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Obstructive sleep apnoea
Patients with obstructive sleep apnea (OSA) have repeated episodes of partial or complete obstruction of the throat during sleep. If partial or complete obstructions occur breathing is reduced or stops for a short time – from 10 seconds up to a minute or more – and blood oxygen levels fall as a result. A brief interruption to sleep (an arousal) that lasts for as little as 3 seconds then occurs, allowing breathing to start again but your sleep is disrupted as a result. These episodes of obstruction may happen many times – even hundreds of times - overnight. Some people know that their breathing is not normal at night, but may be unaware that this is a medical problem that is causing them harm. Fortunately, good treatments are available.
If you have OSA you may snore and others may notice that you stop breathing during the night. Because of the disruptive effects of OSA on sleep you may find yourself waking up often during the night, sometimes gasping or choking, although this does not always happen. You may also need to use the bathroom multiple times a night due to these awakenings. Because sleep is disturbed you may wake up tired and be excessively tired during the day. Irritability and other mood changes are common in untreated OSA.
OSA disturbs your sleep and is a stress on your body and there is strong evidence that people with untreated moderate to severe OA have other health problems. These include increased risk of high blood pressure, heart attack, stroke, diabetes, depression and accidents. Thinking is less clear, mood is down and productivity at work and at home suffer.
OSA can occur at any age. In children, it is often the result of enlarged tonsils or adenoids. In adults, OSA is more common in middle age and in older people.
Signs and symptoms such as snoring, obesity, observed breathing pauses and sleepiness during the day may suggest that a person has OSA. The best way to be really sure is with an overnight sleep study.
For people with a mild level of OSA and few symptoms, losing weight, decreasing the amount of alcohol consumed in the evening or adjusting the sleeping position may be all that is needed. Most people have more OSA episodes sleeping on their backs. However, for those with moderate or severe OSA more active treatment is often required. This is particularly so if daytime tiredness is present or there is a background of heart disease, stroke or high blood pressure that has been difficult to control. The two most commonly used treatments for moderate to severe OSA are nasal continuous positive airway pressure (CPAP).
CPAP uses a small, quiet air pump that takes air from the room and delivers it under gentle pressure to a mask that covers your nose. This acts to hold your throat open during the night. You only use CPAP at night in bed. It is very good in controlling the symptoms and the long term effects of sleep apnea. It stops the snoring and the machine noise is very much quieter than the snoring was. Sometimes it takes a while to get used to CPAP but your CPAP provider will guide you through.
