Sleep Apnoea - The Fatigue Of Sleep

What is Sleep Apnoea?

Sleep apnoea is a sleep disorder characterised by repetitive pauses in breathing during sleep. Whilst sleeping, the muscles of the throat relax to the point of blocking the airways above the voice box. Breathing stops, for between a few seconds and up to one minute, until the brain registers the lack of breathing (or a drop in oxygen levels) and sends a small wake-up call. The sleeper rouses slightly, typically snorts and gasps, then drifts back to sleep almost immediately. In most cases, the person doesn’t even realise they are waking up. This pattern can repeat itself hundreds of times over every night, leaving the person dogged by sleepiness and fatigue.

The most common type of sleep apnoea is Obstructive Sleep Apnoea. There are different degrees of sleep apnoea, with the severity of this disorder depending on how often the breathing is interrupted. The following averages can be used as a guide:

• Normal - less than five interruptions an hour
• Borderline - 5 to 15 interruptions an hour
• Mild sleep apnoea - between 15 and 30 interruptions an hour
• Moderate sleep apnoea - between 30 and 50 interruptions an hour
• Severe sleep apnoea - over 50 interruptions an hour

What causes Sleep Apnoea?

Obesity is one of the most common causes of sleep apnoea. A loss of around 5 to 10 kilograms is often enough to dramatically reduce the severity of the disorder.

Other causes of sleep apnoea include:

• Alcohol, especially in the evening, which relaxes the throat muscles and hampers the brain’s reaction to sleep disordered breathing
• Certain illnesses such as hypo thyroidism or the presence of a very large goitre
• Large tonsils
• Medications, such as sleeping tablets and sedatives
• Nasal congestion

What are the warning signs of Sleep Apnoea?

• Loud, repetitive snoring – sleep apnoea sufferers follow a pattern of loud snoring followed by episodes of silence and then a loud snort or choking sound
• Excessive daytime sleepiness – this can occur whilst at work, watching TV or even driving the car
• Erratic mood shifts – people with sleep apnoea are more susceptible to depression and increased irritability
• Morning headaches
• Memory or learning problems
• Poor concentration
• Dry throat upon waking in the morning

How common is Sleep Apnoea?

It is estimated in Australia that 17% of middle-aged men and 6% or middle-aged women suffer from Obstructive Sleep Apnoea. Anyone can have sleep apnoea, however the more risk factors you have, as well as a family history of sleep apnoea, increases the risk of this disorder.

How is Sleep Apnoea diagnosed?

Your doctor will do a physical exam and check your mouth, nose and throat for large or extra tissue. Your doctor may order a sleep study which is performed in a hospital or sleep centre.
The most common sleep recording to diagnose sleep apnoea is called a polysomnogram or PSG. This test records:

• Brain and muscle activity
• Eye movement
• Breathing and heart rate
• Air movement into your lungs
• Oxygen in your blood

Can Sleep Apnoea be Treated?

Yes It Can!

Treatment is aimed at restoring regular nighttime breathing and relieving symptoms such as very loud snoring and daytime sleepiness. The following methods may be used:

• Continuous Positive Airway Pressure (CPAP) is the most common treatment for sleep apnoea. This involves wearing a mask while you sleep which blows air into your throat at a pressure level which is right for you. The increased pressure keeps the throat open while you sleep
• Oral Devices such as custom-made mouthpieces can be helpful in some people with mild sleep apnoea. The mouthpiece will adjust your lower jaw and your tongue to help keep the airway in your throat open while you are sleeping
• Surgery may be an option only if the above alternatives do not work. Such procedures are effective only in a small proportion of mild obstructive sleep apnoea sufferers

Preventing Sleep Apnoea

Prevention for sleep apnoea relies on changes to lifestyle. It is recommended to:

• Lose weight
• Reduce night time alcohol
• Quit smoking — smoking damages the smaller airways of your lungs which reduces your total lung capacity. Smoking can exacerbate your sleep apnoea

Do I need Help?

To help determine whether you need medical treatment, answer the following questions.

• Do you gasp, choke or stop breathing during sleeping?
• Do you snore loudly at night?
• Do you feel tired and un-refreshed during the day?
• Are you overweight?
• Do you have a neck girth over 42cm?
• Do you have high blood pressure?

If you answer ‘YES’ to two or more of the above questions, you may have sleep apnoea and you should see your GP.