Sleep Apnoea

What is sleep apnoea?

Sleep apnoea is a breathing problem that occurs when you are sleeping. The most common form is called obstructive sleep apnoea. Sleep apnoea can affect everyone at any age, the word apnoea is from the Greek and means “without breath”.

What causes sleep apnoea?

When we sleep our throat muscles relax too much, for some people that just might mean they snore.  However, if your throat closes completely it can stop you breathing for a time. For some this might happen hundreds of times through the night and causes oxygen levels to drop. This drop in oxygen thankfully, triggers your brain to wake you up from your deep sleep so that you can breathe normally. This sleep interruption can cause some people to wake briefly, others are completely unaware and can’t understand why they feel so tired. This constant interruption in your natural sleep rhythm is what causes you to feel so tired.

What are the symptoms of sleep apnoea?

The main symptom of sleep apnoea is snoring and so a partner or family member who observes you at sleep may be aware of it before you. This can be a source of a joke but don’t ignore it, sleep apnoea can have a serious effect on your health. As sleep apnoea disrupts your sleep it can cause you to fell excessive tiredness during the day. Other symptoms may include:

• Loud snoring, this could be with gasps, choking or snorting.
• Waking up still sleepy or short of breath
• Waking in the night with a sensation of choking
• Morning headaches or sore throats
• Clumsiness, leading to an increased risk of accidents
• Difficulty concentrating and forgetfulness
• Depression or changes in moods
• Loss of sex drive

Children who suffer from sleep apnoea may not have as obvious symptoms, look out for bedwetting, behavioural disorders, poor school performance, sleepiness, not growing as they should, weight gain or unusual sleeping positions.

Snoring alone doesn’t mean you have sleep apnoea, snoring doesn’t affect your quality of sleep and so how you feel during the day is the biggest sign.

Am I at risk of sleep apnoea?

You are more likely to suffer with sleep apnoea or make it worse if you:

• Are older than 40
• Are overweight
• Have a neck size larger than 17inches
• Have a large tongue
• Take sedatives
• Drink alcohol in the evenings
• Have nasal congestion or blockages
• Have large tonsils or adenoids, this is the most likely cause in children.
• You smoke 

What is the diagnosis of sleep apnoea?

If sleep apnoea goes undiagnosed it can have a great impact on your life as you will feel exhausted all the time, so it is important to get it diagnosed. If you believe you might have sleep apnoea you should visit your doctor for advice. It might be helpful before you go to have someone monitor and even record you sleep, you could also fill out a form about sleepiness before you attend. The British Lung Foundation has one available which can be found here.

Your doctor will usually ask you about your symptoms and may ask you many lifestyle questions. Your doctor may also take your blood pressure, according to his finding they will usually refer you to a sleep clinic.

What happens at a sleep clinic?

You will usually be asked a long series of questions about your symptoms, quality of life and any clinical history. You will then usually be examined; your weight, height and neck will be measured, and they will usually take your blood pressure. Your jaw and position may also be measured. Other tests may include checking the airflow in your nose and checking upper airways for blockages.

A sleep test is then used to confirm the diagnosis, this can usually be carried out at home but in severe cases an overnight stay for monitoring might be needed. While you sleep the test will monitor your breathing pattern, oxygen levels, air flow, eye movement and heart rate, Your doctor will then decide the best treatment for you based on your results.

What treatment is available for sleep apnoea?

Sleep apnoea can be treated effectively once diagnosed. The treatment you receive will depend on the severity and is aimed at reducing the amount for breathing pauses you have during the night. Lifestyle changes can really help with sleep apnoea, especially if the cause is being overweight, even a small amount of weight loss can improve symptoms. Your doctor will help you with dietary advice. You should also quit smoking, this damages the airways and make them more likely to collapse while you sleep. Avoid alcohol, sleeping pills and sedatives, they relax the muscles and can interfere with breathing. Try to get regular exercise and avoid heavy meals and caffeine at least 2 hours before bedtime. You could try a different sleep position, sleeping on your side can help symptoms.

Treatments you receive from the clinic may include an oral device that you wear in your mouth at night, similar to a gum shield. If this isn’t suitable an effective treatment is a mask that you wear which pumps air through the nose and/or mouth to hold your airways open, this is called CPAP (Continuous Positive Airway Pressure). If sleep apnoea is caused by something that can’t be treated by any of these methods, then surgery might be the only option. For example, if enlarged tonsils are the cause then the removal of your tonsils might be the answer.

Are there any complications or long-term effects of sleep apnoea?

The constant disrupted sleep and tiredness can cause a great impact on your quality of life. Poor performance at work or school can place you under strain and cause depression. If sleep apnoea is not controlled then it can lead to high blood pressure which can increase your risk of heart attack and stroke.

This lack of sleep can also lead to accidents happening. If you drive, then you should stop until you have been successfully treated.  People who are sleepy and less alert are 12 times more likely to cause traffic accidents.