Sleep Apnoea: What Is It and How Can It Be Treated?

Sleep apnoea is a common breathing disorder characterised by pauses in breathing or shallow breaths during sleep. The word “apnoea” comes from Greek and means “without breath.”

There are two main types of sleep apnoea:

• Obstructive sleep apnoea (OSA) – The more common form, caused by throat muscles relaxing too much during sleep. This causes the airway to narrow or close completely, interrupting normal breathing.
• Central sleep apnoea – Caused by a miscommunication between the brain and muscles that control breathing. The airway is not blocked, but the brain fails to signal the muscles to breathe.

These breathing interruptions can happen repeatedly throughout the night. Oxygen levels may drop during these events, causing the brain to briefly wake enough to resume normal breathing. This sleep disruption can prevent you from getting restful, uninterrupted sleep.

Recognising Symptoms

The most obvious symptom of sleep apnoea is loud snoring, sometimes accompanied by gasping or choking noises. But not everyone who snores has sleep apnoea. Other common symptoms include:

• Excessive daytime sleepiness and fatigue
• Restless or interrupted sleep
• Morning headaches
• Irritability and mood changes
• Difficulty concentrating
• Frequent urination at night

People with sleep apnoea often don’t realise they have a problem. Their sleep is so disrupted that they don’t feel refreshed, but they may not fully wake up when their breathing pauses. A partner or family member noticing loud snoring is often the first clue.

Children who suffer from sleep apnoea may not have as obvious symptoms. Look out for bedwetting, behavioural disorders, poor school performance, sleepiness, not growing as they should, weight gain or unusual sleeping positions.

Health Risks of Untreated Sleep Apnoea

Leaving sleep apnoea untreated can result in serious health complications, including:

High Blood Pressure – Repeated oxygen drops during sleep apnoea cause your body to produce more adrenaline and cortisol, which can cause blood pressure to rise. High blood pressure increases your risk of heart disease and stroke.

Heart Problems – With sleep apnoea, oxygen levels fall, and carbon dioxide levels rise, causing strain to the cardiovascular system. The risk of abnormal heartbeats and heart disease increases.

Stroke – Sleep apnoea is associated with an increased risk of stroke. Low oxygen levels and high blood pressure can both contribute to cardiovascular risk.

Type 2 Diabetes – Sleep deprivation and oxygen depletion increase insulin resistance. Studies show people with sleep apnoea are more likely to develop diabetes.

Accidents – Excessive daytime sleepiness can impair judgement, concentration and reflexes, increasing the risk of road traffic and other accidents.

Who Is at Risk?

Certain factors increase your risk of developing sleep apnoea:

• Age – Sleep apnoea risk increases with age.
• Obesity – Carrying excess weight, especially around the neck, increases risk. Fat deposits in the throat narrow the airway.
• Large Tongue/Tonsils – Enlarged tonsils or a large tongue obstruct airflow during sleep. This is a common cause in children.
• Smoking and Alcohol – Smoking causes inflammation in the airway. Alcohol relaxes muscles, increasing airway collapse.
• Nasal Obstruction – Chronic nasal congestion or a deviated septum blocks airflow.
• Gender – Obstructive sleep apnoea is more common in men, although it can affect anyone.
• Family history – Having family members with sleep apnoea increases your genetic risk.

Getting Tested for Sleep Apnoea

If you suspect you may have sleep apnoea, visit your doctor. Bringing a sleep partner who has observed your sleeping can provide helpful information.

Your doctor will assess your symptoms and risk factors. They may have you complete a sleepiness questionnaire, like the Epworth Sleepiness Scale. You’ll also likely get a physical exam, including checking your blood pressure and airway.

If sleep apnoea is suspected, you may be referred to a specialist sleep service for testing. Sleep testing often takes place at home using equipment that monitors breathing and oxygen levels, although more detailed overnight testing may sometimes be needed. The apnoea-hypopnoea index (AHI), which measures the average number of apnoeas and hypopnoeas per hour of sleep, is commonly used to assess severity:

• Mild – AHI of 5 to less than 15 events per hour
• Moderate – AHI of 15 to less than 30 events per hour
• Severe – AHI of 30 or more events per hour

Sleep testing is used alongside your symptoms and clinical assessment to diagnose sleep apnoea. If an initial home test does not explain significant ongoing symptoms, further specialist testing may be considered.

Treating Sleep Apnoea

Treatment for sleep apnoea aims to prevent breathing pauses during sleep. The main treatments include:

CPAP (Continuous Positive Airway Pressure) – A common and effective treatment, CPAP provides a constant stream of air through a mask worn over your nose, or your nose and mouth, during sleep. This air pressure keeps your airway open. It can take some getting used to, but CPAP can significantly improve symptoms in people with obstructive sleep apnoea.

Oral Appliances – Custom-fitted mouthpieces keep your throat and airway open during sleep by bringing your lower jaw forward. A mandibular advancement splint may be considered for some people if CPAP is unsuitable, declined or not tolerated.

Surgery – Surgery can increase the size of your airway to improve breathing during sleep. Procedures such as tonsillectomy or other upper-airway surgery may help selected people with sleep apnoea.

Lifestyle Changes – Losing weight if you are overweight, avoiding excess alcohol, stopping smoking and, for some people, sleeping on your side can help reduce obstructive sleep apnoea symptoms. Treating nasal congestion may also make breathing easier.

Treatment can relieve symptoms of sleep apnoea and reduce associated health risks. If you are prescribed CPAP or an oral appliance, using it as recommended is important.

Supporting a Partner With Sleep Apnoea

If your partner has been diagnosed with sleep apnoea, there are several ways you can be supportive:

• Help them follow the prescribed treatment plan. Offer reminders about using their CPAP machine or oral device.
• Make healthy lifestyle changes together, like losing weight, eating well, and getting more exercise.
• Avoid drinking alcohol before bedtime as it relaxes the throat muscles.
• Help track symptoms to see if treatment is working. Note any snoring, gasping, or daytime sleepiness.
• Consider sleeping in separate beds if their snoring or CPAP machine disturbs your sleep.
• Be patient. It can take time to adjust to sleep apnoea treatment. Offer encouragement.
• If symptoms persist with treatment, recommend they follow up with their sleep specialist to explore adjustments or alternatives.

Supporting your partner’s treatment and making healthy lifestyle changes together is crucial. But make sure to practise self-care, as you need restful sleep too. Discuss any concerns openly and calmly. Working as a team helps manage sleep apnoea successfully.

Sleep Apnoea in Children

While sleep apnoea is less common in children, obstructive sleep apnoea can occur during childhood. Some signs your child may have sleep apnoea include:

• Snoring or noisy breathing during sleep
• Mouth breathing or pauses in breathing
• Restless, disturbed sleep
• Bedwetting
• Excessive daytime sleepiness
• Hyperactive behaviour

Children with sleep apnoea may also experience growth problems or difficulty concentrating and learning in school. Paediatric sleep apnoea is often associated with enlarged tonsils and adenoids blocking the airway. Other risk factors include obesity, allergies, recurrent colds, and genetic factors.

Diagnosing sleep apnoea in children involves specialist assessment and may include a sleep study. Enlarged tonsils and adenoids are common causes of obstructive sleep apnoea in children, and surgery to remove them may be recommended in appropriate cases. CPAP may also be used in some children.

As a parent, watch for signs of sleep disorders in your child. Left untreated, paediatric sleep apnoea can affect development, behaviour, cardiovascular health, and quality of life. Early diagnosis and treatment can help reduce the risk of complications.

Take Snoring Seriously

Listening to a partner complain about your snoring can be annoying. But loud, frequent snoring could indicate sleep apnoea, especially if you never feel rested. Pay attention to other common symptoms like morning headaches, irritability, and constant drowsiness.

Don’t brush off snoring as a mere nuisance. Untreated sleep apnoea negatively impacts your sleep quality and health. Talk to your doctor about testing if you suspect you may have sleep apnoea. Diagnosis and treatment can vastly improve your sleep and wellbeing.

Conclusion

Snoring and sleep apnoea should not be taken lightly. The disrupted breathing and reduced oxygen levels associated with sleep apnoea can affect your health over time. See your doctor if loud snoring, chronic fatigue, or other symptoms suggest sleep apnoea. Diagnosis involves clinical assessment and appropriate sleep testing. Treatments such as CPAP, oral appliances, lifestyle changes and, in selected cases, surgery can help manage sleep apnoea. With appropriate treatment, sleep quality and daytime symptoms can improve significantly.

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