Obstructive sleep apnoea

What is obstructive sleep apnoea?

Obstructive sleep apnoea (OSA) happens when your throat is partly or completely blocked at times while you’re asleep, causing you to stop breathing.

You may stop breathing for between 10 and 90 seconds, and then wake up briefly (called an arousal), which restarts your breathing. These breathing pauses, known as apnoeas, can happen many times a night. You’re often unaware of it happening, but will wake feeling tired.

OSA ranges from mild to severe. In severe cases, your sleep can be interrupted hundreds of times each night with long pauses in your breathing.

Why do I have obstructive sleep apnoea?

OSA can affect anyone, but is more common if you:

• are middle aged or older
• snore
• are overweight (because your throat is narrowed by fatty tissue)
• have OSA in your family
• have a naturally narrow throat or nasal passages

Children can also suffer from OSA, but OSA in children is usually caused by having large tonsils or adenoids.

What are the symptoms of obstructive sleep apnoea?

Symptoms of OSA include:

• pauses in breathing while you’re sleeping, which other people may notice
• snoring (vibration of your throat during sleep)
• tossing and turning during sleep
• waking up gasping or choking
• tiredness and feeling unrefreshed after sleep

How is obstructive sleep apnoea diagnosed?

If you think you may have OSA, see your doctor. You may need a referral to a sleep clinic for an overnight sleep study. Some clinics do this under supervision in a sleep laboratory, but some will set you up for a home sleep study. During the study, your breathing and oxygen levels will be monitored while you sleep.

How is obstructive sleep apnoea treated?

If you have mild OSA, it may be enough to:

• sleep on your side (using special pillows and rubber wedges can help)
• lose weight (if you are overweight)
• drink less alcohol

Other things may help include:

• avoiding sleeping tablets
• quitting smoking if you smoke
• using nasal decongestant sprays, if your nose is blocked

If you have moderate to severe sleep apnoea, you may need other treatments, including:

• an oral appliance (mouthguard or splint) fitted by your dentist, to wear while you are sleeping to help keep your airways open
• a continuous positive airway pressure (CPAP) pump, which feeds pressurised air into a face mask to hold your throat open while you sleep
• surgery, if you have severe OSA and both CPAP and oral appliances haven’t helped you

Treating OSA will help you sleep with fewer interruptions and may reduce your risks of related health problems.

Can obstructive sleep apnoea be prevented?

You can reduce your chances of developing OSA by maintaining a healthy weight, limiting your alcohol consumption and minimising your use of sleeping pills. You should also try to have good sleep habits including a regular sleep pattern.

Complications of obstructive sleep apnoea

OSA is bad for your health. As well as making you tired, untreated moderate to severe OSA increases your risk of other health problems, such as high blood pressure and cardiovascular disease.

People with untreated OSA also have a higher risk of:

• diabetes
• stroke
• poor memory and lack of concentration
• headaches
• moodiness, depression and personality change
• decreased libido, and male impotence

You are also at a higher risk of motor vehicle and workplace accidents.

What is the difference between obstructive sleep apnoea and central sleep apnoea?

If you have central sleep apnoea (CSA), you have breathing pauses (apnoeas) during the night because of pauses in your body’s drive to breathe. This is different to OSA, where apnoeas are caused by a blocked airway. CSA is less common than OSA. You’re less likely to snore loudly with CSA than with OSA.

Illnesses such as stroke, heart failure and some medicines can cause you to develop CSA by affecting your brain’s breathing control centres.

Your doctor may recommend a sleep study to diagnose CSA. Ask your doctor if your medicines may be contributing to CSA. If you have CSA, you may benefit from CPAP, night time oxygen therapy or medicines to treat heart failure.