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Sleep apnoea

Sleep apnoea is a chronic condition where the upper airways become obstructed during sleep. This can lead to loss of sleep, in turn affecting concentration levels and causing tiredness.

  1. Causes loud snoring and gasping during sleep
  2. Can occur due to environmental and genetic factors
  3. Treatment consists of lifestyle changes and specially designed devices

Someone who has sleep apnoea may not realise until a partner tells them about symptoms, but feeling constantly tired can be a sign too. To talk to one of our doctors online about sleep apnoea, click below to make an appointment through our consultation facility. 

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Description

What is sleep apnoea?

Sleep apnoea is the obstruction of the upper airways during sleep. It is characterised by episodes of gasping, breathing problems and loud snoring. It is thought to be associated with obesity, having a large neck and thin airways. Smoking and excessive alcohol consumption can contribute to the condition as well. Complete apnoea is when breathing activity is halted for 10 seconds or more, in which ventilation is reduced by half. These episodes need to have occurred five times per hour on average during the course of one night’s sleep to be defined as sleep apnoea.

What symptoms does sleep apnoea cause?

Symptoms occur when the upper airway narrows during sleep. The general narrowing of the throat is thought to be influenced by an increased pharyngeal and palatal issue which is associated with obesity. This, combined with a thicker neck and a narrower throat often seen in obesity, has led to the theory that sleep apnoea is connected to obesity. Cardiovascular disease is highly prevalent in cases of sleep apnoea. It has also been noted that endocrine disorders, such as type 2 diabetes and hypothyroidism, are associated with sleep apnoea. 

The most common secondary effects of sleep apnoea are those caused by poor sleep quality, such as tiredness. For example, daytime sleepiness can lead to accidents at work and at home, and while driving. Driving is not recommended whilst experiencing daytime sleepiness due to sleep apnoea. It can also have psychological consequences such as depression and general irritability. If it isn’t controlled, sleep apnoea can also increase the risk of high blood pressure and heart disease.

How common is sleep apnoea?

Sleep apnoea can occur at any age, but is more common in people aged over 40, and in men. NICE stipulate that around 4% of middle-aged men and 2% of middle-aged women are affected by sleep apnoea. In children, the international prevalence is around 1-2%, and this is thought to be related to rising levels of obesity.

Making lifestyle changes such as stopping smoking, losing weight, and cutting down on alcohol, can help to reduce the symptoms of sleep apnoea. More severe cases however may benefit from continuous positive airway therapy (CPAT). This is where someone wears a device during sleep, which helps to open the airways and facilitate breathing.

Our video consultation facility enables you to speak to a doctor online about sleep apnoea. They will be able to offer advice on alleviating symptoms, and refer you for further investigation where required. Book an appointment at a suitable time for you.

Page last reviewed:  15/06/2020
Diagnosis and treatment

What are the causes of sleep apnoea?

Sleep apnoea can affect anyone at any stage of life. However, there is no underlying cause that leads to the condition. It is thought that there is a connection between obesity and sleep apnoea, and that smoking and alcohol consumption can also play a part. 

Other possible risk factors include having an inherently thicker neck and also a narrow throat. Apnoea is caused by the upper airway narrowing, and it’s thought that this could be triggered by the actions of neuromuscular mechanisms that occur naturally in a small upper airway. 

How is sleep apnoea diagnosed?

A doctor will normally discuss your symptoms with you, to try and determine whether others factors may be disrupting your sleep.  If you share a bed with a partner, it can be helpful for them to accompany you to this appointment so that they can describe symptoms, such as restless sleep, gasping and loud snoring. 

After this, you will be referred to a specialist sleep centre if a doctor suspects sleep apnoea. 

Will I need tests?

Yes, you will need tests to positively diagnose sleep apnoea.

The sleep centre you are referred to will offer a couple of possibilities for evaluation: usually a polysomnography test and a home sleep test. The polysomnography test involves the use of equipment that monitors your heart, lungs and brain activity, as well as breathing patterns, blood oxygen levels and potential sporadic arm and leg movements. Alternatively, you may be given a simpler and less comprehensive version of this testing; a breathing sensor, heart rate monitor and oxygen sensors can measure breathing movements, heart rate and oxygen levels respectively, throughout the night.

How is sleep apnoea managed?

Depending on how serious the condition is, there are a number of treatments available. The severity of your sleep apnoea can be assessed by measuring the amount of episodes you might have during one night’s sleep. This is called the apnoea-hypopnoea index (AHI). 

In mild cases of sleep apnoea, lifestyle changes may be sufficient to treat it, such as losing weight or stopping smoking (this helps to de-obstruct  the airways). More severe sleep apnoea may require continuous positive airway therapy (CPAT) which involves a pump delivering compressed air through a mask while you sleep to open the upper airway passages, thus preventing apnoea and snoring.

If you are not comfortable sleeping with a mask on, there are alternatives, such as using an oral appliance, which keeps the throat open. These are designed to bring your jaw forward.

Page last reviewed:  15/06/2020
Questions and Answers

How is sleep apnoea treated?

It depends on its severity. For mild sleep apnoea, lifestyle changes can be sufficient to treat it. Continuous positive airway therapy (CPAT) is more likely to be considered in severe cases, and this involves wearing a device which opens the airways during sleep. There are oral appliances available to manipulate the position of the jaw if CPAT is too uncomfortable.

How long will it take for me to recover?

In people who respond well to CPAT, there is a clear benefit in terms of a reduction in snoring and daytime sleepiness. This can take anywhere between 1-2 months, but during this period there should also be an increase in cognitive function, and a general feeling of healthiness that comes with more productive sleep. 

Can I consult a doctor about sleep apnoea online?

Should you wish to speak to a doctor about sleep apnoea online, you can do so by using the consultation service available through our site. The secure video consultation enables you to talk with a doctor, who can offer advice on how you can be tested and treated for sleep apnoea, and make a referral where necessary. Choose a slot at a time that’s convenient for you. 

Page last reviewed:  15/06/2020

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