What you need to know about sleep apnoea

WE know the value of sleep and its importance to our physical and mental wellbeing. Recent research has shown waves of spinal fluid washing over the brain as we sleep to remove waste.

It allows for optimal function, better neuroprocessing, and enhanced and functioning during our day.

Obstructive sleep apnea is a condition that can occur when the walls of the throat become more relaxed and narrow as we sleep.

It’s common to hear somebody snore whilst in slumber, but if it’s excessive it can interrupt the flow of the breath and therefore also interrupt sleep. This narrowing of the throat can lead to partial or total blockage, which can occur several times throughout the night.

If not fully blocked it’s known as hypoapnoea, but if fully blocked for more than ten seconds its known as apnoea.

As one can imagine, the most obvious symptoms are not usually obvious to the sufferer, as they’re asleep when they occur! For this reason, it may be a partner, friend or other household contact that first observes the symptoms of sleep apnoea.

As well as the typical loud snore, there may be gasping or snorting, or heavy breathing that seems laboured. You may also feel extremely tired, as this apnoea interrupts your sleep and can prevent real deep rest from occurring. To protect the body from the lack of oxygen that results during an airway blockage, the brain tells the body to come out of sleep and actively breathe properly again. Sometimes, you may not fully awaken, but instead enter lighter sleep until such time as the breathing returns to normal. How severe the sleep apnoea is can be classified by the Apnoea-Hypoapnoea Index, which categorises its severity into mild (5-14 episodes per night), moderate (15-30 episodes an hour) or severe (over 30 episodes per hour).

While it’s usually more common in males, females going through the menopause report an increase in its prevalence, due to the effect of hormonal changes making the muscles more relaxed.

Furthermore, if you’re overweight, a smoker, or have taken alcohol or sedating drugs, these too are factors that can affect your breathing, and the likelihood of experiencing sleep apnoea.

Sometimes it’s a structural issue (such as large adenoids, a deviated septum in the nose, or a small jaw) that can cause it, and there is also a genetic link, with a higher risk of experiencing sleep apnoea if it already runs in the family.

If you or somebody you know is experiencing sleep apnoea, it is worth speaking to your GP who can direct you to investigate further. They will ask questions about your sleep patterns, take bloods and record your blood pressure. You may then be referred to a sleep clinic to get properly assessed, and be sent home with a portable device to monitor breathing, oxygen and heart rate as you sleep, or the full assessment may take place overnight in the clinic

Treatment may involve the use of specialised breathing apparatus to prevent the occurrence of that blockage. 

This will provide continuous positive airway pressure to prevent the throat from closing up. It may feel uncomfortable to begin with, and can sometimes cause nasal congestion and irritation, but on balance it reduces the time awake and therefore the tiredness levels. Alternatively, for milder apnoea you may be given a gumshield-like device to increase the space in the mouth and reduce the narrowing of the airway as a result.

Lfestyle changes to address the previously mentioned risk factors may also play an important role in treatment of sleep apnoea. Achieving weight loss if overweight will reduce the pressure the muscles are under, making it easier for them to remain open.

Stopping smoking and reducing alcohol intake will also ensure that the airway muscles are not adversely affected. Simple strategies like lying on your side rather than on your back can also help to keep the airways open. Occasionally, surgery to remove large tonsils or adenoids is warranted.

Sleep apnoea, while seemingly benign, particularly if mild, can adversely impact quality of sleep and therefore energy and functioning. Addressing its root cause can improve sleep duration, depth of rest, and physical and mental wellbeing.

ABOUT THE AUTHOR

Dr Michelle O’Driscoll is a pharmacist, researcher and founder of InTuition, a health and wellness education company.

Her research lies in the area of mental health education, and through InTuition she delivers health promotion workshops to corporate and academic organisations nationally.

See www.intuition.ie