What is Obstructive Sleep Apnoea? Symptoms & Treatments | Resmed UK
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Obstructive sleep apnoea

Sleep Health Fatigue Sleep issues

Obstructive sleep apnoea (OSA) is the most common type of sleep disordered breathing. It occurs when your throat relaxes and your airway narrows, restricting airflow to your lungs. Your brain responds by waking you up to breathe. This cycle can happen multiple times during the night, preventing you from getting restful sleep and potentially leading to other, more serious health conditions.1

Obstructive sleep apnoea (OSA) vs. central sleep apnoea (CSA)

Researchers believe up to 1 billion adults aged 30–69 years (men and women), of all shapes, sizes, genders and ages, have mild to severe obstructive sleep apnoea.2 Obstructive sleep apnoea (OSA) is the most common form of this disorder. However, central sleep apnoea (CSA) is a less common type of sleep apnoea that occurs when the brain doesn’t send proper signals to the muscles that control breathing during sleep. While a sleep specialist can confirm which type of sleep apnoea you have, the treatment they prescribe will differ depending on your diagnosis.

 man struggling to sleep

Obstructive sleep apnoea Symptoms

Dragging yourself through the day? Excessive daytime sleepiness may be just one obstructive sleep apnoea symptom. Here are others to look out for3:

Loud snoring, choking or gasping for air during sleep

Snoring is one of the most common symptoms of sleep apnoea. It occurs when your neck muscles relax and your throat partly closes and becomes narrow, causing a vibration sound.

Daytime drowsiness

A lack of restful sleep can make it hard to get through the day. If you find yourself nodding off or feeling unnaturally tired despite thinking you slept well, you may be experiencing a symptom of OSA.

Depression

35% of people living with OSA have symptoms of depression.4 Depression and anxiety may signal a problem with sleep.

Morning headaches

If you wake up regularly with morning headaches, it could be a sign that you’re not getting enough oxygen during the night. During apnoeas, when you temporarily stop breathing, your blood oxygen levels can drop, which may lead to headaches in the morning.

High blood pressure

Like headaches, apnoeas can also lead to high blood pressure. When you stop breathing during apnoeas, your body releases chemicals to wake you up. This can cause your heart rate and blood pressure to spike.

A dry mouth

Do you find yourself waking up with a dry mouth? This could mean you were snoring or breathing through your mouth while sleeping, which could indicate your airway was obstructed.5

Difficulty focusing and remembering things

Sleep deprivation due to apnoeas can lead to reduced sleep quality, which may make it difficult to focus or remember things during the day. Our brains and bodies need quality sleep to perform their best.6

Waking up exhausted

Ever wonder why you feel exhausted in the morning even though you’re sure you got enough sleep? One of the reasons may be sleep apnoea, which disrupts your circadian rhythm. This prevents you from getting the quality sleep you need to feel rested.

Insomnia

Insomnia can be an unexpected symptom of OSA.7 When you repeatedly wake up from apnoeas, it can be difficult to achieve quality sleep. This can lead to a frustrating cycle of not being able to sleep because you’re worried about not sleeping or being jolted awake by apnoeas. Trouble sleeping is a common symptom of obstructive sleep apnoea and 35% of people with insomnia have OSA.7

Sexual dysfunction

Men with OSA may experience sexual issues due to the repeated drop in oxygen levels throughout the night, which can cause testosterone levels to go down.8

Severe obstructive sleep apnoea symptoms

Severe obstructive sleep apnoea means you have an AHI > 30.9 Prolonged, untreated OSA can heighten symptoms like depression and exhaustion, as well as contribute to more severe and potentially life-threatening conditions. When left untreated, OSA can lead to an increased risk of stroke and heart disease, along with insulin resistance that can lead to Type 2 diabetes.10 In some instances, obstructive sleep apnoea’s impact on your ability to focus and stay alert can even increase your risk of being involved in a car accident.11 Therefore, severe, untreated OSA can significantly decrease your quality of life and take a long-term toll on your health.12

Causes of obstructive sleep apnoea

People may develop OSA for different reasons.13 There are many lifestyle choices that can put you at risk for developing OSA, including smoking, having excess weight or obesity, taking narcotics and frequently drinking alcohol. Physical factors can also lead to a sleep apnoea diagnosis. Enlarged tonsils or adenoids, a receding chin or a deviated septum can all cause symptoms of obstructive sleep apnoea.14

 Restless man sitting on bed

Risk factors of obstructive sleep apnoea

No one is immune from developing sleep apnoea, which is why it’s important to pay attention if you’re experiencing symptoms that could be related to a sleep disorder. The following risk factors may increase your chances of developing obstructive sleep apnoea:

Excess weight

Excess weight can lead to fat deposits in the upper airway tract, which can cause the airway to narrow while sleeping. Doctors often recommend losing weight in a healthy and sustainable way as part of the treatment for OSA.15

Age

As we get older, our brain’s ability to control our throat muscles may decrease. This can cause the upper airway to partially collapse during the night. The prevalence of sleep apnoea is higher in older adults.16

Gender

While the exact reasons are not known, men are more likely to develop OSA. This could be due to hormones, the anatomy of the upper airway, ageing or even differences in obesity. For women, hormonal changes may increase the risk of OSA.17

Smoking

Smoking can cause the upper airway to become inflamed, causing it to narrow and partially close while sleeping.18

Alcohol use and sedatives

Alcohol and sedatives can slow your breathing down and cause your throat muscles to relax to the point where your airway partially closes while you are asleep.18

Allergies or nasal congestion

Not surprisingly, if you suffer from allergies or nasal congestion, it can be harder to breathe at night. Without medications, you may experience obstructive sleep apnoea symptoms.18

Your anatomy

Some people may simply be predisposed to developing OSA due to their anatomy. Anatomical factors could include a large tongue, large tonsils or an abnormal bone structure in the upper jaw, lower jaw, face or skull.18

Long-term effects of untreated obstructive sleep apnoea

Untreated OSA poses significant long-term health risks for people of all ages and genders. These include19:

  • Increased blood pressure
  • Reduced oxygen in your blood
  • Spikes in insulin levels
  • Elevated blood glucose levels
  • Heart failure
  • Stroke

Without proper diagnosis and treatment, OSA disrupts more than just your sleep. It can also dramatically impact your health and turn into a life-threatening condition.

If you suspect you have OSA, it’s important to take charge of your health and get a professional diagnosis. Your doctor can put you on the right path to treatment, so you can start enjoying life again. If left untreated, OSA can have a negative impact on your everyday activities, contributing to chronic fatigue, memory problems and an increased risk of auto accidents. What may seem like a minor problem at first may quickly become a major risk to your health and safety.

 Doctor talking with patient

How is obstructive sleep apnoea diagnosed?

The two most common ways to diagnose OSA are either an in-lab polysomnography or a home sleep test.

  • Home sleep test (HST): Your doctor may recommend a home sleep test if you’re showing symptoms of a sleep disorder and have not been diagnosed with any other chronic medical conditions. HSTs can be conveniently completed from the comfort of your own bed, reducing the amount of time you have to wait to get tested.20
  • In-lab polysomnography sleep study (PSG): Your doctor may recommend a PSG if you have a more complex medical history and may benefit from comprehensive sleep monitoring. PSGs are usually conducted overnight in a sleep lab or hospital, where a trained sleep physiologist can monitor your sleep.20

On the road to a confirmed sleep apnoea diagnosis, you’ll work with various medical professionals to help you uncover the mystery behind your sleeping patterns. Your primary care provider will look at your current and prior medical history before referring you to a sleep specialist. These specialists will run diagnostic tests. If you have sleep apnoea, they’ll assist with creating a treatment plan to help you breathe, sleep and live better. Early detection and diagnosis can help you better manage your sleep apnoea symptoms and get the treatment you need for a more restful sleep.

Obstructive Sleep Apnoea Treatment Options

While sleep apnoea is a serious medical condition, the good news is that it’s treatable. Your doctor can discuss treatment options with you based on the type and severity of your condition.13

CPAP therapy

Continuous positive airway pressure (CPAP) therapy is considered highly effective and one of the most widely used ways to treat obstructive sleep apnoea.21 The most common form of PAP therapy is continuous positive airway pressure, or CPAP. The CPAP device delivers a consistent and continuous level of pressurised air through a tube and mask to keep your airway open while you sleep. This continuous flow of air is delivered to your airway and helps prevent the stops and pauses in overnight breathing that sleep apnoea can cause.

Alternative airway pressure devices

Unfortunately, some people cannot tolerate the consistent and continuous level of pressure delivered with CPAP therapy, so alternative treatments may be discussed. One option is automatic positive airway pressure (APAP) therapy, which allows the level of delivered air to adjust based on the person’s needs and only delivers the amount of pressure needed at any given moment.

Another option is a bilevel PAP device, which is a type of PAP that delivers two different pressure levels—one for inhaling and one for exhaling.

Some people who need alternative types of PAP therapy may have central sleep apnoea, a form of sleep apnoea in which the brain fails to send a signal to the body to breathe.1

Lifestyle changes

Your doctor may recommend lifestyle changes to help manage your obstructive sleep apnoea symptoms. This could include weight loss, cutting down on alcohol or giving up smoking.

Oral appliance therapy

While CPAP therapy remains the gold standard for treating mild to moderate sleep apnoea, your doctor may offer oral appliance therapy as another option. An oral appliance, or a mandibular repositioning device (MRD), holds your lower jaw in a forward position to help keep the airway open and reduce snoring.22

Changing medication

Your doctor may look at your medications to try and determine if they’re contributing to your sleep apnoea symptoms. Certain medications can worsen sleep apnoea symptoms by causing the airway to relax and narrow. These may include opiates and benzodiazepines for anxiety.23

Decongestants

Allergies and chronic nasal congestion may cause blood vessels in your nose to swell and your airway too narrow. Your doctor might prescribe decongestants to help alleviate symptoms.24

Surgery

While surgery isn’t generally a first line of defence against sleep apnoea, some surgical treatments are available.

For people with moderate to severe OSA who may not respond to CPAP or oral appliance therapy, another option is hypoglossal nerve stimulation (HGNS), also known as upper airway stimulation (UAS). This is an implantable therapy that is intended to help keep the airway open during sleep.25

Other less common surgical options include nasal surgery to fix a crooked or deviated septum, jaw surgery to change the position of the jaw, surgery to remove the tonsils or adenoids or somnoplasty, which uses radiofrequency to shrink the tissue in the upper airway.26

Obstructive sleep apnoea tips: Living with OSA

Following your doctor’s treatment plan is the most effective way to manage OSA. Lifestyle changes, CPAP use and early diagnosis can significantly improve sleep quality and overall health.

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This blog post contains general information about medical conditions and treatments. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. The information is not advice, and should not be treated as such. You must not rely on the information on this website as an alternative to medical advice from your doctor or other professional healthcare provider.

If you have any specific questions about any medical matter, you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition, you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website. The views expressed on this blog and website have no relation to those of any academic, hospital, practice, or other institution with which the authors are affiliated and do not directly reflect the views of Resmed or any of its subsidiaries or affiliates.

Resources:
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