The use of alcohol, sleeping tablets and tranquillisers prior to sleep help to relax the upper airway muscles and make OSA worse. Alcohol can also reduce the brain's response to an apnoea which in turn leads to longer and more severe apnoeas in people who would otherwise only have mild OSA and who would otherwise only snore. Most people with OSA snore loudly and breathing during sleep may be laboured and noisy. Sleeping partners may report multiple apnoeas lasting up to 90 seconds which often end in deep gasping and loud snorting. Sufferers may report waking for short periods after struggling for breath.
Symptoms are often worse when lying on the back in deepest sleep.
Although a person with OSA may not be aware of the many arousals from deep sleep, they suffer from poor quality sleep in spite of long periods of time spent in bed. Such people wake feeling that they haven't had a full refreshing night's sleep. They report difficulty maintaining concentration during the day, have a poor memory, and suffer from excessive daytime sleepiness. At first an OSA sufferer may be sleepy only when seated and relaxed, eg watching TV, but eventually sleepiness becomes so severe that car accidents and accidents in the workplace occur. Other symptoms of OSA include morning headache, depression, short temper, grumpiness, personality change, and loss of interest in sex with impotence in males.