What is sleep apnoea and the symptoms?
A good night’s sleep makes everything seem better. Sleep apnoea can be treated and managed leading to more restful sleep and better quality of life.
What is obstructive sleep apnoea (OSA)?
Obstructive sleep apnoea is a sleep disorder which can stop you getting restful sleep. This can have a significant effect on quality of life. The good news is that treatments are available.
Mild OSA is common, affecting up to one in five adults. One in fifteen have what’s classed as moderate OSA.
OSA happens when the soft tissues at the back of the throat temporarily block the airway. This affects breathing and disrupts normal sleep patterns.
What are the effects of OSA?
The effect of good sleep on your overall health can’t be overstated. OSA is associated with a series of health and social issues, so it’s important to identify the problem and find solutions.
Some of the problems OSA is associated with are:
- Obesity(BMI 30+)
- Stroke
- Hypertension
- Arrhythmia (the heart not beating normally)
- Heart failure
- An increased risk of motor vehicle incidents
What are the symptoms that point to OSA?
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Snoring
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Daytime tiredness
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Choking or gasping during sleep
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Restless sleep
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Increased frequency of urination during the night
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Poor memory or concentration
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Dry mouth upon waking
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Irritability
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Depression/anxiety
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Morning headaches
The appropriate treatment depends on the type and severity of sleep apnoea, as well as patient factors such as age, weight, medications, anatomical features and medical history. Ultimately, the specific course of treatment should be recommended by a GP or respiratory and/or sleep specialist, so please discuss your options with your doctor.
CPAP is the most common treatment for OSA, however there are other treatment methods available such as oral appliance, positional therapy and surgery.
Click here for more information on CPAP treatment.
CSA is much less common than OSA. CSA causes breathing to stop for a short period of time and then restart. This happens repeatedly and is caused by the brain failing to send or receive a signal to the muscles of the chest that control breathing.
Similar to OSA, CSA can result in reduced oxygen in the blood and disruption to normal sleep patterns. CSA shares many signs and symptoms with OSA but people with CSA tend not to snore loudly.
There are a number of factors that can cause or contribute to CSA including:
- Reduced heart function
- Some medications (i.e. narcotics)
- Stroke
- Muscle weakness
- The brain being too slow to respond to changes in oxygen levels in the blood
Many heart disorders such as high blood pressure, atrial fibrillation, and heart failure are more frequent and more difficult to control in people with sleep apnoea. Untreated sleep apnoea increases your risk of heart attack and stroke.
A sleep physicians review of OSA in pregnancy is recommended due to the complexity, clinical changes and regular follow-up needed for pregnant women.
Obstructive Sleep Apnoea in Pregnancy
Pregnancy is associated with:
- changes in physiology and sleep
- increased risk of developing OSA
- increased severity of preexisting OSA
OSA in pregnancy is associated with significant maternal and
fetal complications.
OSA in pregnancy is thought to be underdiagnosed.
Diagnostic challenges include:
- common symptoms (snoring, daytime sleepiness) are also common symptoms in normal pregnancy
- commonly used screening questionnaires (ESS, Berlin questionnaire) – poor predictive values in pregnancy1
- clinical picture can change rapidly as pregnancy progresses
1 Tantrakil et al Sleep Med Rev 2016
Diagnosis and monitoring
Whilst there is a lack of evidence-based management guidelines, there is general consensus:
- screen at-risk groups [Obese, hypertension (HTN), preclampsia, gestational diabetes mellitus (GDM)]
- serial monitoring is required
- Type 1 Polysomnogram (PSG) (overnight in lab study = gold standard in sleep diagnostic testing
- – Consider Type 2 (?home sleep) study if resource issues
CPAP therapy should be recommended for pregnant patients with:
- moderate/severe OSA, mild OSA with significant hypoxia (as per general guidelines)
- query for all pregnant patients with OSA (incl. mild OSA) – repeat PSG post-partum)
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Sleep & respiratory disorders
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