Sleep apnoea
Sleep apnoea is a “Sleep-related Disorder” characterized by episodes where breathing decreases or stops during sleep – often associated with excessive snoring. The breathing resumes after a period of time, but it is associated with a number of physical complaints and poor quality sleep with daytime sleepiness.
Sleep apnoea may be caused by obstruction in the upper airways, poor automatic breathing effort, or a combination.
It occurs much more commonly in older men.
Recognising sleep apnoea:
The person suffering from sleep apnoea may not always be aware of it, but may experience symptoms like the following:
- Daytime sleepiness
- Morning headaches
- Impaired concentration
The sleeping partner may report excessive and worsening snoring, culminating in an episode where breathing stops. There may then be a gasp for air or a choking sound, whereupon the breathing resumes, only for these episodes to recur.
Diagnosis:
To confirm the diagnosis, the patient would require a referral to a sleep laboratory. Previously, a sleep-over in the laboratory or hospital was required, but nowadays, with newer technology, the assessment can be done in one’s home environment.
The investigation is called a polysomnogram (PSG), and it measures various aspects related to sleep and breathing while one is asleep. These include sleep stages, oxygen levels, rate of breathing and episodes where breathing stops, etc.
Treatment:
Depending on the severity of the condition, the following options are possible:
- Lifestyle changes: These include losing weight, avoiding alcohol and sedatives, quitting smoking, sleeping on your side instead of your back, and maintaining a regular sleep schedule.
- Continuous positive airway pressure (CPAP) therapy: CPAP is delivered by a machine that provides a continuous stream of air through a mask or a ‘nasal pillow’ that is worn over the nose/nostrils and/or mouth. This helps to keep the airways open and prevent breathing interruptions during sleep. These masks may take some time to adjust to.
- Oral appliances: These are special devices that are worn in the mouth during sleep to help keep the airway open. They work by repositioning the jaw or tongue to prevent obstruction of the airway. The evidence for efficacy of these devices is limited.
- Surgery: In severe cases of sleep apnea, surgery may be necessary to correct structural issues in the airway. This may involve removing excess tissue, repositioning the jaw, or other procedures.
