What is sleep apnoea?
Sleep apnoea is a condition which affects your breathing while you sleep. It causes you to stop breathing for a short period of time. There are two types of sleep apnoea – one is called ‘central’ and the other is ‘obstructive’.
Most people who have sleep apnoea do not know that they stop breathing, but they may be woken up by gasping for breath or startled. They also often have a history of snoring.
When we sleep, the muscles in our throat become ‘floppy’, or relaxed. In the majority of people, this does not affect our breathing. In obstructive sleep apnoea, there is a problem with the upper airway, causing narrowing or closing when you are asleep which stops your breathing. When the airway is restricted, this first causes snoring, but if the blockage is complete then breathing can stop, usually for a period of about 10 seconds. The brain is instructed to wake you up and tell you to start breathing again by low levels of oxygen in the blood. You will normally go back to sleep and not realise you have woken up.
In central sleep apnoea, the brain stops sending signals to the muscles that help you breathe, which stops your breathing. This article will focus on the obstructive type.
Who gets sleep apnoea?
Obstructive sleep apnoea can occur at any age, including in children. Risk factors for obstructive sleep apnoea include:
Overweight or obesity
Alcohol consumption in the evening (as alcohol relaxes muscles more and makes the brain less responsible to an apneic episode)
Use of sedative drugs such as sleeping tablets
Sleeping on your back rather than your side
Having a small or receding jaw
Family history of sleep apnoea
What are the symptoms of sleep apnoea?
The main symptoms reported are snoring, tiredness and daytime sleepiness. Other symptoms can include:
Waking up choking or gasping
Morning headaches, dry mouth or sore throat
Waking up often to urinate
Waking up feeling unrested or groggy (due to waking up multiple times overnight)
Trouble thinking clearly or remembering things
Often these symptoms are thought to be normal by the patient. If you experience any of these, please see your GP for assessment.
How is sleep apnoea diagnosed?
The best test for sleep apnoea is a ‘sleep study’. This can often be done at home, but in some cases may involve a stay in a sleep laboratory overnight. The test requires you to be hooked up to different machines, which monitor your sleep and breathing overnight and the results are used to determine if you have sleep apnoea.
It is common for most people to have the odd episode of ‘apnoea’ when we are asleep. These usually cease with a snort. When people have sleep apnoea, they have more than 5 episodes of apnoea per hour of sleep, as monitored by a sleep study. There are different classifications of sleep apnoea, ranging from mild to severe.
Can sleep apnoea be treated?
Yes! There are a number of ways to treat sleep apnoea.
Some things you can do on your own include:
Avoiding laying on your back while sleeping (this is not always practical as people cannot control their position when they sleep)
Lose weight (if you are overweight)
Avoid alcohol as it can worsen sleep apnoea
Not using sedative drugs
If you are diagnosed with sleep apnoea by your doctor, they may suggest a CPAP machine to wear overnight. This machine has a mask which is attached to the face which helps to keep the patient breathing overnight. This machine can be noisy, and it is often used by the patient as a trial before purchasing the it to determine whether the machine works for them. If CPAP works, there is usually an immediate improvement in sleep and an improvement in daytime well-being, and a reduction in daytime sleepiness.
Your doctor may also suggest a device that can be worn in the mouth to keep it open, often known as a ‘mandibular advancement device’. If these methods fail, they may even suggest surgery to correct the airway problem.
Lifelong treatment is usually needed for sleep apnoea.
Is sleep apnoea dangerous?
Sleep apnoea can potentially be dangerous as you may not get good quality sleep, so they are often tired and not alert. This can put you at risk of car accidents or other types of accidents. There have also been studies to show that people with sleep apnoea have higher incidences of high blood pressure, heart attacks and other heart problems. Using treatments for sleep apnoea may help prevent some of these problems.
If you think you have sleep apnoea, or are feeling very sleepy during the day, please avoid using vehicles or machinery and see your GP for a review.
Newson L 2015, Obstructive Sleep Apnoea Syndrome, Patient Info, retrieved 7/1/18, retrieved from < https://patient.info/health/obstructive-sleep-apnoea-syndrome-leaflet >
Crowly K, Martin KA 2017, Patient Education: Sleep Apnoea (The Basics), UpToDate, retrieved 7/1/18, retrieved from < https://www-uptodate-com.proxy.library.adelaide.edu.au/contents/sleep-apnea-the-basics?search=sleep%20apnoea&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H17011527 >
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