What Is Sleep Apnoea?

If there was an instruction manual that would guarantee a good night’s sleep, we would all read it, right? The problem is sleep is more complicated than that; everyone has very different needs and environments that affect the way you sleep. In many cases making positive changes to your overall lifestyle can have a positive impact on your sleep, while for others, it’s more complicated than that.

Having a sleep disorder can make sleeping very problematic, potentially negatively impacting your overall wellbeing. Sleep apnoea is estimated to impact 13% of adult men and 6% of adult women, a staggering 3.9 million people in the UK alone. What is this disorder and how does it affect people?

What is sleep apnoea?

Obstructive sleep apnoea (OSA) is a condition that causes frequent pauses in your breathing while you sleep. According to the NHS there are two types of breathing interruption characteristic of OSA:

• Apnoea – where the muscles and soft tissues in the throat relax and collapse sufficiently to cause a total blockage of the airway; it’s called an apnoea when the airflow is blocked for 10 seconds or more.
• Hypopnoea – a partial blockage of the airway that results in an airflow reduction of greater than 50% for 10 seconds or more.

Suffers of OSA can experience episodes of both apnoea and hypopnoea, therefore doctors sometimes refer to this as obstructive sleep apnoea-hypopnoea syndrome, or OSAHS. People with OSA can experience repeated episodes throughout the night, with more severe cases occurring every one or two minutes.

The sensation of OSA can feel like choking, gasping or feeling out of breath, due to the upper airways in your mouth, nose and throat narrowing or completely collapsing, stopping you from breathing for a short period of time. In many cases you will quickly fall asleep again, meaning you may not remember in the morning.

What are the symptoms of obstructive sleep apnoea?

It is most likely a partner, friend or family member will notice the first symptoms of OSA while you sleep. Some of the common signs of OSA are as follows:

• Loud snoring
• Repeated short periods where breathing is interrupted by gasping or snorting
• Noisy and laboured breathing
• Excessive sleepiness during the day
• Having a headache, sore throat or dry mouth when you wake
• Difficulty concentrating or feeling irritable
• Night sweats or waking frequently in the night to urinate

You should always seek medical advice from your GP if you suspect you may have OSA. A GP can check for other possible reasons for your symptoms and if required arrange for an assessment at a local sleep clinic.

Is there a treatment for obstructive sleep apnoea?

The good news is OSA is a treatable condition, with a number of varying treatments available to help reduce the symptoms. Some of the most common treatments are as follows:

• Using a CPAP (continuous positive airway pressure) device - if you have moderate to severe OSA one of the most effective treatments is using a CPAP device. The machine connects to a mask which you wear over your mouth or nose, which then blows pressurised air into your upper airways. This essentially prevents your airway closing while you sleep by delivering a continuous supply of compressed air. CPAP is considered to be a long-term treatment and therefore needs to be used every night. Using the device can take some getting used to, however in the long run this should help improve your sleep.
• Lifestyle change - making positive changes to your lifestyle can be very effective in reducing the symptoms of OSA. Losing excess weight, reducing alcohol, stopping smoking and sleeping on your side are all things that could make a positive improvement.
• Wearing mandibular advancement device (MAD) - the device is like a type of gum shield that fits around your teeth, holding your jaw and tongue forward which helps to increase the space at the back of your throat while you sleep.
• Surgery - Surgery may also be an option if OSA is deemed to be the result of a physical problem such as an unusual inner neck structure, which can only be rectified surgically. For most people surgery is a last resort if other treatments haven’t proven to be successful.

What happens if obstructive sleep apnoea is left untreated?

OSA can have a significant impact on your life if untreated; this is why it is important to seek medical advice. It can cause problems in all aspects of your life such as poor productivity at work and increased strain on relationships with loved ones.

OSA can also increase your risk of:

• Having a heart attack or stroke
• High blood pressure
• An abnormal heartbeat
• Heightened chances of type 2 diabetes, although it is unclear if this is a result of an underlying issue such as obesity.

OSA can affect your ability to drive; therefore it is a legal obligation to inform the DVLA if you have a medical condition that could impact your ability to drive. You may be advised to stop driving once you are diagnosed with OSA until your symptoms are controlled.

Someone who is deprived of sleep because of OSA may be up to 12 times more likely to be involved in a car accident.

What are the causes of obstructive sleep apnoea?

For most people the muscles and soft tissues in the throat relax and collapse to some degree while sleeping, this is normal. However suffers of OSA can have a narrowed airway as a result of a number of factors, such as:

• Gender - although there is no conclusive evidence to suggest why, men are more likely than women to suffer from OSA.
• Alcohol - drinking alcohol, particularly before bed can heighten the chances of snoring and sleep apnoea.
• Weight - being overweight increases the bulk of soft tissue in the neck, placing a strain on the throat muscles. Increased stomach fat can also cause breathing difficulties, therefore potentially making OSA worse.
• Smoking - smoking increases the chances of sleep apnoea.
• Age - OSA is more common in people over 40, although it can occur at any age.
• Medicine - certain medicines with a sedative effect such as sleeping tablets can cause OSA.
• Family history - it is believed there may be genes inherited from your parents, making you more susceptible to suffering from OSA.
• Neck size - men with a neck size greater than 17 inches are more at risk of developing OSA.
• The menopause - hormone level changes during the menopause can cause the throat muscles to relax more than usual.

As they say prevention is always better than the cure and making positive lifestyle changes can greatly reduce your risk of developing OSA. If you are currently experiencing difficulties with your sleep it is always advised to seek professional medical advice.