Signs include snoring, mouth breathing during sleep, restless sleep, bedwetting, and daytime behavioural issues (hyperactivity, poor concentration — sometimes misdiagnosed as ADHD).

Treatment in children is usually tonsillectomy and adenoidectomy, which resolves the apnoea in most cases. Talk to your GP if your child snores regularly and seems tired during the day.

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