Sleep apnoea is a very common condition affecting a significant proportion of the population. Many are unaware they have it as patients often feel that they “sleep well”.
An apnoea refers to a cessation of breathing for a short time. Patients with sleep apnoea can stop breathing many times in an hour.
There are two types of sleep apnoea. Obstructive sleep apnoea refers to mechanical blocking of breathing because the throat collapses during sleep. Central sleep apnoea is due to failure of your brain to tell you to breathe.
Sleep apnoea causes a drop in your oxygen levels at night causing increased risk of heart attack, stroke, heart failure, irregular heart rate, high blood pressure and other health problems.
Symptoms can include:
- Unrefreshing sleep
- Daytime sleepiness and tiredness
- Difficulty with memory or concentration
- Waking up with a choking or gasping sensation
- Urinating frequently through the night
- Chronic cough
- Irritability and depression
Sleep apnoea is commoner in patients who are obese, have narrow airways, or a recessed chin.
Smoking, alcohol and sedatives can worsen sleep apnoea.
To diagnose sleep apnoea you will need a sleep study which can be done at home (home sleep study) or in a sleep lab where a nurse monitors you all night.
Treatment for sleep apnoea may include continuous positive airway pressure or CPAP which works by applying air pressure through a nose or face mask, to keep your airway open. Other options include mouth guards which work by pulling your jaw forward to open up your airway during sleep, and EPAP devices such as Provent which are disposable adhesive devices placed across the nostrils at night that generate pressure through the use of a valve, keeping the airway open.
Some patients who have more than simple obstructive sleep apnoea may may a more sophisticated machine such as BIPAP (bi level positive airway pressure) device or ASV (adaptive servo ventilation ), which provide more breathing support.
Surgery is usually a last resort in sleep apnoea and a successful outcome cannot be guaranteed.
Lifestyle modifications are also important particularly losing weight, avoiding smoking and alcohol