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Sleep Apnoea

Obstructive sleep apnoea (OSA) is a fairly common condition, estimated to affect more than 1.5 million people in the UK alone. Caused by a relaxing and narrowing of the walls of the throat during sleep, this condition results in loud snoring or heavy breathing that can have a big impact on daily life. Not only can OSA regularly affect your own quality of sleep, but also the other people in your household.  

Facts about Obstructive Sleep Apnoea:

  • OSA is estimated by British Lung Foundation to affect over 1.5 million people in the UK
  • 45% of those with OSA have moderate to severe symptoms
  • Fewer than 50% of those with moderate to severe symptoms are receiving treatment
  • OSA affects twice as many men as women
  • It generally affects people over age 40, although it can affect younger people too
  • According to various sleep studies, there are more than 25,000,000 snorers in the UK, equating to 40% of the population
  • It is calculated that approximately 5% of the UK adult population is thought to have undiagnosed OSA, equalling over 2.5 million people
  • If OSA is untreated it can increase the risk of heart disease, stroke and type 2 diabetes
  • Studies also suggest that tiredness could be the cause of 20% of road accidents
  • Lifestyle choices can greatly help to improve symptoms of mild to moderate OSA
  • There are also a number of effective treatment options available to assist when cases become moderate to severe

Symptoms of sleep apnoea

Symptoms of sleep apnoea are usually first noticed by a partner, family member or friend. As you are asleep, even if your sleep quality is poor, you likely won’t be aware that you have a problem.

Common symptoms of OSA include:

  • Loud snoring
  • Heavy breathing
  • Gasping or snorting over repeated short periods
  • Night sweats
  • Frequency to urinate during the night

If you live alone, what you may be aware of though is feeling excessively tired during the day and never feeling like you have properly rested, even if you have been in bed for many hours.

If you are experiencing any symptoms of sleep apnoea then seek the help of a medical specialist that can help determine your options.

What causes OSA?

Obstructive sleep apnoea causes the throat walls to relax and narrow during sleep. This affects normal breathing patterns and causes symptoms such as snoring and heavy breathing.

Two ways that breathing is affected are:

  • Apnoea – the muscles and soft tissue in the throat relax to the point where your airway is completely obstructed. Apnoea refers to a blocked airway for more than 10 seconds.
  • Hypopnoea – this refers to a partial blockage of the airway, reducing airflow by 50% for 10 seconds or more.

If you suffer with OSA, you may experience both apnoea and hypopnoea through the night. Therefore, this condition is sometimes referred to as obstructive sleep apnoea-hypopnoea syndrome (OSAHS).

For severe cases, symptoms of either apnoea or hypopnoea may occur every couple of minutes, making sleep extremely disturbed.

Common aggravates of OSA

A number of factors affect the narrowing of the throat walls to the degree where it causes breathing problems. These include:

  • Obesity, or being overweight – this is one of the main causes of OSA as excess tissue in the neck area puts stress on the throat muscles during sleep
  • Being male – OSA is twice as more common in men than women, possibly due to different fat distribution in the body
  • Age – OSA can affect people of all ages, but it is more common in over 40 year olds
  • Having a large neck – if your neck is greater than 17 inches, you could have an increased risk of OSA
  • Having naturally narrow airways, large tonsils or tongue, or a small lower jaw
  • Taking sedative medications
  • Being prone to nasal congestion
  • Drinking alcohol, particularly high volumes before going to bed
  • Being a smoker
  • Hormone changes for women, related to the menopause
  • Genetics – a family history may have an impact
A specialist consultation gives your health the attention it deserves.

Diagnosing and treating OSA

Diagnosing OSA is the first step to managing your symptoms and considering your treatment options.

OSA is typically diagnosed by being observed at a sleep clinic, where you will be tested using a number of different tools. These could include

  • EEG (electroencephalography – used to monitor brain waves
  • EMG (electromyography) – used to monitor muscle tone
  • ECG (electrocardiography) – used to monitor your heart
  • Pulse oximetry – used to measure heart rate and blood oxygen levels

Assessments will also be made of your chest and abdomen movements and airflow in your nose and mouth.

Instead of a sleep clinic, you could also use a home testing device for diagnosis, if recommended by your doctor. Here, you will be given equipment to use overnight, including:

  • Breathing sensor
  • Sensors to track heart rate
  • Chest bands to monitor movement
  • Oxygen sensors on your finger

Simple home assessment with oxygen sensors and pulse monitoring is as effective as a detailed sleep study. Therefore, this is our first line of assessment, minimising your inconvenience.

Upon diagnosis, your doctor will give your condition an OSA score to show the severity of your symptoms. This score is determined from the results of all the various specialist tests according to the apnoea-hypopnoea index (AHI).

  • AHI of 5 to 14 episodes per hour = MILD
  • AHI of 15 to 30 episodes per hour = MODERATE
  • AHI of 30+ episodes per hour = SEVERE

Treatments for OSA will depend on the severity of your symptoms, as well as key causes.

Initially, lifestyle choices can help reduce symptoms:

  • Losing weight, stopping smoking, drinking less alcohol and maintaining higher levels of general good health is a good start to improve symptoms
  • Changing sleeping habits, to sleep on your side instead of your back, may also help

Other treatments include:

  • Continuous positive airway pressure (CPAP) – where a mask is used to assist breathing at night
  • Mandibular advancement device (MAD)
  • Surgery for OSA, may include:
    • Tonsillectomy
    • Adenoidectomy
    • Tracheostomy
    • Weight loss (bariatric) surgery

Seek the right help to feel your best

To feel our best is ultimately everyone’s goal in life.

Often it is only when a condition arises, leaving us feeling unwell, that it becomes clear as to the value of our health.

Expert help is available to help you to better understand, manage and improve symptoms related to your respiratory health.

A specialist consultation gives your health the attention it deserves.