Question

Like most people with ME/CFS, I always wake up from what is often an erratic night’s sleep feeling totally unrefreshed. I also went through a phase of sleeping for very long periods at the start of my illness. I now find that I’m feeling very sleepy during the day but this isn’t the same as the debilitating ME fatigue that I also experience.

My GP has queried whether I might have a condition called sleep apnoea. Is this more common in people with ME? And can it be treated?

Answer

Sleep apnoea is a fairly common sleep disorder where breathing stops and starts while you sleep. The most common type is called obstructive sleep apnoea (OSA) where there is an episodic narrowing of the airways during sleep.

Sleep apnoea often causes daytime fatigue. So it can be misdiagnosed as ME/CFS. At the same time sleep apnoea can sometimes co-exist with ME/CFS.

But there’s no evidence that sleep apnoea is more common in people with ME/CFS. However, sleep apnoea is more common in people who:

• are obese
• have a large neck
• are getting older – although children and young adults can also get it
• have other family members with sleep apnoea
• have large tonsils or adenoids
• sleep on their back
• a lung condition called COPD (chronic obstructive pulmonary disease)

Symptoms of sleep apnoea mainly happen while you sleep and include:

• breathing stopping and starting
• making gasping, snorting or choking noises
• waking up a lot
• loud snoring

During the day, sleep apnoea can cause the following symptoms:

• feeling very tired
• finding it hard to concentrate
• having mood swings
• having a headache when you wake up

It’s important to diagnose and treat sleep apnoea because it can cause other medical problems such as high blood pressure, depression and diabetes.

If your GP thinks that you might have sleep apnoea, they can refer you to a specialist sleep clinic for tests that can check your breathing and heartbeat while you sleep. The tests can usually be done at home, but you may need to stay in the clinic overnight.

If sleep apnoea is diagnosed, these are some simple self-help measures that can help:

• try to lose weight if you’re overweight
• make sure your bedroom is dark and quiet, and try going to bed and waking up at the same time each day
• sleep on your side – try taping a tennis ball to the back of your sleepwear, or buy a special pillow or bed wedge to help keep you on your side
• do not smoke or drink alcohol – especially shortly before going to sleep
• do not take sleeping pills unless recommended by a doctor – they can make sleep apnoea worse

Where sleep apnoea is more severe you may be offered a CPAP (continuous positive airway pressure) machine which gently pumps air into a mask you wear over your nose, or nose and mouth, while you sleep.

CPAP should help to improve breathing while you sleep by stopping the airways getting too narrow, improve the quality of sleep, help you feel less tired and reduce the risk of medical problems linked to sleep apnoea. Using a CPAP machine may feel strange or awkward at first, but try to keep using it. It works best if you use it every night.

From what you say, it sounds as though you ought to ask your GP if you could be referred to a hospital sleep clinic to see if you do have sleep apnoea and whether it requires treatment because left untreated it can cause these other medical problems.

• MEA information booklet covering all aspects of sleep management
• The Sleep Apnoea Trust provides more information and guidance

See Also: What is non-restorative/unrefreshing sleep?, Paralysed by Sleep, Night sweats, Symptoms: Myoclonic Jerks, Symptom: Vivid Dreams