Sleep apnoea: what is it and how can it affect you?

Sleep apnoea is a widespread yet often misunderstood condition that can greatly affect your health, sleep quality, and overall well-being. Characterised by repeated interruptions in breathing during sleep, sleep apnoea affects millions of people worldwide. These interruptions can lead to disturbed sleep and, if left untreated, may contribute to various long-term health complications. We speak to an esteemed consultant respiratory physician who explores what sleep apnoea is, why it occurs, how it can impact you, and what treatment options are available.

What is sleep apnoea?

Sleep apnoea is a sleep disorder in which breathing temporarily stops and starts repeatedly throughout the night. The word "apnoea" refers to these temporary pauses in breathing, which can last from a few seconds to over a minute. There are two main types of sleep apnoea: obstructive sleep apnoea (OSA) and central sleep apnoea (CSA).

Obstructive sleep apnoea is the most common type and occurs when the muscles at the back of your throat relax too much. This relaxation can cause the airway to narrow or close, temporarily blocking airflow.

Central sleep apnoea, less common than OSA, is due to a failure in communication between the brain and the muscles that control breathing. Essentially, the brain “forgets” to signal your body to breathe, causing brief pauses in respiration.

What are the symptoms of sleep apnoea?

The symptoms of sleep apnoea can be subtle, making it difficult to detect without proper diagnosis. The most common symptom is loud snoring; however, not everyone who snores has sleep apnoea. Other symptoms may include gasping for air during sleep, frequent awakenings, and daytime sleepiness. People with sleep apnoea often experience morning headaches, difficulty concentrating, and mood changes such as irritability or depression. These symptoms can be exhausting for the sufferer and also impact those who share a bed or room.

How is sleep apnoea diagnosed?

Sleep apnoea is diagnosed through a sleep study, also known as polysomnography. During this test, sensors monitor your breathing, heart rate, oxygen levels, and brain waves as you sleep. In some cases, you may undergo a home sleep study, which involves a simplified version of these tests that can be conducted in your own bed. If your doctor suspects sleep apnoea based on your symptoms, they will likely recommend one of these diagnostic tests to confirm the condition and determine its severity.

What causes sleep apnoea?

Several factors can increase the risk of developing sleep apnoea, including:

Excess weight: Obesity is one of the leading risk factors for obstructive sleep apnoea, as fatty deposits around the upper airway can obstruct breathing.

Age: Sleep apnoea is more common in adults over 40, although it can occur at any age.

Anatomy: Structural factors, such as a thick neck, enlarged tonsils, or a small jaw, can make it more likely for the airway to become blocked.

Family history: Genetics can play a role, so if a close family member has sleep apnoea, you may be more prone to developing it.

What are the health risks of sleep apnoea?

If left untreated, sleep apnoea can have serious consequences. The frequent drops in oxygen levels associated with sleep apnoea put strain on the cardiovascular system, increasing the risk of high blood pressure, heart disease, stroke, and diabetes. Sleep apnoea also contributes to daytime fatigue, which can lead to accidents and reduced productivity. Persistent fatigue due to poor-quality sleep can impair memory, concentration, and overall cognitive function.

How is sleep apnoea treated?

Treatment for sleep apnoea varies depending on the type and severity of the condition. Common treatments include:

Continuous positive airway pressure (CPAP): A CPAP machine delivers constant air pressure to keep the airway open during sleep. It’s highly effective, although some people find it takes time to adjust.

Lifestyle changes: Weight loss, avoiding alcohol before bed, and quitting smoking can reduce symptoms in some individuals.

Oral appliances: Custom-fitted dental devices can help keep the airway open by repositioning the jaw or tongue.

Surgery: In cases where other treatments have not been effective, surgery may be considered to remove excess tissue or correct structural issues blocking the airway.

If you think you or someone you know may have sleep apnoea, it is crucial to seek medical advice. Diagnosing and treating sleep apnoea can significantly improve both your sleep quality and overall health.