Obstructive Sleep Apnoea WHAT YOU NEED TO KNOW

Ill man sitting on his bed

What is OSA?

Obstructive sleep apnoea, or OSA, is a dangerous sleep disorder that makes patients stop breathing repeatedly. So if you snore heavily, or have severely disturbed sleep where you gasp for air, then don’t ignore it because it will get worse and not go away. Lots of cases go undiagnosed because many people simply aren’t aware they have OSA, although their partners will be.

 Anyone with OSA has repeated episodes of partial or complete obstruction of the throat when sleeping. This blockage of the pharynx or upper airway often causes heavy snoring as well. These airway obstructions will cause you to stop breathing for a period of 10 seconds up to a minute or more, and blood oxygen levels fall as a result.

Sleep will then be briefly interrupted for as little as 3 seconds and this allows breathing to start again, but with a disruption to your sleep. This can happen hundreds of times a night in the worst cases but you may not know. Most cases of OSA go untreated and it may be your partner who is more aware of your problem than yourself.

What are the key symptoms of OSA?

You will probably toss and turn a great deal as you have these episodes where your breathing stops. In addition, you may find yourself waking up often during the night, sometimes gasping or choking, although this does not always happen. However, even if there are few awakenings overnight, your sleep is disturbed and will not be refreshing because of this. As the day goes on, you may struggle to stay awake, especially in the afternoon. Grumpiness and other mood changes are common in untreated OSA.

Your OSA affects other people too

Snoring can keep a bed partner awake and sometimes people in other parts of the house. Some partners even try to stay awake to make sure that the person with OSA starts breathing again after a breathing pause. It worries them greatly when breathing stops. Lack of sleep may also make people who are living with a person with OSA more grumpy and irritable as well as the individual themselves. OSA is a problem for the whole family.

Should you worry if you have symptoms of OSA

There is strong evidence that people with untreated moderate to severe OSA have other health problems. If you have OSA, you are more likely to have high blood pressure and other cardiovascular disease than someone without it. Each time you stop breathing, your blood pressure may go up and over time, this may also contribute to high blood pressure during the day (hypertension). There is also real evidence that having OSA, particularly if it is severe it may increase the risk of diabetes, heart attack, stroke or depression. Treating sleep apnoea may reduce these risks considerably.

How is obstructive sleep apnea diagnosed?

Signs and symptoms such as snoring, obesity, observed breathing pauses and sleepiness during the day might suggest that a person has OSA. The best way to be really sure is by having a simple sleep study and this can easily be done at home. This measures sleep, breathing and oxygen levels.

How is obstructive sleep apnea treated?

For people with a very mild level of OSA, and few symptoms, losing weight, decreasing the amount of alcohol consumed in the evening or adjusting the sleeping position may be all that is needed. Most people have more OSA episodes sleeping on their backs. Using a simple oral appliance to stop snoring and keep the airway open will help.

However, for those with moderate or severe OSA, much more active treatment is often required. This is particularly so if daytime tiredness is present or there is a background of heart disease, stroke or high blood pressure that has been difficult to control. The two most commonly used treatments for moderate to severe OSA are continuous positive airway pressure (CPAP) where a mask attached to an oxygen supply is worn all night, or using a medically approved bespoke oral appliance.

Many people find CPAP difficult and uncomfortable to use, and in those cases the medical advice is to use a mouthpiece instead rather than not have preventative treatment of any form at all. The mouthpiece is designed to move the lower jaw forward which helps to keep the airway open. This mandibular advancement device fits over both the upper and lower teeth and these devices are being used more and more for the treatment of snoring and mild to moderate forms of sleep apnea.

The important thing, having identified the problem, is treating it without delay.

John Redfern