Do you snore? Do you feel tired during the day? Obstructive Sleep Apnoea could be affecting you. Do you wake up frequently in the night, get headaches, feel tired throughout the day and have a partner that complains about your snoring? You may be suffering from something called Obstructive Sleep Apnoea (OSA)… The walls of the throat naturally relax and become floppy during sleep, but in some people this causes frequent and persistent blocking of the airway, which prevents oxygen from getting to the lungs and a decrease in body oxygen levels.
What symptoms might suggest Obstructive Sleep Apnoea?
Symptoms include loud snoring, frequent interruptions of sleep with choking or gasping for breath when the airflow is blocked.
As it occurs while people are sleeping, most people do not remember these events and may often present with other symptoms, such as feeling very tired throughout the day due to broken sleep, and experiencing headaches as a result.
Are you at risk?
Anyone can develop OSA, however there are some specific factors that significantly increase the risk of OSA. These include being overweight, over 40 years of age, having a large neck size, smoking, alcohol and a family history of OSA.
In women, the menopause can cause hormonal changes which may cause the throat muscles to relax more than usual.
The Epworth Sleepiness Scale is a score used by health professionals as a screening tool. It helps health professionals to understand whether you could be suffering from excessive sleepiness and can help to give an idea whether OSA might be the cause. You can have a go at this questionnaire by following the link to the British Lung Foundation http://bit.ly/ESSBLF
How is OSA diagnosed?
To diagnose OSA a sleep study must be undertaken, either at home or as part of a sleep clinic. To make a diagnosis, you need to have more than 5 episodes per hour when breathing stops for more than 10 seconds.
It is varying degrees of severity, with the most severely affected experiencing episodes more than 30 times per hour.
If you think you are suffering from OSA it’s really important to seek advice from your GP or a specialist in OSA to decide whether further tests are required to aid a diagnosis. A lot of treatments can be done without a specialist, which we discuss later in this article.
The Cycle of OSA while sleeping – sleepsociety.org
Is OSA serious?
The main problem people notice with OSA is tiredness, lethargy and an increased tendency to fall asleep during the day. This lack of sleep can have a significant negative impact on your day to day life, causing problems such as lowering performance at school or at work, and putting stress on your relationships.
In the long term, unidentified or poorly managed OSA has been linked to an increased chance of developing a number of other conditions including type 2 diabetes, high blood pressure and cardiovascular problems including strokes and heart attacks.
So it is important to realise OSA is an important condition to manage, otherwise the risk of developing more serious conditions increases.
Do you drive?
If you are a driver, you have a significantly higher risk of falling asleep at the wheel and having an accident. Someone with impaired sleep through OSA is nearly 2.5 times more likely to be involved in a road traffic accident.
This means that a diagnosis of OSA may mean your ability to drive is affected so by law, you have to inform the Driver and Vehicle Licensing Agency (DVLA) if you are diagnosed with OSA.
There are a number of options that can help to reduce the symptoms and negative effects of OSA
Lifestyle management which is vital to make big improvements in the long term. Obstructive Sleep Apnoea can be treated without medical treatments such as devices or surgery. By addressing the main risk factors, you may be able to stop OSA in its tracks.
Lose weight, Stop Smoking, Reduce Alcohol Consumption.
It could really be that simple…by reducing weight, this will contribute to a reduction in your neck size and pressure on your airway when you’re sleeping. By reducing alcohol and smoking this will help to improve and maintain the integrity of your airway and stopping smoking will also reduce carbon monoxide levels in your blood stream, leading to increased oxygen in your blood.
TheDoctorService.co.uk is able to assist with managing obesity and also in smoking cessation. See our medications available and our blog for further information on these topics at TheDoctorService.co.uk
What are the other options?
These are more invasive and unpleasant, hence why addressing the lifestyle problems are much more important.
Mandibular Advancement Device (MAD)
This is a bit like a retainer that you put in your mouth and fits around your teeth. The MAD holds your jaw forward to increase the space for air to flow to the back of your throat whilst you sleep.
Continuous Positive Airway Pressure (CPAP)
This is mask that you wear over your nose and mouth at night which is connected to a machine. This device delivers a continuous supply of compressed air down your airway which stops it from closing in the night.
The above interventions are more about managing the condition rather than treating and curing the condition. For some it is very difficult to modify lifestyle factors, or despite modification they are not able to improve their symptoms of OSA. For those then the above interventions will be the main way to manage the symptoms.
Finally, there is surgery.
For most people surgery isn’t appropriate. However, it may be considered as a last resort if other treatments haven’t worked or if the doctors think the cause of your OSA may be an abnormality in the structure of your inner neck.
OSA is common, and many people do have some of the modifiable risk factors for OSA, so if OSA is affecting you, a lifestyle improvement may just do the trick.
Further health information on a variety of topics can be found on our website along with effective treatments for a range of ailments.
Edited by Dr Kiran Sodha & The Doctor Service
- Tregear S, Reston J, Schoelles K, Phillips B. Obstructive Sleep Apnea and Risk of Motor Vehicle Crash: Systematic Review and Meta-Analysis. Journal of Clinical Sleep Medicine. 2009;5(6):573- 81.