A more in-depth look at sleep apnoea and the affect it has

How do I know if I have Sleep Apnoea?

People with sleep apnoea may complain of excessive daytime sleepiness often with irritability or restlessness. But it is normally the bed partner, family or friends who notice the symptoms first.

Sufferers may experience some of the following:

• Extremely loud heavy snoring, often interrupted by pauses and gasps
• Excessive daytime sleepiness, e.g., falling asleep at work, whilst driving, during conversation or when watching TV. (This should not be confused with excessive tiredness with which we all suffer from time to time)
• Irritability, short temper
• Morning headaches
• Forgetfulness
• Changes in mood or behaviour
• Anxiety or depression
• Decreased interest in sex

Remember, not everyone who has these symptoms will necessarily have sleep apnoea. We possibly all suffer from these symptoms from time to time but people with sleep apnoea demonstrate some or all of these symptoms all the time.

Diagnosing Sleep Apnoea

OSA can range from very mild to very severe. The severity is often established using the apnoea/hypopnoea index (AHI), which is the number of apnoeas plus the number of hypopnoeas per hour of sleep – (hypopnoea being reduction in airflow). An AHI of less than 10 is not likely to be associated with clinical problems. To determine whether you are suffering from sleep apnoea you must first undergo a specialist ‘sleep study’. This will usually involve a night in hospital where equipment will be used to monitor the quality of your sleep. The results will enable a specialist to decide on your best course of treatment.

The ultimate investigation is polysomnography, which will include:

• Electro-encephalography (EEG) – brain wave monitoring
• Electromyography (EMG) – muscle tone monitoring
• Recording thoracic-abdominal movements – chest and abdomen movements
• Recording oro-nasal airflow – mouth and nose airflow
• Pulse oximetry – heart rate and blood oxygen level monitoring
• Electrocardiography (ECG) – heart monitoring
• Sound and video recording

This is a very expensive investigation, with few centres able to offer it routinely for all suspected sleep apnoea patients. A ‘mini’ sleep study is more usual, consisting of pulse oximetry and nursing observation. Home sleep study is becoming more popular.

Central & Mixed Sleep Apnoea

OSA is the commonest form of sleep apnoea, (about 4% of men and 2% of women) but there is also a condition called Central Sleep Apnoea (CSA). This is a condition when the brain does not send the right signals to tell you to breathe when you are asleep. In other words the brain ‘forgets’ to make you breathe. It can also be associated with weakness of the breathing muscles. The assessment for CSA is often more complicated than for OSA and the treatment has to be carefully matched to the patient’s requirements. There is also a condition called Mixed Sleep Apnoea that is a combination of both obstructive and central sleep apnoea.

Treating Sleep Apnoea

There are several forms of treatment for sleep apnoea. In mild and moderate cases weight loss and the use of mandibular advancement devices can be wholly successful. In moderate and severe cases mandibular advancement device or nasal continuous positive airway pressure (CPAP) are normally prescribed. CPAP is the gold standard treatment for OSA.

Travel with Sleep Apnoea

One of the biggest concerns we hear from customers with sleep apnoea is “how can I still travel”, while there is more pre planning required, the good news is you still can. Don’t let the thoughts of travelling with your machine put you off travelling as there really are some nifty gadgets to help you out. Most importantly, don’t risk your health by not taking it with you.

Considerations need to be made in particular for flying and driving after receiving a diagnosis of obstructive sleep apnoea (OSA) and arguably even more important if you are pre diagnosis but aware you may be at risk.

If you are unsure if you have Sleep Apnoea it may be wise to make an appointment with your GP as they can refer you to a sleep study for diagnosis. Your GP knows your complete medical history and is always the best person to advise you about medical matters.