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Obstructive Sleep Apnea

What is it?

Obstructive Sleep Apnea (OSA) is a condition that occurs only during sleep. OSA sufferers experience repeated complete or partial closure of their throat (pharynx or airway) while they sleep. This airway closure leads to reduced depth of breathing and periods of breathing cessation. These episodes can last between 10 seconds to over a minute, causing a fall in the oxygen levels in the blood as a result. These disturbances to breathing lead to interruptions in sleep called an arousals. Arousals can be as quick as 3 seconds in duration but they disrupt the sleep cycle. You may not be aware of these as they may not wake you fully out of your sleep. These periods of obstruction are called events and can happen many times (sometimes hundreds) throughout the night. The disruption to the normal sleeping cycle can cause fatigue, headaches, difficulty focusing on daily tasks, irritation and may also be linked with medical conditions such as high blood pressure, irregular heart rhythms and diabetes.

What are the symptoms of obstructive sleep apnea?

Symptoms can include:

  • Snoring
  • Restless sleep
  • Daytime fatigue
  • Regular waking during the night to urinate
  • Morning headaches
  • Difficulty focusing on daily tasks
  • Irritability
  • Teeth grinding
  • Bed partner witnessing you stopping breathing during the night
  • Decreased libido
  • Depression
For those with moderate or severe OSA more structured treatment is usually recommended especially if there is a direct or family history of high blood pressure, heart disease or stroke. Discussing these options with your GP or sleep therapist is important and ensuring ongoing monitoring or a repeat sleep study after treatment is a good idea. 
 What are the effects of having untreated OSA?

There is well documented evidence that people with untreated severe to moderate OSA can develop (or indeed may already have) other health conditions. The regular interruptions to breathing and the dropping oxygen levels can lead to the development of quite serious health issues. OSA has been closely linked with:

  • Hypertension – high blood pressure
  • Ischemic heart disease – the cause of heart attacks or the need for open heart surgery
  • Atrial fibrillation – irregular heartbeat
  • Cardiovascular Accident (CVA) – stroke
  • Type 2 Diabetes
  • Depression
  • Early onset cognitive decline and later development of more severe disease such as Alzheimer’s and Dementia
  • Increased risk of accidents (motor vehicle, work place) due to fatigue and poorer concentration.

Indeed if you are diagnosed with OSA you are unable to maintain a commercial drivers or pilots licence until your apneas have been treated.

How is OSA diagnosed?

The best way to clearly establish a diagnosis of OSA is via a overnight sleep study. In the past these were only able to be performed in a hospital environment. This lead to long waiting times for diagnosis and treatment. With technological advancements, these tests are more portable and accessible. The devices used to treat OSA are much better at preventing the apneas; they are smaller, quieter, and more efficient than in the past. Sleep study tests can be performed quite simply in your home. There are a variety of types of home studies available, from simple screening devices the size of your fingernail, to a more sophisticated device that can monitor heart and sleep function as well. Studies can still also be performed in a controlled environment in a hospital setting if this is deemed best for you. Your GP or specialist can refer you for a sleep study. If you have any concerns you can also call us for support.

How is obstructive sleep apnea treated?

Treatment of OSA needs to be individualised to achieve the best clinicial outcome for each person. For those with mild OSA – weight loss and a change of sleeping postures may be enough.

For those with moderate or severe OSA more structured treatment is usually recommended especially if there is a direct or family history of high blood pressure, heart disease or stroke. Discussing these options with your GP or sleep therapist is important and ensuring ongoing monitoring or a repeat sleep study after treatment is a good idea. These treatments can include an oral splinting device, a postural correction device, weight loss and CPAP. Usually, it is only once these treatments have been trialled would a surgical review then be offered.

CPAP is essentially a small air pump that takes in air from the room and deliveries it under a small amount of pressure to the airways via a mask. The CPAP device is quiet and is only used while you sleep. Masks vary in size and style and should be carefully selected in consultation with your therapist to ensure effective treatment. The air pressure acts to ‘splint’ open your throat, stopping the airway closure and allowing you to stay asleep during the night. It can take some time to adjust to using CPAP so it is important to get the right support with qualified, trained therapists.

You will find other treatment ideas on the market, however, many have been shown to have no or very limited benefit in managing OSA. Please ask your doctor or health care professional for advice.