The clocks go back this Sunday, 25 October, and many of us welcome the extra hour in bed. Then the dark mornings and early evenings arrive, and energy dips. Feeling more tired in winter is common and often has a straightforward explanation. If you are exhausted every day, though, and a full night in bed does not touch it, the season may not be the whole story.
One possible cause is obstructive sleep apnoea (OSA), a condition in which the throat repeatedly narrows or closes during sleep. Obstructive sleep apnoea interrupts breathing for seconds at a time, and the brain briefly rouses to reopen the airway. These awakenings are usually too short to remember, but they fragment the night. People who are always tired with sleep apnoea behind it often assume they are simply run down, busy or getting older.
Tiredness has many causes, and sleep apnoea is only one of them. The signs that point towards it are specific, and a simple test can settle the question.
Constant tiredness that sleep does not fix, especially alongside snoring or pauses in breathing, deserves assessment rather than a winter shrug.
Why winter makes many of us more tired, and when it is more than that
Shorter days reduce the daylight we receive, and light is the main signal that sets the body clock. Less morning light can delay the release of the hormone that governs wakefulness, which makes getting up harder and leaves us groggy for longer. Colder weather also tends to mean less time outdoors, less exercise and more disrupted routines, all of which can leave us feeling flat. Some people also experience a seasonal dip in mood that adds to the sense of fatigue.
Winter does not cause OSA. What the season can do is make existing tiredness more noticeable, or make it easier to explain away. Seasonal tiredness typically eases with a good night's sleep, a lie-in at the weekend or more time in daylight, and it lifts as the days lengthen.
Daytime sleepiness has a long list of possible causes, and sleep apnoea sits among them:
Sleep habits: irregular bedtimes, late caffeine or alcohol, screens late at night, or too little time in bed.
Medical conditions: anaemia, an underactive thyroid, low vitamin D, diabetes or other long-term illness.
Mood and stress: depression, anxiety, burnout or a period of heavy workload or caring responsibility.
Medication: some prescribed drugs, including certain antihistamines and sedatives, cause drowsiness.
Other sleep disorders: insomnia, restless legs and, less commonly, narcolepsy.
Sleep apnoea: broken sleep caused by repeated airway collapse, whether or not you are aware of it.
Tiredness is more than seasonal when it lasts for several weeks, persists despite seven to nine hours in bed, or leaves you struggling to stay awake in quiet moments such as reading, watching television or sitting in a meeting. It also warrants attention when it comes with any of the signs below.
Sleep apnoea signs that are easy to miss
Many people with sleep apnoea do not describe their problem as a breathing problem at all. They describe a life lived on low battery. Knowing the pattern helps you recognise it:
Unrefreshing sleep: you wake feeling as though you have not slept, however long you were in bed.
Morning headaches: a dull headache on waking that eases within an hour or two.
Snoring: loud, habitual snoring is the best-known sign, and snoring and sleep wellness assessment is often where the underlying cause comes to light.
Pauses seen by a partner: someone else notices that you stop breathing, then gasp, snort or jolt before resuming.
Poor concentration and memory: difficulty focusing, slower thinking and mistakes that are out of character.
Low mood and irritability: feeling flat, short-tempered or tearful without an obvious reason.
Night-time clues: a dry mouth on waking, night sweats, or needing to pass urine more than once in the night.
Any one of these can have another explanation. The combination matters more than any single sign, particularly unrefreshing sleep together with snoring or witnessed pauses. If you notice drowsiness while driving, do not drive until you have taken advice, as sleepiness at the wheel is a safety concern for you and for others.
A fuller account of how the condition is recognised and managed is in our guide to sleep apnoea symptoms, diagnosis and treatment.
Who is more likely to be affected, including women
Sleep apnoea is common and often goes undiagnosed. Several factors raise the likelihood:
Excess weight: extra tissue around the neck and throat narrows the airway during sleep.
Age: the risk rises through middle age and beyond as throat muscles lose tone.
Male sex: men are diagnosed more often, although this partly reflects under-recognition in women.
Nasal obstruction or enlarged tonsils: anything that restricts airflow through the nose or throat can contribute.
Alcohol and sedatives: taken in the evening, they relax the throat muscles further.
Smoking and family history: both increase the chance of airway collapse during sleep.
Menopause: falling hormone levels are linked with a rise in risk in women.
Being slim does not rule sleep apnoea out. In some people the cause is the shape of the jaw, tongue or throat rather than body weight.
Women deserve particular mention. Women with sleep apnoea are less likely to report loud snoring or witnessed pauses, and more likely to describe fatigue, insomnia, morning headaches, anxiety or low mood. Those symptoms are frequently attributed to menopause, depression or stress, so the diagnosis can be delayed for years. We cover this in more detail in our article on sleep apnoea in women.
How sleep apnoea is assessed
Assessment starts with a conversation. We ask about your sleep, your daytime energy, snoring, and what a partner has noticed, and we often use a short questionnaire to measure how sleepy you are in everyday situations. We then examine the nose, mouth and throat, because structural factors such as a blocked nose, enlarged tonsils or a narrow airway influence both the diagnosis and the choice of treatment.
The test that confirms or excludes sleep apnoea is usually a home sleep study. You collect a small, portable device, wear it overnight in your own bed and return it the next day. It records your breathing, oxygen levels, heart rate, snoring and sleeping position, without needles or wires attached to the head. The recording is then analysed to count how often your breathing is interrupted each hour, which indicates whether sleep apnoea is present and how severe it is.
A home sleep study is simple and non-invasive. A consultation finds out whether sleep apnoea is behind the tiredness. If the result is unclear, or another sleep condition is suspected, a hospital-based study can follow. For a step-by-step account of what the night involves, read our guide to what happens during a sleep study.
What treatment can do
Treatment depends on the severity of the condition and on what is causing the airway to narrow. Options include:
CPAP: a machine delivers gentle air pressure through a mask to keep the airway open, and is the standard treatment for moderate to severe disease.
Mandibular advancement device: a custom-fitted oral appliance holds the lower jaw forward and suits some people with mild to moderate disease.
Lifestyle measures: weight management, reducing evening alcohol and sleeping on your side can each reduce airway collapse.
Nasal treatment: addressing a blocked nose can improve comfort and make other treatments easier to tolerate.
Surgery: considered for carefully selected patients when a specific, correctable blockage is identified.
The aim is unbroken sleep, and the benefits reach beyond the bedroom. Many people notice better energy, sharper concentration, fewer morning headaches and a steadier mood once breathing at night is controlled, and a partner often sleeps better too. Treating sleep apnoea also reduces strain on the heart and circulation, since untreated disease is associated with higher blood pressure and cardiovascular risk over the long term.
If your tiredness has outlasted the winter blues, or you recognise several of the signs above, an assessment will tell you whether sleep apnoea is part of the picture. If it is not, the process still helps narrow down what else might be responsible.
Frequently asked questions about sleep apnoea and tiredness
How do I know if my tiredness is sleep apnoea?
You cannot tell from tiredness alone, because many conditions cause it. The pattern that raises suspicion is unrefreshing sleep, daytime sleepiness, snoring and pauses in breathing noticed by a partner. A sleep study is the only way to confirm the diagnosis.
Can I have sleep apnoea without snoring?
Yes. Snoring is common in sleep apnoea but not universal, and women in particular may have little or no snoring. Persistent fatigue, morning headaches and low mood can be the main signs.
What is a home sleep study?
A home sleep study is an overnight recording made in your own bed using a small portable device. It measures breathing, oxygen levels, heart rate and snoring, and is painless and non-invasive. The results show whether your breathing is interrupted and how often.
Is feeling tired in winter normal?
Many people feel more tired when days are short and daylight is limited, so some seasonal tiredness is normal. It tends to ease with good sleep habits and more time in daylight, and it improves as spring approaches. Tiredness that is severe, constant or unaffected by rest is worth discussing with a doctor.
When should I see a doctor about constant tiredness?
Seek advice if tiredness lasts several weeks, interferes with work or daily life, or comes with snoring, witnessed pauses in breathing or morning headaches. Also seek advice if you feel sleepy while driving. Your doctor can check for common causes such as anaemia or thyroid problems alongside sleep disorders.
Will treating sleep apnoea improve my energy?
For many people it does. Once breathing is controlled at night, sleep becomes more continuous and daytime alertness, concentration and mood often improve. The degree and speed of improvement vary from person to person.
Book a sleep apnoea consultation at Hillser Clinic
We offer expert evaluation of persistent tiredness and suspected sleep apnoea at Hillser Clinic, with home sleep studies and a clear, consultant-led plan based on your results. To arrange a consultation, please contact our team.
