Obstructive sleep apnoea is a condition characterised by episodes where a person's breathing repeatedly stops while they sleep. 'Apnoea' refers to the lack of breathing, while 'obstructive' describes the cause of the apnoea.
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Obstructive Sleep Apnoea (OSA)
During normal sleep, the muscles lining the upper throat relax slightly, but stay strong enough to keep the airway open, allowing air in and out of the lungs. Some individuals have a narrower passage, and during sleep, the relaxation of these muscles causes the passage to close, resulting in air not getting to the lungs. Loud snoring and laboured breathing occur.

When complete blockage of the airway occurs, air cannot reach the lungs. This tends to cause the sufferer to wake briefly (known as an 'arousal'). This wakefulness restores the airway and the patient returns to sleep. This cycle can be repeated as many as 500 times each night, leaving the sufferer feeling tired and lethargic due to broken sleep.

Symptoms of Obstructive Sleep Apnoea

Night-time symptoms
  • Snoring, usually loud, habitual, and bothersome to others, is found in almost all patients with obstructive sleep apnoea. However, not all snorers suffer from OSA.
  • Apnoeas (pauses in breathing) that often interrupt the snoring and end with a snort
  • Gasping and choking sensations that intermittently arouse the patient from sleep
  • Restless sleep (insomnia), with patients often complaining of frequent arousal and tossing/turning during the night

Daytime symptoms

  • Excessive tiredness, for example inability to stay awake while reading or watching television
  • Waking without feeling refreshed
  • Morning headache
If untreated, obstructive sleep apnoea may have serious consequences. Obstructive sleep apnoea affects the cardiovascular system due to the periods of poor oxygenation during sleep and the stress on the body during attempts to re-initiate breathing. This may result in heart failure, arrhythmias (abnormal heart rhythms), or hypertension (high blood pressure).

Poor sleep due to recurrent arousals may result in excessive daytime sleepiness, personality changes, memory loss and intellectual impairment.

How is Obstructive Sleep Apnoea Treated?

Several simple lifestyle changes can reduce the symptoms of obstructive sleep apnoea in many patients. These changes include:
  • Weight loss (via meal replacement programs, drugs or surgery)
  • Smoking cessation
  • Avoidance of alcohol and sedative medications, particularly before sleep
  • If symptoms are worse in one position, e.g. when lying flat on the back, avoidance of this position may help.
While some patients can be effectively managed with these lifestyle modifications, many patients with obstructive sleep apnoea will require further treatment. Options include:
  • Oral appliances: these are worn at night. They pull the jaw forward and are designed to prevent the collapse of the upper airway during sleep. They can be used for mild and moderate disease.
  • Continuous positive airway pressure (CPAP) via nasal mask: this is a machine which blows air through a mask into the patient's mouth and nose during sleep. The pressure of the air keeps the throat open, preventing the airway from collapsing. It is the most effective treatment for obstructive sleep apnoea, reducing daytime sleepiness and improving sleep quality. However, some patients find the mask or feeling of pressure difficult to tolerate.
  • Surgical treatment is rarely used. Several procedures have been trialled, including uvulopatatopharyngoplasty (UPPP), which is designed to remove some of the soft tissues of the throat which collapse the airway during sleep. However, while UPPP may reduce snoring, it is often ineffective at treating true obstructive sleep apnoea.
Here at Life Time Smiles we can help you decide which option best suits your individual needs and tailor your treatment for the best possible outcome.

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