Obstructive Sleep Apnea: Diagnosis and CPAP Changed My Life

Every morning for years, I would wake up with a dull throbbing headache. It happened so frequently that it became part of my life. By 11 am, after a coffee or two, it had gone.

I put it down to stress and getting older. But things were steadily getting worse.

I was 42. It was 2014. And I had no idea what was wrong with me.

The Years Before I Got Answers

Then migraines came first. Big Migraines. The kind where light is physically painful, and you lie in a darkened room willing your brain to quiet down. I would stay in bed most of the day until the nausea came. Then I would explssivly vomit, and migraine passed, like a cyclone passing through a demolished city!

My wife was worried. She would watch me stop breathing and gasping in my sleep. She described my snoring as violent. Not just loud but alarming. She’d recorded me on her phone once and played it back to me, and I genuinely didn’t recognise the sound as something a human being made. And then she told me what happened in the gaps between the snoring. The silence went on too long. The gasping. She said she’d lie there watching me, counting the seconds, not sure if I was going to start breathing again.

I told her I was just a heavy sleeper.

At work, I was struggling in ways I couldn’t explain to anyone, including myself. I’d read the same paragraph four or five times and still not be able to tell you what it said. I’d have conversations in the morning and forget them by afternoon. I’d sit in meetings and realise I’d been staring at the wall for several minutes without taking in anything that was said. My performance was slipping, and I knew it, and I couldn’t do anything about it because I didn’t know what was causing it.

The personality changes were the part I find hardest to look back on. I became short-tempered with my son in ways that weren’t fair to him. Irritable with my wife. Withdrawn from friends. I stopped making plans because the effort of being present felt like too much. Depression had moved in quietly and made itself at home, and I was starting to wonder whether this was just what the middle of life felt like. Whether I was simply tired in a way that wasn’t going to lift.

The turning point came when the migraines stopped responding to anything. I had one that put me in bed for a full day, completely unable to function, and eventually I was sick, and after that the migraine finally eased. My wife stood in the doorway of the darkened room and said she wasn’t going to keep watching this happen without me getting help.

So I finally made the appointment.

The Sleep Study

The sleep study revealed something I genuinely wasn’t prepared for. My Apnea-Hypopnea Index was 51. For context, anything above 30 is classified as severe. I was at 51, meaning I was stopping breathing more than fifty times every single hour throughout the night. Once roughly every minute. My blood oxygen was dropping repeatedly as my airway collapsed and my brain scrambled to pull me back into lighter sleep to restart breathing. Over and over, all night, every night, for years.

The sleep specialist talked me through the results carefully. He explained that I wasn’t getting any meaningful deep sleep. That my brain was being wrenched out of the deeper stages continuously before it could do the repair and restoration work that deep sleep is for. That the oxygen drops were putting strain on my heart that I wouldn’t have been able to feel but that was accumulating nonetheless. That my blood pressure, which had recently crept up enough to concern my GP, was almost certainly being driven by this.

I sat there listening to this and thought about all the mornings. All the migraines. All the meetings. All the evenings I’d been short with my son because I had nothing left.

If you want the full picture of what a sleep study involves and what to expect from it, I wrote about that in detail on my sleep study page. But the short version is that it was the most important night of my life in terms of what it led to, even though I spent most of it wired up to sensors in a room that wasn’t my own.

What Obstructive Sleep Apnea Actually Is

Obstructive sleep apnea is a condition where the soft tissues in your upper airway, the muscles in your throat and the tissue around them, relax too much during sleep and collapse inward, blocking airflow. When your airway closes, you stop breathing. Your blood oxygen drops. Your brain detects the emergency and pulls you into a lighter sleep state just enough to restore muscle tone and reopen the airway. You rarely wake up fully. You have no memory of any of it. And then the cycle starts again.

In my case that cycle was completing itself more than fifty times an hour. My body was working through an emergency protocol continuously while I was supposed to be resting. No wonder the sleep wasn’t doing anything. The architecture of it was completely destroyed.

The “obstructive” in the name distinguishes it from central sleep apnea, which is a different condition where the problem is neurological, the brain failing to send the right signals to the breathing muscles rather than the airway physically collapsing. Most people, including me, have the obstructive kind. The treatment is different for each, which is one of the reasons a proper diagnosis matters rather than just assuming.

Why It Had Got So Bad

Looking back, my risk factors weren’t hidden. I’d put on significant weight over the five years before my diagnosis, gradually enough that I hadn’t really registered how much. Excess weight around the neck creates fatty deposits in the airway tissue that make collapse more likely during sleep. My neck circumference was on the larger side. I was male, over forty, and I had, though I didn’t know it at the time, a slightly recessed jaw that my sleep specialist pointed out as a contributing structural factor. My dad, it turned out when I mentioned all of this to my family, had almost certainly had undiagnosed sleep apnea for years. There’s reasonable evidence that sleep apnea runs in families, and I watch my son with that in mind now.

The cruel irony of all of this, which I only understood properly after starting treatment, is that sleep apnea makes it harder to lose the weight that contributes to it. The hormonal disruption from fragmented sleep drives hunger and suppresses the signals that tell you you’re full. The exhaustion kills the motivation to exercise. The metabolic effects compound over time. I’d been trying to manage my weight and not getting anywhere, and the condition I didn’t know I had was working against me the whole time.

The Symptoms I Kept Explaining Away

I want to be direct about this because I spent too long dismissing what were, in hindsight, clear signals.

The morning headaches and migraines were caused by oxygen deprivation and carbon dioxide buildup through the night. I thought they were stress-related. The brain fog and memory problems were the result of never getting proper deep sleep. I thought I was just getting older. The personality changes and creeping depression were in large part the psychological and neurological consequences of chronic sleep deprivation at a severe level. I thought that was just what my life was like.

The daytime exhaustion was so consistent and so total that I’d genuinely normalised it. I’d stopped expecting to wake up feeling rested because I never did, and I’d adjusted my expectations of what normal felt like downward to match. That adjustment is one of the most insidious things about chronic sleep deprivation. You lose the reference point for how you’re supposed to feel, and so you stop recognising how bad things have got.

The snoring my wife was describing, loud and then suddenly silent, is called witnessed apnea and it’s one of the clearest warning signs. If someone who sleeps near you has described that pattern, loud snoring followed by alarming silence followed by gasping or choking, that is worth taking to a doctor promptly. It’s not dramatic to act on it quickly. It’s the right call.

Other things I’d been ignoring included waking up with a very dry or sore throat most mornings, needing the toilet three or four times a night which I’d attributed to drinking too much water in the evenings, and a blood pressure reading that had come back higher than it should have been for my age.

Starting CPAP

My sleep specialist prescribed CPAP therapy immediately given the severity of my results. Continuous Positive Airway Pressure. A machine that delivers a constant pressurised stream of air through a mask, maintaining enough pressure in the airway that it cannot collapse during sleep.

I had my titration the same night as my diagnostic study, which meant they fitted me with a mask in the second half of the night and adjusted the pressure until they found the setting that eliminated my apneas. My first experience of properly treated sleep happened in a clinical room with sensors stuck to my head, and I woke up the next morning feeling something I hadn’t felt in years. Alert. Genuinely alert, without the leaden quality that had become my baseline.

The migraines stopped. Not gradually, not over weeks. The morning after my first proper night on CPAP I woke up without one. I haven’t had a sleep-related migraine since.

I use a ResMed AirSense 10 with a full face mask. I’m a mouth breather, so a nasal mask alone doesn’t work for me. It took a few weeks to get fully comfortable with the setup, mostly working through early mask leak issues and getting the humidifier settings right for my environment, but the improvement in how I felt was immediate and significant enough that sticking with it was never really in question. The guide I wrote on troubleshooting CPAP problems covers most of what I worked through in those first weeks if you’re at that stage yourself.

My blood pressure normalised within a few months. The brain fog cleared. The depression lifted in a way that several other things I’d tried hadn’t managed to touch, because it had never really been depression in the standalone sense, it had been what severe chronic sleep deprivation does to a person’s mental state. I lost weight the following year in a way I hadn’t been able to before, because I finally had the energy to exercise and my hunger hormones were no longer working against me.

My AHI on therapy sits under 5. From 51 to under 5, every night, as long as I wear the machine.

What to Do If This Sounds Like You

The sleep apnea symptoms I described, the snoring, the witnessed breathing pauses, the morning exhaustion that sleep doesn’t fix, the headaches, the fog, the mood changes, are worth taking seriously rather than explaining away. I explained them away for too long and I lost years to that decision.

The starting point is talking to your GP and asking for a referral for a sleep assessment. Depending on where you are and what your symptoms look like, that might lead to an in-lab sleep study or an at-home sleep apnea test, which is a simpler device you wear overnight in your own bed. Either way, getting a number on what’s actually happening while you sleep changes everything, because you can’t treat something you haven’t measured.

If you get diagnosed, CPAP is where treatment starts for most people with moderate to severe obstructive sleep apnea. There are other treatment options worth knowing about, and your sleep specialist will walk you through them based on your specific results and circumstances. But CPAP has the best evidence behind it for significant OSA, and in my experience, the reputation it has for being difficult to tolerate is mostly about the adjustment period, which is real but temporary.

The version of me that gets to be a present father, a functional husband, and someone who wakes up in the morning without dread is the post-CPAP version. I don’t say that to be dramatic. I say it because it’s simply true, and because if you’re living in the before version right now, as I was for years without understanding why, it’s worth knowing that there is a specific medical reason for it and a specific treatment that works.

Get the sleep study. Find out what your number is. Go from there.

⚠️ MEDICAL DISCLAIMER This blog provides general information only and is not a substitute for professional medical advice, diagnosis, or treatment. Sleep apnea is a serious condition, and CPAP equipment should be used under proper medical supervision. Always consult your doctor or sleep specialist before starting, stopping, or changing any therapy. I share personal experiences as a CPAP user, not as a medical professional. Individual results vary. For medical guidance, please consult a qualified clinician or the American Academy of Sleep Medicine (aasm.org).