Understanding obstructive sleep apnoea syndrome

What are the risk factors for developing sleep apnoea?

In addition to being overweight and getting older, other risk factors for obstructive sleep apnoea include:

• Being male
• Having a large neck
• Taking sedating medication
• Drinking alcohol in the evening

How is sleep apnoea diagnosed?

Your doctor will perform a physical examination and take a medical and sleep history. The doctor may also ask people who live with you about your sleeping habits.

You might also be asked to take a sleep test called a polysomnogram, or PSG. Sleep testing is performed in a sleep laboratory and is supervised by a trained technologist. The test will measure various body functions, including:

• Air flow
• Blood oxygen levels
• Breathing patterns
• Electrical activity of the brain
• Eye movements
• Heart rate
• Muscle activity

After the study is completed, the technologist will tally the number of times your breathing was impaired during sleep and grade the severity of sleep apnoea. In some cases, a multiple sleep latency test is performed on the day after the overnight test. This measures how quickly you fall asleep. In this test, patients are given several opportunities to fall asleep during the course of a day when they normally would be awake.

How is sleep apnoea treated?

There are several possible treatments for obstructive sleep apnoea. They range from a change in behaviour to facial surgery. The aim of treatment is to restore normal breathing during sleep and to alleviate the troublesome symptoms, such as snoring and daytime fatigue. Treatment may also help lower blood pressure and decrease the risk of stroke, diabetes and heart disease.

Conservative treatments - In mild cases of sleep apnoea, conservative therapy may be all that is needed. These treatments include the following:

• Overweight individuals can benefit from losing weight. Even a 10% weight loss can reduce the number of sleep apnoea events for most patients.
• Individuals with sleep apnoea should avoid the use of alcohol and sleeping pills, which make the airway more likely to collapse during sleep and prolong the apnoeic periods.
• In some patients who have mild sleep apnoea, breathing pauses occur only when they sleep on their backs. In such cases, using pillows and other devices that help them sleep in a side position may be helpful.
• People with sinus problems or nasal congestion (who are more likely to experience sleep apnoea) can try nasal sprays or breathing strips to reduce snoring and improve airflow for more comfortable night-time breathing.
• Avoiding sleep deprivation is important for all patients with sleep disorders.

Mechanical therapy - Continuous positive airway pressure (CPAP) is the preferred initial treatment for most people with obstructive sleep apnoea. With CPAP, patients wear a mask over their nose and/or mouth. An air blower forces air through the nose and/or mouth. The air pressure is adjusted so that it is just enough to prevent the upper airway tissues from collapsing during sleep. The pressure is constant and continuous. CPAP prevents airway closure while it is being used, but apnoea episodes return when CPAP is stopped or it is used improperly. Other styles and types of positive airway pressure devices are available for people who have difficulty tolerating CPAP.