SNORING & SLEEP APNOEA

Obstructive Sleep Apnoea

What's Obstructive Sleep Apnoea?

Obstructive Sleep Apnoea (OSA) is a sleep disorder that causes the upper airway to constrict excessively during sleep - sometimes to the point of complete blockage. This process is like holding your breath underwater, leading to a severe drop in blood oxygen levels and disrupted sleep, as your brain strives to keep you awake and breathing.

Symptoms of Obstructive Sleep Apnoea

Obstructive Sleep Apnoea has several signs and symptoms, often heard or seen by others long before we recognise them ourselves. It affects both daytime and night-time routines.

During sleep:

• Loud, chronic snoring

• Intermittent pauses in breathing

• Choking or gasping for air

• Restless tossing and turning

• Getting up to pass urine

During the day:

• Morning headaches

• Excessive sleepiness

• Frequent napping

• Difficulty concentrating

It's crucial to understand that not everyone who snores suffers from obstructive sleep apnoea. The diagnosis of sleep apnoea is made only with a polysomnogram or sleep study.

What Are the Causes of Obstructive Sleep Apnoea?

OSA occurs when throat muscles relax during sleep, blocking the airway and causing brief awakenings to resume breathing. Factors that contribute to airway collapse include:

• Excess Weight: Fat around the neck can press on the airway.

• Large Neck Circumference: Indicates more tissue narrowing the airway.

• Structural Issues: Enlarged tonsils, large tongue, or a receding jaw can reduce airway space.

• Weak Airway Muscle Tone: Reduced strength in throat muscles can cause collapse.

• Fluid Buildup: Conditions like heart or kidney failure may cause neck fluid retention, increasing airway pressure.

• Hormonal Changes: Hormonal imbalances can influence the development and progression of obstructive sleep apnoea.

What Are the Risk Factors for Obstructive Sleep Apnoea?

While anyone can develop sleep apnoea, several factors significantly increase one’s risk:

• Age: Throat muscle tone weakens with age, increasing the risk of airway collapse.

• Gender: Men are more likely to develop OSA.

• Family History: Genetics can affect facial and airway structure.

• Alcohol and Sedative Use: These relax throat muscles, increasing airway blockage.

• Smoking: Causes airway inflammation and reduces muscle reflexes that keep airways open.

• Nasal Obstruction or Sinus Issues: Chronic congestion or structural problems can disrupt breathing and increase OSA risk.

What Are the Complications of Obstructive Sleep Apnoea?

Untreated Obstructive Sleep Apnea (OSA) can lead to a range of serious, and sometimes life-threatening, health complications. These include:

• High blood pressure (hypertension)

• Heart problems like arrhythmias, heart failure, and an increased risk of sudden cardiac death

• Pulmonary hypertension

• Stroke

• Cognitive decline and dementia

• Diabetes

• Excessive daytime sleepiness

Are you experiencing persistent snoring, daytime fatigue, or witnessed breathing pauses?

Don't let these symptoms go unaddressed. Contact our ENT clinic today for a comprehensive evaluation and personalised care.

How Is Obstructive Sleep Apnoea Diagnosed?

To diagnose sleep apnoea, your doctor will evaluate your symptoms and sleep history. It is very helpful if a bed partner or household member can share observations like loud snoring, gasping, or breathing pauses. Following the initial evaluation, our  ENT sleep specialist will determine the need for further testing to confirm a diagnosis and assess the severity of sleep apnoea. The two primary types of sleep tests are:

Polysomnography

Polysomnography is considered the "gold standard" for diagnosing sleep apnoea and other sleep disorders. This comprehensive overnight test is conducted in a hospital, with or without a technician present to monitor your sleep.

During the study, you are connected to sensors that continuously monitor various bodily functions, including:

• Brain waves (to identify sleep stages)

• Heart rate and rhythm

• Blood oxygen levels

• Breathing patterns and airflow

• Eye movements

• Arm and leg movements

This test is particularly recommended when other sleep disorders are suspected or if there is concern about central sleep apnoea.

Home Sleep Apnoea Testing

Home Sleep Apnoea Testing (HSAT) offers a more convenient and cost-effective alternative to an in-lab study, allowing you to perform the test in the comfort of your own home. These simplified tests typically measure key indicators such as heart rate, blood oxygen levels, airflow, and breathing patterns.

While HSATs are convenient, it is important to note that portable monitoring devices can occasionally miss cases of sleep apnoea or other sleep disorders. Therefore, if your symptoms persist or if there is a strong clinical suspicion of sleep apnoea, your healthcare provider may still recommend a polysomnography even if your initial home sleep test results appear normal.

Treatment of Obstructive Sleep Apnoea

Treating Obstructive Sleep Apnoea requires a personalised treatment plan factoring in your individual health history, lifestyle, and severity of symptoms.

• Lifestyle modifications such as losing weight, quitting smoking, and limiting alcohol intake. Furthermore, changing your sleep position from lying on your back can alleviate symptoms.

• Continuous Positive Airway Pressure (CPAP) therapy that involves wearing a mask over your nose and/or mouth while you sleep, which is connected to a machine that delivers air at high pressures to keep your airways open.

• Oral Appliance Therapy which involves custom-fitted dental devices that help keep the airway open.

• In certain complex instances, surgery may be recommended to remove excess tissue from the throat or nose, or to reposition the jaw.