Sleep apnoea is a breathing disorder that occurs during sleep
There are brief periods during which breathing stops
The causes depend on the type of sleep apnoea
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2% of women and 4% of men suffer from sleep apnoea
Overweight people and those with facial deformities that could obstruct airways are more at risk
Treatment may include behavioural changes, mouth devices, C-PAP treatment and surgery
What is sleep apnoea?
Sleep apnoea is a breathing disorder that occurs during sleep. It is typically accompanied by loud snoring and consists of brief periods during which breathing stops. As a result, sufferers of sleep apnoea do not get enough oxygen during sleep. There are three types of sleep apnoea:
The first is obstructive sleep apnoea – this is the most common type and also known as the pickwickian syndrome. It occurs due to an obstruction in the throat during sleep. Approximately 10 to 60 seconds pass between loud snores and the narrowing of the upper airway may be a result of several factors including inherent physical characteristics, excess weight, and alcohol consumption before going to bed.
The second is central sleep apnoea which is caused by a delay in the signal transmitted from the brain to elicit breathing. With both obstructive and central apnoea the sufferer must wake up briefly in order to breathe, sometimes hundreds of times during the night. Usually there’s no memory of these awakenings.
Thirdly, there is mixed sleep apnoea. As the name suggests, it’s more or less a mixture of the above. It usually starts as unobstructive apnoea that is then followed by upper airway obstruction. It occurs less frequently than obstructive sleep apnoea, but more frequently than central sleep apnoea.
What causes sleep apnoea?
Obstructive sleep apnoea is caused by something blocking the windpipe – the tongue, tonsils or uvula (the little piece of flesh at the very back of the throat). Fatty tissue or lax throat muscles may also cause the blockage.
Central sleep apnoea involves the nervous system and is more rare. The muscles used to breathe get mixed or confused messages from the brain – or the signal might be interrupted.
Who gets sleep apnoea and who is at risk?
Studies indicate that 2% of women and 4% of men suffer from sleep apnoea. Overweight people and those with facial deformities that could obstruct airways are more at risk.
Symptoms and signs of sleep apnoea
Loud snoring
Waking up still tired, groggy and struggling to stay awake during the day
Waking up with headaches
Waking up feeling a choking sensation
Gasping, holding your breath during sleep
Waking up sweating and excessive perspiring during sleep
Frequent stopping of breathing during sleep
High blood pressure
Overweight (sometimes), rapid weight-gain
Dry mouth upon awakening
Depression
Difficulty concentrating during the day
Several trips to the bathroom during the night
Heartburn
Reduced libido
Insomnia
How is sleep apnoea diagnosed?
A sleep test, called polysomnography, is usually done to diagnose sleep apnoea. There are two kinds. An overnight test involves monitoring brain waves, muscle tension, eye movement, respiration, oxygen level in the blood and audio monitoring of snoring and gasping. In some countries home monitoring test are available. A sleep technologist hooks you up to all the electrodes and instructs you on how to record your sleep with a computerised polysomnograph that you take home and return in the morning.
How is sleep apnoea treated?
When the condition is mild it could usually be easily treated by behavioural changes. Losing weight and sleeping on your side is almost always recommended. There are mouth devices available that help to keep the airway open and can reduce snoring in three different ways.
Some devices bring the jaw forward while others elevate the soft palate. You also get devices that retain the tongue from falling back in the airway and blocking breathing.
Moderate to severe sleep apnoea is usually treated with C-PAP – Continuous Positive Airway Pressure. A machine blows air into your nose via a nose mask, keeping the airway open and unobstructed. For more severe cases, there is a Bi-level (Bi-PAP) machine. This machine blows air at two different pressures. When the patient inhales, the pressure is higher and when exhaling, the pressure is lower.
Some people have facial deformities that may be the cause of their sleep apnoea. It simply may be that their jaw is smaller than it should be or they could have a smaller opening at the back of the throat. Others have enlarged tonsils, a large tongue or some other tissues partially blocking the airway. Fixing a deviated septum may help to open the nasal passages. Removing the tonsils and adenoids or polyps may also help.
Other surgical treatments include removing excess tissue to clear the airway and moving the upper and lower jaw forward.
Success of treatment is measured by the reduction of respiratory disturbance to normal levels. If untreated, the personal and professional life of someone who has sleep apnoea could suffer considerably. And the risk of a heart attack or stroke rises.
If you suffer from sleep apnoea and you have been taking sleeping aids of any kind – stop. Rather resort to sleeping on your side instead of your back. If you are overweight, try to lose weight.
What is the outcome of sleep apnoea?
If treated correctly – whether it is through behavioural changes, C-PAP treatment or surgery - a sufferer of sleep apnoea could be successfully cured of this debilitating condition and once again enjoy a quality life thanks to quality sleep.
Can sleep apnoea be prevented?
It is impossible to prevent facial deformities and blocked airways due to tissue. Also, if the condition is central – and involves the nervous system, it is not something that can be prevented. What should and could be prevented is for the condition to continue.
When to call the doctor
When your partner starts complaining about your snoring, you keep waking up tired and groggy and it is detected that you gasp for air during sleep, you should see a doctor about you condition. If you wake up during the night with the sensation of being choked, you need to get medical advice.
Sleep apnoea is a potentially life-threatening condition that requires immediate medical attention. The risks of undiagnosed obstructive sleep apnoea include heart attacks, strokes, impotence, irregular heartbeat, high blood pressure and heart disease. In addition, obstructive sleep apnoea causes daytime sleepiness that can result in accidents, lost productivity and interpersonal relationship problems.
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