Sleep apnoea is not just snoring and disrupted sleep - it’s a serious medical condition.

People who have obstructive sleep apnoea (OSA) will experience continuous episodes of partial or complete obstruction of the throat while sleeping (Sleep Health Foundation 2019a).

This obstruction occurs when the walls of the upper airway collapse and narrow, preventing air from reaching the lungs (Better Health Channel 2021).

A person with OSA will stop breathing for a short period of time. Typically this will last between 10 seconds to one minute (Better Health Channel 2021).

This cycle repeats multiple times during the night. The effect of this is fragmented sleep, causing a person to feel un-refreshed upon waking; daytime tiredness; poor concentration; and general fatigue (Better Health Channel 2021).

Someone with sleep apnoea will:

• Cease breathing completely (apnoea), and/or
• Experience severely restricted breathing (hypopnoea).

(Better Health Channel 2021)

Note: Central sleep apnoea also causes breathing to stop and start during sleep, but it’s not the same as OSA. Rather than being caused by upper airway obstruction, central sleep apnoea occurs when there is disrupted communication between the brain and the muscles that control breathing (Mayo Clinic 2021; Newsom & Truong 2022).

The Apnoea / Hypopnoea Cycle

1. Muscles of the airway relax, a person’s breathing slows and snoring may begin.
2. The airway is blocked, which causes breathing to stop.
3. Oxygen in the blood decreases and the heart rate slows. The body struggles for air.
4. The brain arouses and jolts the airway clear.
5. The person gasps for air, possibly violently, disturbing their sleep.
6. Breathing returns to normal.

(Mayo Clinic 2021)

How Prevalent is Sleep Apnoea?

An estimated 5% of Australians experience sleep apnoea. Around one in four men over the age of 30 years are affected (Better Health Channel 2021).

Causes of Sleep Apnoea

Obesity is seen as being the leading cause of sleep apnoea. Other factors include:

• Alcohol consumption
• Some illnesses including hypothyroidism
• Large tonsils
• Certain medications such as sleeping tablets and sedatives
• Nasal congestions and / or obstruction
• Facial bone shape and size of muscles.

(Better Health Channel 2021)

Symptoms of Sleep Apnoea

• Snoring
• Tossing and turning in the night
• Gasping and choking in the night
• Daytime tiredness
• Reduced concentration
• Irritability and decreased mood
• Impotence and reduced sex drive
• Morning headaches
• Polyuria.

(Sleep Health Foundation 2019a; Better Health Channel 2021)

What are the Consequences?

Evidence indicates that people who have moderate to severe OSA will have other health problems. This includes higher risk of heart attack, stroke, depression, hypertension and diabetes (Sleep Health Foundation 2019a).

Research suggests that people who have OSA are roughly two and a half times more prone to motor vehicle accidents than those without it (Sleep Health Foundation 2019a).

Degrees of Severity

• Normal sleep: Less than 5 breathing interruptions per hour
• Mild sleep apnoea: Between 5 and 15 breathing interruptions per hour
• Moderate sleep apnoea: Between 15 and 30 breathing interruptions per hour
• Severe sleep apnoea: Over 30 breathing interruptions per hour.

(Better Health Channel 2021)

Diagnosis of Sleep Apnoea

If the symptoms of OSA are present: snoring, breathing pauses and sleepiness during the day, a person may want to be checked for OSA. The way this condition is typically diagnosed is by an overnight sleep study (Sleep Health Foundation 2019a).

Treatment for Sleep Apnoea

It’s necessary to know the cause of a person’s sleep apnoea, as no single treatment is applicable for everyone (Sleep Health Foundation 2019b).

Lifestyle changes are considered to be the first line of treatment for sleep apnoea - specifically, losing weight and reducing alcohol consumption (Better Health Channel 2021).

Continuous Positive Airway Pressure (CPAP)

In addition to lifestyle changes, it is often recommended that patients wear a mask at night that prevents their throat from collapsing. The mask gently transmits increased air pressure to the throat. The term for this is nasal continuous positive airway pressure or CPAP. A person with OSA should work with a health professional to find the mask and machine that works for them (Better Health Channel 2021). CPAP is typically very successful at managing the symptoms and effects of OPA (Sleep Health Foundation 2019a).

For people with mild to moderate sleep apnoea, a mouthguard or similar apparatus may be useful (Better Health Channel 2021).

In severe cases where other therapies have been unsuccessful, surgery to the palate and base of the tongue might be recommended. This surgery is best undertaken by otolaryngologists, who are specifically trained in sleep-related surgery (Better Health Channel 2021).

References