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Obstructive Sleep Apnoea: More Than Just a Bad Night's Sleep

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Published: 19 November 2019

Cover image for article: Obstructive Sleep Apnoea: More Than Just a Bad Night's Sleep

Sleep apnoea is not just snoring and disrupted sleep, it is a serious medical condition.

People who have obstructive sleep apnoea (OSA) will experience continuous episodes of partial or complete obstruction of the throat while sleeping (Sleep Health Foundation n.d.a).

This obstruction occurs when the walls of the upper airway, including the tongue, relax and block or restrict the airway (Healthy Sleep Solutions n.d.)

A person with OSA will stop breathing for a short period of time. Typically this will last between 10 seconds to one minute (Better Health Channel 2019).

obstructive sleep apnoea
Diagram showing normal breathing, snoring, and obstructive sleep apnoea.

This cycle repeats multiple times during the night. The effect of this is fragmented sleep, causing a person to feel unrefreshed upon waking; daytime tiredness; poor concentration; and general fatigue (Better Health Channel 2019).

Types of Sleep Apnoea

Someone with sleep apnoea will:

  • Cease breathing completely (apnoea);
  • and/or

  • Experience severely restricted breathing (hypopnoea).

(Healthy Sleep Solutions n.d.)

The Apnoea / Hypopnoea Cycle

  1. Muscles of the airway relax, a person’s breathing slows and snoring may begin.
  2. The airway is blocked, which causes breathing to stop.
  3. Oxygen in blood decreases and heart rate slows, the body struggles for air.
  4. The brain arouses and jolts the airway clear.
  5. The person gasps for air, possibly violently, disturbing their sleep.
  6. Breathing returns to normal.

(Healthy Sleep Solutions n.d.)

How Prevalent is Sleep Apnoea?

An estimated five per cent of Australians experience sleep apnoea. Around one in four men over the age of 30 years are affected (Better Health Channel 2019).

What are the Consequences?

OSA interrupts sleep and causes stress on the body (Sleep Health Foundation n.d.a). This stress presents in tachycardia; hypertension; changes in metabolism; reduced liver function; nerve dysfunction; and severe fatigue (Healthy Sleep Solutions n.d.).

Evidence indicates that people who have moderate to severe OSA will have other health problems. This includes higher risk of heart attack; stroke, depression; fatty liver disease; hypertension; and diabetes (Sleep Health Foundation n.d.a; Healthy Sleep Solutions n.d.).

Research suggests that people who have OSA are roughly two and a half times more prone to motor vehicle accidents than those without it (Sleep Health Foundation n.d.a).

image of man tired as a result of OSA
The effect of OSA is fragmented sleep, causing a person to feel unrefreshed upon waking; daytime tiredness; poor concentration; and general fatigue.

Degrees of severity

  • Normal sleep: Less than 5 breathing interruptions per hour.
  • Mild sleep apnoea: Between 5 and 14 breathing interruptions per hour.
  • Moderate sleep apnoea: Between 15 and 29 breathing interruptions per hour.
  • Severe sleep apnoea: Over 30 breathing interruptions per hour.

(Healthy Sleep Solutions n.d.; Better Health Channel 2019)

Symptoms of Sleep Apnoea

  • Snoring;
  • Tossing and turning in the night;
  • Gasping and choking in the night;
  • Daytime tiredness;
  • Reduced concentration;
  • Irritability and decreased mood;
  • Impotence and reduced sex drive;
  • Morning headaches;
  • Polyuria.

(Sleep Health Foundation n.d.a; Better Health Channel 2019; Snore Australia n.d.)

Causes of Sleep Apnoea

Obesity is seen as being the leading cause of sleep apnoea. Other factors include:

  • Alcohol consumption;
  • Some illnesses including hypothyroidism;
  • Large tonsils;
  • Medications such as sleeping tablets and sedatives;
  • Nasal congestions and/or obstruction; and
  • Facial bone shape and size of muscles.

(Better Health Channel 2019)

Treatment for Sleep Apnoea

It is necessary to know the cause of sleep apnoea, as no single treatment is applicable for everyone (Sleep Health Foundation n.d.b)

Lifestyle changes are considered to be the first line of treatment for sleep apnoea. Specifically losing weight and reducing alcohol consumption (Better Health Channel 2019).

Continuous Positive Airway Pressure (CPAP)

In addition to lifestyle changes, it is often recommended that patients wear a mask at night that prevents their throat from collapsing. The mask gently transmits increased air pressure to the throat. The term for this is nasal continuous positive airway pressure or CPAP. A person with OSA should work with a health professional to find the mask and machine that works for them (Better Health Channel 2019). CPAP is typically very successful at managing the symptoms and effects of OPA (Sleep Health Foundation n.d.a).

For people with mild to moderate sleep apnoea, a mouthguard or similar apparatus may be useful (Better Health Channel 2019).

In severe cases where other therapies have been unsuccessful, surgery to the palate and base of the tongue might be recommended. This surgery is best undertaken by otolaryngologists, who are specifically trained in sleep-related surgery (Better Health Channel 2019).

CPAP
It is often recommended that patients wear a mask at night that prevents their throat from collapsing (CPAP).

Diagnosis of Sleep Apnoea

If the symptoms of OSA are present: snoring, breathing pauses and sleepiness during the day, a person may want to be checked for OSA. The way this condition is typically diagnosed is by an overnight sleep study (Sleep Health Foundation n.d.a).

Additional Resources

Multiple Choice Questions

Q1. True or false: Irritability is a symptom of obstructive sleep apnoea.

  1. True
  2. False

Q2. What percentage of Australians suffer from sleep apnoea?

  1. 10
  2. 25
  3. 4
  4. 5

Q3. Experiencing between 5 and 14 interruptions per hour is a sign of…?

  1. Mild sleep apnoea
  2. Moderate sleep apnoea
  3. Severe sleep apnoea
  4. Normal sleep
References

(Answers: a, d, a)

Author

Portrait of Ausmed Editorial Team
Ausmed Editorial Team

Ausmed’s Editorial team is committed to providing high-quality and thoroughly researched content to our readers, free of any commercial bias or conflict of interest. All articles are developed in consultation with healthcare professionals and peer reviewed where necessary, undergoing a yearly review to ensure all healthcare information is kept up to date. See Educator Profile

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Learner Reviews

4.5

31 Total Rating(s)

Portrait of Marianne Hoeft
Marianne Hoeft
27 Nov 2019

Informative.

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Carissa Foley
23 Nov 2019

Gives good evidenced based information about sleep apnoea, which we can apply to our practice and use for patient education.

Portrait of Laura Kennedy
Laura Kennedy
23 Nov 2019

Succinct education on the causes, symptoms and possible treatment available for sleep apnoea. I found the severity grading particularly helpful and will be a useful tool in educating those patients who may demonstrate symptoms whilst in my care.