Sleep Apnoea

Sleep apnoea is the term used for periods in which a person temporarily stops breathing while asleep. Sleep apnoea is a common sleep disorder that is increasingly being diagnosed. When a person has sleep apnoea, he or she stops breathing for short periods of time. In most cases this lasts from 10 seconds to one minute or more while asleep. A person may stop breathing only a few times or hundreds of times in the course of the night. The consequences of untreated sleep apneoa can be both physical or psychological.

Classifications of sleep apnoea, including:

  • obstructive sleep apnoea syndrome, in which something is blocking the airway or the airway does not open all the way during sleep. This is the most common type of sleep apnoea.
  • central apnoea, in which the brain isn’t signaling the lungs to breathe or the muscles don’t receive the signal to breathe
  • mixed apnoea, which is a combination of obstructive and central apnoea

Symptoms include:

  • loud snoring
  • snoring interrupted by periods of not breathing
  • frequent night awakenings
  • awakening not rested in the morning
  • falling asleep when talking, driving, or during daytime activities
  • fatigue
  • irritability
  • decreased interest in sex
  • mood changes
  • poor concentration and memory loss
  • headaches

Sleep apnoea can occur in anyone. However, certain factors make a person more at risk for sleep apnoea, including:

  • being overweight
  • being over 40 years old
  • being a man
  • smoking cigarettes
  • drinking excessive amounts of alcohol
  • using sleep medications
  • sleeping on the back

Causes of sleep apnoea vary. When a person has obstructive sleep apnoea, the airway obstruction may occur from:

  • enlarged tonsils or adenoids or excess tissue in the back of the throat
  • the tongue falling back and blocking the airway
  • relaxed muscles in the back of the throat
  • an obstruction in the nasal passages
  • chronic obstructive pulmonary disease, such as emphysema
  • abnormal bone formation of the mouth and jaw
  • hypothyroidism, in which there is a low level of thyroid hormone circulating in the blood
  • Down syndrome
  • masses in the head or neck
  • vocal cord paralysis

Some of the causes of central sleep apnoea include:

  • central nervous system disorders
  • Stroke
  • brain tumours
  • viral brain infection

Changing sleeping positions or using a different pillow may help prevent sleep apnoea. Avoiding alcohol, sleeping medications, obesity, and smoking will decrease a person’s risk of sleep apnoea.

A physical examination and full history will be done. A doctor may also want information from the spouse or any family members regarding anything they notice while the person sleeps. To help determine the cause of sleep apnoea, other tests are often ordered. A blood test called a full blood count, or FBC, can make sure there are a normal number of blood cells. An arterial blood gas test can measure the level of oxygen in the blood. Chest x-rays can show many heart and lung disorders. An electroencephalogram, or EEG, may be done to measure the electrical activity of the brain. A cranial CT scan may also be done to look for any deformities, tumours, or masses in the brain. A special test called a polysomnography, or sleep study, will usually be done. Undiagnosed and untreated sleep apnoea can cause serious long-term side effects, including day time tiredness, heart disease, arrhythmias, high blood pressure, memory and concentration problems, headaches, depression, panic and anxiety symptoms, feeling stressed, decreased libido. Persons with sleep apnoea who drive or operate machinery pose a risk to others if they fall asleep and cause an accident.

Treatment for sleep apnoea varies depending on the cause. Some treatments include changing sleeping position, such as lying on the side or using a different pillow. Weight loss is also helpful in persons who are overweight.

Treatment of obstructive sleep apnoea often involves the use of a special machine called a CPAP, or continuous positive airway pressure. This machine adds pressure to the air a person breathes in and keeps the airway open while the person is asleep.

Surgery, such as a tonsillectomy and adenoid removal, may be needed to remove tissue that is blocking the airway.

Medications may be needed to increase respiratory function while the person sleeps. Antidepressants may be prescribed. These reduce the amount of time a person spends in deep sleep.

A person using a CPAP machine will need it every night. If a person has surgery, there may be a recovery period of a few days to a few weeks.

A spouse or partner can monitor symptoms. If symptoms get worse or the apnoea spells begin to be more frequent or longer, the doctor should be informed.

Availability of sleep specialists, sleep studies and effective treatment means that more people are being diagnosed and treated. If does seem to a growth area in medicine as a large percentage of the population complain of poor sleep.