Sleep apnoea

Sleep apnoea

Sleep Centre


Sleep apnoea

Sleep apnoea is a disorder in which one repeatedly stops breathing during the night. It has many potential causes, all of which lead the upper airway to collapse while someone is asleep. Treatment of sleep apnoea is necessary to prevent major health problems.


Definition

Obstructive sleep apnoea occurs when the muscles in the back of your throat relax. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate (uvula), the tonsils and the tongue.

When the muscles relax, your airway narrows or closes as you breathe in, and breathing momentarily stops. This may lower the level of oxygen in your blood. Your brain senses this inability to breathe and briefly rouses you from sleep so that you can reopen your airway. This awakening is usually so brief that you don’t remember it.

You can awaken with a transient shortness of breath that corrects itself quickly, within one or two deep breaths, although this is rare. You may make a snorting, choking or gasping sound. This pattern can repeat itself five to 30 times or more each hour, all night long. These disruptions impair your ability to reach the desired deep, restful phases of sleep, and you’ll probably feel sleepy during your waking hours. Sleep apnoea is diagnosed with an overnight sleep test called a polysomnogram, or a “sleep study”.

Causes

The causes of sleep apnoea range from overweight, obesity and acid reflux to central nervous system disorders and physical abnormalities. No matter what the cause, the results are the same: the throat collapses or becomes obstructed, causing breathing to stop for several seconds.

Sleep apnoea and obesity have an interrelated relationship. There is little doubt that excess weight can cause sleep apnoea: the extra fat and soft tissue in the throat puts pressure on the airway, increasing the chance that the airway passage will collapse. Sixty to seventy percent of sleep apnoea patients are obese.

While obesity is a cause of sleep apnoea, the relationship between sleep apnoea and obesity is even more complex. Additional weight gain is a common sleep apnoea symptom, so obesity can cause sleep apnoea, and sleep apnoea in turn can worsen obesity.

GERD, or gastro-oesophageal reflux disease, is a possible cause of sleep apnoea. GERD symptoms occur due to acid reflux. Stomach acid seeps into the oesophagus (gullet), damaging oesophageal tissue. In cases of severe GERD, acid reflux can cause scarring and tissue damage as far up the throat as the vocal cords. Chronic acid reflux can scar the inside of the throat, causing obstructions that result in sleep apnoea.

Treatment

To prevent the obstruction of the airway, which is the most common cause of sleep apnoea, there is one treatment that is the best option. To keep the upper airway open, it is often necessary to support it with a constant flow of air delivered through a face mask worn while sleeping. This most common treatment is called Continuous Positive Airway Pressure or CPAP.

Once it has been determined by a physician that this is the best treatment option, it is necessary to visit with a provider of durable medical equipment. The CPAP machine will be set with a prescribed pressure, and other equipment — including a humidifier, hosing, and a personally fitted mask — will be issued. It is important to find a mask that is comfortable, with minimal leakage when it is worn. Most individuals who use CPAP are able to tolerate it after a few weeks of regular use.

Other options

Although CPAP therapy is clearly the best option in moderate to severe sleep apnoea, some individuals cannot tolerate it. In this case, other treatment options might be pursued, including:

    • weight loss
    • surgery to remove excess tissue in the throat
    • positional sleep aids (such as “sleep shirts” or wedges)
    • dental devices to move the lower jaw forward
    • oxygen support (which is not usually sufficient alone)

Our Employee Wellbeing Programme (EWP) is available 24 hours a day if you want to know more about sleep apnoea. Call us on our EWP number or email us at
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2018-04-26T07:41:43+00:00