Sleep Apnoea - Your Questions Answered
By Karen Lillington, RGN
Sleep Apnoea is a condition which stops you breathing when you are asleep. The cessation of breathing automatically forces you to wake up in order to start breathing again. This can happen many times during the night, making it hard for your body to get enough oxygen, and preventing you from obtaining enough good quality sleep. There are three types of sleep apnoea, which are caused by different factors:- Obstructive Sleep Apnoea (OSA) is the most common form. It is the result of structures in the throat blocking the flow of air in and out of the lungs during sleep. Central Sleep Apnoea (CSA) 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. Mixed Sleep Apnoea is a combination of both OSA and CSA.
People with sleep apnoea may complain of excessive daytime sleepiness, irritability or restlessness. But it is often a bed partner, family or friends who notice the symptoms first. People who have sleep apnoea may experience some of the following:
- Extremely loud heavy snoring, often interrupted by pauses and gasps.
- Daytime sleepiness, e.g., falling asleep at work, whilst driving, during conversation, or when watching TV.
- Decreased daytime alertness, loss of energy, or just constant fatigue. They will often say 'I could fall asleep immediately if I let myself.'
- Irritability, short temper.
- Morning headaches.
- Changes in mood or behaviour.
- Anxiety or depression.
- Decreased interest in sex.
What should I do if I think I have these symptoms?
You must consult your GP. Remember not every one who has these symptoms will necessarily have sleep apnoea.
Once you have discussed your symptoms with your GP, he may decide to send you to a specialist in the diagnosis and treatment of such conditions.
It is likely that he or she will want to take a record of your sleep pattern. This may involve a night or two in hospital where equipment will be used to monitor the quality of your sleep, and the amount of oxygen your body is getting. Alternatively, you may be sent home with a simple monitor to measure your own oxygen levels. Sometimes both types of investigations are used. The results of these tests, together with other information, will enable the specialist to diagnose whether or not you have sleep apnoea and decide on the best course of treatment for you.
Your GP will ask you what your collar size is, as there is a strong correlation between collar size over 18 inches and sleep apnoea. Information about the length of time you have been aware of your symptoms, your general health, and your bedtime routine will all help the specialist to build up a picture of your problems and decide how they can best be solved.
Sleep apnoea can be treated in different ways. Surgery is one option, and until recently it was the only treatment available for sufferers of sleep apnoea. The operation involves reshaping the breathing tubes, so that air can pass through to the lungs more easily. If your condition is the result of obstructions in the nose, such as polyps or allergic rhinitis, surgery may be an effective form of treatment.
An alternative method of treatment is CPAP (pronounced 'see-pap'). This is a medical product which delivers a small amount of pressure to the airways (breathing tubes). The pressure prevents structures in your throat from blocking air movement in and out of the lungs whilst you sleep. You will be sent to see a specialist in Ear Nose and Throat surgery.
If it is decided that you need CPAP therapy, the specialist will arrange this for you. He or she will have specially trained technicians who will know which is the best equipment for you to use, and what pressure you need in order to stop your symptoms.
You will need to use CPAP at night. This involves wearing a mask fitted over your nose which is fixed on by a head strap or cap. The tubing from the mask is connected to the CPAP machine which will have been set to the correct pressure by the technician or specialist. You then simply breathe in and out as normal. You will be shown how to use the machine correctly before you go home, and you will be seen regularly by hospital staff to make sure you have no problems.
Using CPAP may seem strange at first, but you will soon get used to it! Sleep apnoea cannot as yet be cured, but it can be effectively controlled. It is important for anyone who thinks they may have sleep apnoea to visit their GP. There is no need for anyone to have to live with these symptoms, and your GP or specialist will be able to give you support and information, and monitor your condition on a regular basis.