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Understanding Obstructive Sleep Apnea
What is Obstructive Sleep Apnea (OSA)
A previous article has covered central sleep apnea (CSA) but obstructive sleep apnea (OSA) is really quite different. Obstructive sleep apnea (OSA) is characterised by repeated episodes of partial or complete obstruction of the throat (also known as the “pharynx” or “upper airway”) during sleep. Additionally, a narrow, floppy throat is more likely to vibrate during sleep, causing snoring. During partial or complete obstructions, breathing is slowed or stops for a short time – up to a minute or more – and blood oxygen levels plummet. This short interruption to sleep (arousal) then occurs, allowing breathing to resume, but disrupting sleep. Overnight, episodes of obstruction can occur many times – or even hundreds of times. While some people are aware that their breathing is not normal at night, they may not know that it is a medical condition that is causing them harm. Thankfully, there are good treatments for this condition.
Sleep apnea is characterised by certain symptoms.
Snoring, tossing, and sleeping with your mouth open during the night are common symptoms of OSA. Because of OSA’s disruptive effects on sleep, you may find yourself waking up frequently during the night, sometimes gasping or choking, although that may not always occur. Even if there are few awakenings overnight, sleep is disturbed and you are unrefreshed because of it. As the day progresses, you may struggle to stay awake, especially in the afternoon. Grumpiness and other mood changes are common when OSA is not treated.
Obstructive sleep apnea affects others too
In addition to keeping a bed partner awake, snoring can also wake people in other parts of the house. It is common for partners to stay awake to ensure the person with OSA begins breathing again after a breathing pause. People who live with someone with OSA may become grumpy and irritable due to lack of sleep too. So, OSA affects not only the person with it but also others in the household.
Symptoms of obstructive sleep apnea should concern you
Sleep apnea disturbs your sleep and stresses your body. There is strong evidence that people with moderate to severe OSA who are untreated may suffer from other health problems. High blood pressure, heart attacks, strokes, diabetes, depression, and accidents are among the risks. It is harder to think clearly, moods are low, and productivity at work and at home suffers.
Obstructive sleep apnea is a risk factor in car accidents
OSA sufferers are approximately 2.5 times more likely to be involved in a motor vehicle accident than those without it. Inadequate nighttime sleep reduces alertness, slows reaction times, impairs concentration, and increases the risk of falling asleep at the wheel. Your risk of work accidents increases if you operate machinery or transport.
Who can develop obstructive sleep apnea?
Any age can be affected by OSA. In children, it is often caused by enlarged tonsils or adenoids and in adults, OSA is more common in middle age and in older people. It is also more common in men than in women, although after menopause the risk becomes similar. The risk of OSA increases with body weight, but not always. Due to fatty tissue, obesity can cause a narrowing of the throat. Having a large waistline can also make the lungs smaller during the night, which in turn increases the risk of the throat collapsing. Some people are born with narrow throats or face structures that cause narrowing.
How is obstructive sleep apnea diagnosed?
OSA can be indicated by snoring, obesity, breathing pauses, and daytime sleepiness. Overnight sleep studies are the best way to tell for sure. These test your sleep, respiration, and oxygen levels. Your doctor can refer you for a sleep study.
What treatment is available for obstructive sleep apnea?
For people with a mild level of OSA and few symptoms, losing weight, reducing the amount of alcohol consumed in the evening, or adjusting their sleeping position may suffice. People who sleep on their backs experience more OSA episodes and so side sleeping may be recommended.
However, more active treatment is needed for those with moderate or severe OSA. Particularly if you suffer from daytime fatigue, heart disease, stroke, or high blood pressure that has been difficult to manage in the past. CPAP and oral appliances are the two most commonly used treatments for moderate to severe OSA.
CPAP works by using a small air pump to take air from the room and deliver it gently to a mask that covers the nose. This keeps your throat open at night. You only use it while you sleep. It is very effective at treating the symptoms of sleep apnea as well as its long-term effects. The snoring stops and the machine noise is much quieter than the snoring used to be. It can take a while to adjust to CPAP and your supplier will be able to offer solutions to help you adjust to using it.
A specialist dentist can fit an oral appliance (or mandibular advancement device) for some people. The mouthguard covers both upper and lower teeth like a double mouthguard. As the upper and lower mouthguards clip together the jaw is held forward during the night and this aids in keeping the airway open. These devices are particularly helpful for mild cases of sleep apnea and snoring.
Several surgical procedures are available for sleep apnea. These are not generally offered unless there has been no success with CPAP or oral appliances. An experienced surgeon is essential when selecting an operation.
There are also a variety of other remedies that have been marketed. Some have value for selected patients, while others appear to offer no benefit to most patients. Ask your doctor for advice.
What else you can do if you have sleep apnea?
Being overweight is a contributing factor to sleep apnea in many people. As well as helping or even curing OSA, losing weight is extremely beneficial for other health conditions, including high blood pressure, diabetes, high cholesterol, and joint pain.
You should make sure that you are doing everything you can to improve your sleep if you are diagnosed with OSA. Sleeping tablets and alcohol relax muscles and may worsen sleep apnea. Use of these products should be limited. In addition, it is important to ensure that you are sleeping as well as possible and that your sleep pattern is regular.
If you are always feeling tired and others are complaining about your persistent snoring, you should certainly seek the advice of your doctor. It’s likely you’ll be referred for a sleep study to see if obstructive sleep apnea is the cause. If you’ve got any questions about what this might involve our sleep professionals are on hand to help and can be contacted on 1800 717 566.
