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What is sleep apnoea?
Sleep apnoea is a common sleep disorder in which breathing stops and restarts during sleep.
Although it is common, sleep apnoea can be a serious condition. This is because when you stop breathing during an episode of sleep apnoea, it prevents you from getting enough oxygen. In most cases of sleep apnoea, the brain kicks in to wake you up so that breathing starts again, but this means sleep can become very disrupted, meaning you wake up unrefreshed and can be tired and sleepy in the daytime.
The severity of sleep apnoea can vary too. You could have 1 or 2 episodes of sleep apnoea in one night, or more than a hundred. The more severe your sleep apnoea is, the more obvious and debilitating your symptoms are likely to be.
Types of sleep apnoea
There are 2 different types of sleep apnoea. These are known as obstructive and central, and they are caused by 2 very different things.
Obstructive sleep apnoea
Obstructive sleep apnoea is by far the most common type of sleep apnoea. It gets its name from its cause – obstruction of the airway. In obstructive sleep apnoea, your breathing is affected because the upper airway either narrows or becomes completely blocked while you sleep.
Most commonly, this is due to excessive weight in the neck area, although it can occur if the tonsils and adenoids (areas of tissue that sit right at the back of the nose) are overly large. When the muscles (which normally hold the airway open during sleep) relax, the airway narrows or can close off completely.
Central sleep apnoea
Central sleep apnoea is a fairly rare condition and happens when part of the brain that controls breathing isn’t working properly. It can affect premature babies, as their brains are not fully formed at the time of birth. However, it is more common in older people, particularly those aged 65 or older, as they are more likely to have health conditions affecting their sleep.
Central sleep apnoea often occurs as a result of heart or neurological disorders such as brain injuries and tumours or severe heart failure. Certain medications, including opiates, can also cause central sleep apnoea.
What are the symptoms of sleep apnoea?
The symptoms of central sleep apnoea and obstructive sleep apnoea are virtually the same. It can be easy to identify sleep apnoea in other people, for example your partner, as the symptoms may be very visible or audible.
Symptoms of sleep apnoea include:
- gasping for breath during sleep
- loud snoring
- times where breathing stops during sleep
- breathing restarting with snorting, coughing or choking sounds
- headaches in the mornings
- difficulty falling and staying asleep
- irritability
- daytime sleepiness, tiredness or fatigue
- trouble focusing during the daytime
What complications can sleep apnoea cause?
Sleep apnoea can lead to complications if left untreated, including:
- type 2 diabetes
- high blood pressure
- heart disease
- increased risk of stroke
- heart rhythm problems, particularly atrial fibrillation
The sooner you can be diagnosed and receive treatment, the lower your chances of developing sleep apnoea-related complications are.
How is sleep apnoea diagnosed?
The diagnosis of sleep apnoea is confirmed with an overnight sleep study, which uses very unobtrusive equipment. This equipment monitors several aspects of your breathing, including oxygen levels, and some heart parameters, as well as your position in bed.
If you visit our team at Royal Brompton Centre for Sleep for a sleep study, our team will fit the sensors to you before 10pm, allowing you to go to sleep at your convenience. As you rest, the sensors will transmit data to a computer, monitoring your breathing patterns and oxygen levels. If you have a chest condition, we will measure your oxygen levels with a finger clip and assess your carbon dioxide levels using a sensor pad secured to your forearm.
Sleep studies are entirely painless, and most participants experience a typical night’s sleep. A nurse will be on hand throughout your sleep study should you require any assistance. (Please note that this description reflects a standard sleep study, but individual circumstances may vary.)
These sleep studies can now generally be undertaken in your own home. You will receive medical equipment to track your blood oxygen levels, airflow, breathing patterns, and heart rate. Our team will then analyse your recordings and provide an assessment based on the results, which is the first step in developing a personalised treatment plan for you.
Sleep apnoea treatments
There are a number of different treatments that can be used to successfully improve sleep apnoea. Exactly which treatment you are recommended will depend on the type and severity of sleep apnoea experienced, your symptoms and your other health conditions.
Oral appliance therapy
In some cases, you may be recommended to try an oral appliance to help with your sleep apnoea. This is a device worn in the mouth while you sleep to keep the airway open.
Known as a mandibular advancement device, these appliances tend to look a lot like mouthguards used in sports. The device will gently adjust the position of your jaw and tongue while you sleep, easing the lower jaw and tongue forward slightly to make the airway wider.
Positional therapy
Some individuals have more significant sleep apnoea when they lie on their back (known as positional sleep apnoea). In these cases, various devices can help to prevent you rolling on to your back, to reduce or even prevent your sleep apnoea entirely.
CPAP therapy
CPAP stands for ‘continuous positive airway pressure’. In this treatment, you would wear a mask over your mouth and nose, or nose only, while you sleep.
This mask is connected to a machine that delivers a constant stream of air at pressure into the upper airway, to hold it open throughout the night, preventing snoring and keeping oxygen levels stable throughout the night, improving sleep and reducing the risk of longer-term health issues.
Tonsillectomy
This is a surgical procedure to remove tonsils that could be obstructing your airway while you sleep. It’s performed under general anaesthetic but is low-risk and the recovery period tends to be quite quick. This treatment is only suitable for a few individuals who have particularly enlarged tonsils. Sometimes tonsils and adenoids are removed at the same time. This is known as an adenotonsillectomy.
Locations
Treatment for sleep apnoea is available at the following locations:
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