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    Obstructive Sleep Apnoea

    Overview
    Symptoms
    Diagnosis
    Treatment
    FAQs
    Where To Seek Treatment

    Contributed by Dept of Respiratory & Critical Care Medicine


    Overview

    Obstructive Sleep Apnoea is a condition in which the patient has recurrent blockage to his breathing during sleep. The muscles of the upper airway relax as the patient is entering the deeper stages of sleep, causing the upper airway to collapse. Oxygen levels in the blood drop, and there is a reflex rise in heart rate and blood pressure. The brain will arouse enough to allow the muscles in the upper airway to regain their tone and open up the airway and allow the blockage to resolve. However, as the patient again attempts to fall into a deeper stage of sleep, the process recurs.

    Symptoms

    • Your bed partner notices that you have loud, frequent snoring
    • Your bed partner notices that you periodically stop breathing during your sleep and gasp for breath
    • You wake up feeling tired. Some patients have a morning headache and dry mouth as well
    • You are sleepy and tired through the day

    However, not everyone who snores has sleep apnoea and conversely, not everyone with sleep apnoea snores.

    I don't awake repeatedly throughout the night. Does it mean I do not have sleep apnoea?

    No. Most people with sleep apnoea do not realize that they are awakening to breathe repeatedly throughout the night. This is because the arousal is slight and most people become accustomed to this. However even this slight arousal is enough to disrupt the pattern of sleep and lead to unrefreshing sleep.

    What should I do if I think I may have sleep apnoea?

    The best thing is see your doctor. He may refer you to a specialist or sleep disorders unit for you to undergo evaluation which may include spending the night in a sleep lab to undergo a sleep study call 'polysomnogram'.

    Diagnosis

    A sleep study or polysomnogram is a diagnostic test for sleep apnoea that involves sleeping overnight in a sleep laboratory. The patient is connected to a machine that records a variety of body functions during sleep including the electrical activity of the brain, eye movement, muscle activity, heart rate, respiratory effort, air flow and blood oxygen levels. In addition to diagnosing sleep apnoea, the severity of the sleep apnoea can also be determined.

    Treatment

    There are a few effective treatments for obstructive sleep apnoea, namely weight loss, breathing-assistance devices, dental appliances and surgery. A commonly recommended treatment involves using a breathing-assistance device known as the CPAP (Continuous Positive Airway Pressure) device, during sleep. This device delivers air under pressure to the airway through a mask applied over the nose (held down by straps). This pressure that is applied keeps your airway from collapsing during sleep. It is probably the most effective form of treatment for obstructive sleep apnoea at present.

    Surgery is effective in a select group of patients and usually involves procedures that trim excess soft tissue from the upper part of the throat ( uvulopharyngeopalatoplasty) and may involve moving the base of the tongue forward and anchoring it to the base of your chin (genioglossus advancement).

    Specially-cast dental appliances ( something like braces) can also be worn at night to treat obstructive sleep apnea.

    Frequently Asked Questions

    Is obstructive sleep apnoea dangerous and must it be treated?

    Obstructive sleep apnoea has been linked to increased chances of heart disease, stroke, and irregular heart rhythms. Unfortunately, not all the long term effects of untreated sleep apnoea are known today. However, continual lack of refreshing sleep can lead to depression, irritability, lack of energy, a high risk of motor vehicular accidents, workplace accidents and many other problems. Most specialists agree that obstructive sleep apnoea is dangerous and should not be ignored.

    If I have sleep apnoea, how can I help myself?

    Besides seeking medical attention, there are several things doctors suggest you can do to alleviate obstructive sleep apnoea including weight loss, quitting smoking, eliminating alcohol and avoiding sedatives especially before bedtime.


    Need indepth information ?

    Access our Conditions & Treatments sections for related topics on Abnormal Heart Rhythm (Arrhythmia), Coronary Artery Disease and High Blood Pressure.

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