ARE YOU A TIRED, GRUMPY SNORER? YOU COULD HAVE SLEEP APNOEA   

There is nothing quite like a good night sleep and waking up feeling refreshed and ready to enjoy your day. However, if you are someone that wakes up feeling unrefreshed, experience daytime sleepiness, have poor concentration, headaches, depressed mood and irritability you could have sleep apnoea. 3 in 10 men and 1 in 5 women have sleep apnoea and if left undiagnosed can lead to a higher risk of health problems.

What is Sleep Apnoea?

Sleep apnoea is a condition where you stop breathing for short periods when you sleep. This results in a drop in oxygen levels in the blood and triggers your brain to wake up to take a breath. You then fall back asleep, and the cycle begins again. This can happen multiple times per hour and usually people don’t completely wake up and are not aware it is happening.  Consequently, you feel more tired and sleepy than usual. The most common type of sleep apnoea is ‘’Obstructive Sleep Apnoea’’ which occurs when the upper airways become relaxed and floppy when you sleep and cause partial or complete blockage of the airways. If the airway gets narrowed, it can cause snoring but when there is complete blockage your oxygen levels drop and your brain wakes you up to take a breath.

Risk Factors for Sleep Apnoea

• Overweight/obesity – especially if you have a thick neck as this can block the airways when you sleep
• Alcohol consumption
• Sleeping on back rather than side
• Jaw structure (smaller or receding lower jaw)
• Smoking
• Sleeping tablets
• Enlarged tonsils and adenoids (a common cause in children )
• Nasal congestion
• Age – as age increases, throat muscles tend to relax more during sleep.
• Family history of sleep apnoea

Symptoms

People with obstructive sleep apnoea may not be aware they have it as they don’t remember waking up during the night. They may notice waking up gasping or chocking during the night. Partners or parents may report loud snoring or that they stop breathing during their sleep. During the day however, people with sleep apnoea may notice the following;

• Wake up feeling non refreshed
• Day time sleepiness
• Poor concentration and mental functioning
• Headaches
• Depression and or irritability
• Reduced sex drive and erectile dysfunction.

Untreated sleep apnoea can also increase the risk of high blood pressure, therefore heart attack and stroke. There is also an increased risk of type 2 diabetes. It can also lead to increased incidence of motor vehicle and workplace accident due to daytime sleepiness and poor concentration.

Testing for Sleep Apnoea

If you have symptoms suggestive of sleep apnoea you should have a chat to your General Practitioner. If you GP suspects you may have sleep apnoea, they may refer you for sleep studies. Sleep studies involve the measurement of your breathing and oxygen levels overnight to help diagnose or exclude sleep apnoea. These may be done at home or at a specialised sleep laboratory.

Your GP may also check your blood pressure and do some blood tests to exclude other causes of sleep apnoea and associated health conditions such as diabetes.

The diagnosis of sleep apnoea can be made depending on the amount of apnoea’s or events that occur.  An event is when breathing stops for a minimum of 10 seconds.

• Normal sleep: less than 5 events per night
• Mild Sleep Apnoea: 5 – 14 episodes per hour
• Moderate Sleep Apnoea: 15 – 30 episodes per hour
• Severe: More than 30 episodes per hour.

Management  

The good news is there are many treatment options available for sleep apnoea depending on the cause and severity of symptoms.

• Lifestyle Measures
  • The first line of treatment is making changes to your lifestyle. This may include weight loss, smoking cessation, reduction of alcohol intake, avoiding sedating medication, and sleeping on your side can make a big difference to symptoms.
• Positional devices
  • To help you avoid sleeping on your back. There is the tennis ball technique (where you attach a tennis ball to your back), and special pillows to help change your sleeping position.
• Sleep apnoea mouthguards or splints
  • These can be fitted by your dentist and can sometimes work well for those with mild sleep apnoea.
• CPAP Machine (Continuous Positive Airway Pressure)
  • Is the most effective treatment for moderate and severe obstructive sleep apnoea. It involves wearing a face mask when you sleep which is connected to a pump that pushes pressurised air into your airways to keep your throat open and prevent it blocking as your sleep. Although the thought of such a machine to help with sleep is daunting there is good evidence it makes a big difference to patients quality of sleep and therefore quality of life.
• Surgery
  • May sometimes be required as is more common in children with sleep apnoea and may involve removal of enlarged adenoids or tonsils.

If you have daytime sleepiness, are a loud snorer and perhaps a little bit grumpy please have a chat with your doctor.  Untreated sleep apnoea can have significant consequences for your health and quality of life. We all know how much better we feel after a good quality night’s sleep.