What is Obstructive Sleep Apnoea?

Obstructive Sleep Apnoea

Obstructive Sleep Apnoea (OSA)

Firstly, you may have noticed two spellings of Sleep Apnoea. Sleep Apnea is the spelling used in the United States, and Sleep Apnoea is used in the United Kingdom.

What is Obstructive Sleep Apnoea?

Obstructive Sleep Apnoea, or OSA, is the most common form of Sleep Apnoea, which is caused by a blockage in the airway whilst you sleep. The blockage is typically caused by soft airway tissue relaxing too much (the tongue, the soft palate, etc.). These obstructions cause shallow breathing (hypopnoea) and breathing pauses (apnoea). The breathing pauses reduce the amount of oxygen reaching your brain, which can cause your body to wake up to breathe suddenly, and in many cases, you will experience choking and gasping for air.

There are various symptoms of Sleep Apnoea, and not all of them are experienced by everyone. These include snoring in some individuals, but just because you snore doesn’t mean you have Obstructive Sleep Apnoea. However, it remains one of the critical indicators of the condition.

 

sleep apnoea event
Obstructive Sleep Apnoea Event

The concerning part of the condition is that it stops you from breathing. We have an animation showing a typical Sleep Apnoea episode on the right. The pause in breathing can last 10 seconds (or more) before the brain wakes you up (micro-arousal). Once awake, your airway opens again, and you fall asleep.

These micro-arousals, caused by the apnoeas, often go unnoticed by the sufferer despite occurring up to 400 times a night. The continuous breathing pauses cause your blood oxygen levels to drop, reducing the amount of oxygen that reaches your lungs. Partners or roommates are likelier to notice the gasping or loud snoring noise associated with the apnoeas.

When Obstructive Sleep Apnoea is left untreated, it disrupts your sleep cycle, impacting the quality of your deep sleep. The effect on your sleep cycle leaves you chronically sleep-deprived, affecting your energy levels, concentration and memory.

 

Obstructive Sleep Apnoea Symptoms (OSA Symptoms)

Key warning signs and symptoms of Obstructive Sleep Apnoea:

Any combination of these symptoms will adversely affect your day-to-day life and the life of your bed partner. Sleep deprivation alone can disrupt relationships and cause increasing amounts of stress. In one study of 421 people, researchers found that 95% of those diagnosed with OSA thought they suffered from a snoring or fatigue problem. They didn’t know about OSA, the symptoms or the risks.

 

Obstructive Sleep Apnoea is a common and treatable condition

There are several types of Sleep Apnoea, but the most common is Obstructive Sleep Apnoea. The most popular treatment is CPAP therapy.

The first step is to understand if the symptoms you are experiencing are due to Sleep Apnoea. To do that, you can use our Free Online Sleep Apnoea Risk Test to assess your risk. Click below to get started.

If the risk test shows that you are at risk of having Obstructive Sleep Apnoea, the next step would be to complete a simple overnight Sleep Study. The In-Home Sleep Test will confirm if you have the condition or not.

 

What does Sleep Apnoea sound like?

When observing someone with Obstructive Sleep Apnoea, you may hear different breathing patterns, choking and gasping. Watch the video below showing a Sleep Apnoea event happening.

Obstructive Sleep Apnoea Statistics UK

Obstructive Sleep Apnoea is more common in men than women, especially men who are overweight and have severe snoring. Seniors are more likely to develop the condition – as are people with hypertension, diabetes, and obesity. With the increasing age of the population and the rise in obesity in the UK, the number of OSA cases is expected to increase in the coming years.

Most cases of OSA go undiagnosed for years, but experts estimate that in the UK, 10 million adults have the disorder. Only a tiny number – just 330,000 people – have had OSA confirmed and treated. When the condition is not treated, people don’t get the restorative sleep the body requires.

Related topic: Sleep Apnoea Symptoms In Women

Statistics of risks for untreated OSA

Statistics show that sufferers of Obstructive Sleep Apnoea are more likely to experience higher risks of other conditions and accidents relating to sleep deprivation.

  • 40% increased excessive daytime sleepiness
  • Two times more traffic accidents per mile
  • Three times greater risk of occupational accidents
  • 40% increased risk of depression
  • 1.3 to 2.5 times more hypertension
  • 1.6 times increased chance of stroke
  • 1.4 to 2.3 times greater risk of heart attack
  • 2.2 times higher risk of nocturnal cardiac arrhythmia
  • 3.9 times more likely to have congestive heart failure

What are the dangers of untreated Obstructive Sleep Apnoea?

Many wonder if OSA can cause them to choke to death or suffocate from repeated breathing pauses. It is unlikely for this to happen. However, when Obstructive Sleep Apnoea is left untreated, the risk of other health conditions developing increases.

Many people with Obstructive Sleep Apnoea develop high blood pressure (hypertension), which can increase the risk of heart disease. When Sleep Apnoea is left untreated, your body’s oxygen levels repeatedly drop, triggering your body to release stress hormones and increase your heart rate and blood pressure. This puts you at a higher risk of cardiovascular conditions, including:

Other complications of Obstructive Sleep Apnoea include:

  • Complications with medications and surgery: Sleep Apnoea is also concerned with certain medications and general anaesthesia. Medications, such as sedatives, narcotic analgesics and general anaesthetics, relax your upper airway and can worsen your sleep disorder.
  • Eye problems: Some research has found a connection between Obstructive Sleep Apnoea and certain eye conditions, such as glaucoma.
  • Alzheimer’s: There is a close link between untreated Sleep Apnoea and the development of Alzheimer’s due to cognitive decline and memory loss.
  • Type 2 diabetes: The oxygen deprivation associated with the condition can worsen insulin resistance and lead to difficulty regulating blood sugar levels.

These health comorbidities mean Obstructive Sleep Apnoea itself won’t kill you, but the conditions that develop can.

How to treat Obstructive Sleep Apnoea

If an In-Home Sleep Test confirms the presence of OSA, several clinically proven treatments are available.

1. CPAP Therapy for Sleep Apnoea

What is Obstructive Sleep Apnoea?

CPAP (Continuous Positive Airway Pressure) therapy is the most widely used method to treat Obstructive Sleep Apnoea of all severities. It consists of a CPAP machine that pumps air through a connecting hose into a CPAP mask worn while sleeping. The air gently creates an ‘air splint’ to open the airway. The pressure provided by the CPAP machine stops the throat from constricting and closing, preventing the apnoea and hypopnoea from occurring so you can sleep and breathe normally. While this may sound like a ventilator, CPAP does not breathe for you or provide oxygen. You breathe air normally while the increased pressure from the machine prevents Obstructive Sleep Apnoea Hypopnoea Syndrome (OSAHS) from occurring.

If you are suffering from Sleep Apnoea, you may be able to obtain the CPAP therapy treatment you need via the NHS (although waiting times can be several months to a couple of years), or you can purchase all the equipment you need privately.

Most Sleep Apnoea sufferers who receive CPAP treatment experience a dramatic improvement in their health and quality of life. They demonstrate significant improvements in driving, daytime sleepiness, cognitive performance and mood. It can also work in unison to improve other health conditions when your Sleep Apnoea is being treated.

2. OAT (Oral Appliance Therapy) or MAD (Mandibular Advancement Device)

Mandibular Advancement for OSA

Oral Appliance Therapy uses a splint worn in the mouth to move the lower jaw slightly forward. to allow for more airflow. Positioning the lower jaw forwards creates more space inside the throat to pass air. It reduces the frequency of apnoeas and hypopnoeas as a result. In many cases, snoring can also be significantly reduced.

The splint can be either a custom-made appliance fitted by a dentist or a much lower-cost ‘heat and bite’ device that provides simple customisation. OAT is a clinically-proven method of treating mild OSA, and some find it more comfortable or less invasive than CPAP therapy.

A mandibular repositioning appliance is a commonly used OAT device. Similar to a gum shield.

3. Positional Obstructive Sleep Apnoea Therapy

Positional Obstructive Sleep Apnoea Therapy

An alternative to CPAP therapy is Positional Therapy, which treats people with Obstructive Sleep Apnoea, primarily when they sleep on their backs. When sleeping on the side, the airway can remain open, and breathing returns to normal. Positional Therapy involves wearing a small device on your forehead; it vibrates when you turn onto your back, encouraging you to roll back to sleeping on your side. Many people need Positional Therapy in addition to other Sleep Apnoea treatments.

4. Lifestyle changes for Obstructive Sleep Apnoea

If appropriate, a nutrition and weight-loss program can often relieve symptoms of OSA. Living a healthier lifestyle has been found to have a positive effect on sleep, OSA and many other health issues (4). The different lifestyle changes you can try include:

There is a direct link between excess weight and the onset of snoring and Obstructive Sleep Apnoea, so if you are overweight, you may find that weight loss will improve your symptoms.

If you have any questions about Sleep Apnoea, your symptoms or how to get tested, please contact us. Our friendly team can offer you the help and support you need.

REFERENCES

  1. NICE (2021) Overview: Obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s: Guidance, NICE. National Institute for Health and Care Excellence. Available at: https://www.nice.org.uk/guidance/ng202 (Accessed: October 21, 2022).
  2. Sleep Matters (ed.) (2020) HOW MANY PEOPLE IN THE UK HAVE OBSTRUCTIVE SLEEP APNOEA (OSA)?, The Sleep Apnoea Trust. SLEEP MATTERS. Available at: https://sleep-apnoea-trust.org/research/ (Accessed: October 20, 2022).
  3. Vgontzas, A.N. (1994) “Sleep apnea and sleep disruption in obese patients,” Archives of Internal Medicine, 154(15), pp. 1705–1711. Available at: https://doi.org/10.1001/archinte.154.15.1705.
  4. Kaleelullah, R.A. and Nagarajan, P.P. (2021) “Cultivating lifestyle transformations in obstructive sleep apnea,” Cureus, 13(1). Available at: https://doi.org/10.7759/cureus.12927.

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