Many people who have sleep apnoea, which results in repeated interruptions to normal breathing during sleep, are unaware that they have the condition. If you are experiencing persistent tiredness, morning headaches or poor concentration, or if snoring has become a problem, you may be suffering from sleep apnoea and should seek medical advice.
What is sleep apnoea?
Sleep apnoea is when the breathing stops and starts repeatedly when you are asleep. It can cause you to stop breathing for 20-30 seconds at a time throughout the night. It’s not always easy to tell if you have the condition as you are likely to be unaware that it is happening. Loud snoring, persistent tiredness and morning headaches are all potential indicators and should not be ignored.
What happens during sleep apnoea?
There are different types of sleep apnoea.
Obstructive sleep apnoea is the most common form and occurs when the throat narrows, blocking the flow of air into the lungs. As the throat walls relax, they block the airway which is what creates loud snoring, or a choking or gasping noise. A drop in the oxygen levels in your blood triggers you to wake up briefly to breathe. You may not remember waking, but these constant interruptions to your sleep throughout the night prevent you from dropping into a deep sleep and leave you feeling constantly tired during the day.
Central sleep apnoea is caused by the brain failing to send proper signals to the muscles that control the breathing. This is due to issues with your respiratory control centre, which is linked to your central nervous system. Central sleep apnoea most often affects people with neuromuscular diseases like amyotrophic lateral sclerosis, as well as those with heart failure or other forms of heart, kidney or lung disease, along with people who’ve had a stroke. It can also be linked to hormone levels, ageing or opioid use.
Complex sleep apnoea is a combination of obstructive and central sleep apnoea. It begins as obstructive sleep apnoea but develops into central sleep apnoea during treatment for the former.
What are the symptoms of sleep apnoea?
You may have sleep apnoea if:
- You snore loudly and persistently
- Your partner notices interruptions to your breathing when you are asleep
- You jolt awake gasping or choking
- You wake up with a very dry throat or a headache
- You are constantly tired, maybe even falling asleep during the day
- You have trouble concentrating or experience mood swings or forgetfulness
- You feel anxious or depressed
The more serious your condition, the more often your sleep will be interrupted and, therefore, the most severe your symptoms are likely to be.
What causes sleep apnoea?
Anyone can be affected by sleep apnoea however certain factors increase your risk. These include being overweight or having a large neck circumference that can make your airways narrower. If you have a narrowed airway due to your unique anatomy or because of enlarged tonsils or adenoids you may be prone to sleep apnoea. Men are more likely to have the condition than women and it is more common as you age. Smoking, drinking alcohol and using sedatives or tranquilisers all increase your risk. It is also common if you have nasal congestion or a family history of sleep apnoea. Certain medical conditions are associated with sleep apnoea, including type 2 diabetes, Parkinson’s disease and PCOS.
How is sleep apnoea diagnosed?
To diagnose sleep apnoea, your doctor or respiratory consultant will ask about your symptoms and health history. They may suggest wearing a breathing monitor while you are asleep which will track your breathing patterns, heart rate and blood oxygen levels. You may then be invited to a sleep clinic which will connect you to sensors that assess brain, heart and lung activity as well as the movements of your arms and legs.
If you have mild sleep apnoea, you typically experience 5-15 episodes of breathing interruption per hour. Moderate sleep apnoea causes 15-30 episodes per hour, while more than 30 episodes is categorised as severe.
Are there treatments for sleep apnoea?
Sleep apnoea cannot be cured however there are treatments available. These will vary depending on what type of sleep apnoea you have and how severe it is. A sleep apnoea mask is worn over your face at night to deliver air directly into your airways. A continuous positive airway pressure (CPAP) machine has a mask that covers your nose and mouth and blows air directly into your airways. A bilevel positive airway pressure (BPAP) machine delivers a greater force as you inhale, which works better for some people.
Some people prefer to use an oral appliance, such as a sleep mouth guard or tongue retaining device. Other devices are designed to encourage you to sleep on your side rather than your back, which can help prevent airway obstruction.
With central sleep apnoea you may need extra oxygen when you sleep, alongside treatment for any underlying conditions.
Dr Shalin Diwanji also offers surgical options for severe cases of sleep apnoea. These include:
- Uvulopalatopharyngoplasty (UPPP) to remove excess tissue from the throat
- Genioglossus advancement to reposition the tongue muscle attachment
- Maxillomandibular advancement to reposition the jaw
Frequently Asked Questions
Is sleep apnoea dangerous?
Sleep apnoea is associated with an increased risk of long-term health conditions that could shorten your lifespan. It causes persistent tiredness that puts you at increased risk of accidents and can seriously impact your quality of life.
When should you seek help?
If you suspect you may have sleep apnoea it’s important to seek medical advice. This is particularly important if the symptoms are worsening or having a detrimental impact on your quality of life.
Are there complications associated with sleep apnoea?
Yes, sleep apnoea is associated with an increased risk of certain, serious medical conditions including: high blood pressure, heart attack or stroke, type 2 diabetes, metabolic syndrome, and liver complications.