Obstructive Sleep Apnoea

Obstructive Sleep Apnoea

Obstructive Sleep Apnoea (OSA) is a serious disorder where one actually stops breathing during sleep as a result of collapse and closure of the throat. While asleep intermittent narrowing and collapse of the airway at the back of throat, causes airflow obstruction and a cessation of breathing.  Obstruction of the airway may be caused by:

• An inherited narrowing of the back of the throat
• Excessive weight and fat around the neck narrowing the space of the throat
• The tongue falling back in the throat
• A combination of the above

When the airway in the throat collapses, the normal flow of breath is prevented.  Due to a pause in breathing the body detects it is not inhaling enough oxygen or exhaling enough carbon dioxide, prompting a disturbance or arousal from sleep and interrupting your sleep with sleep fragmentation. During this event increased muscle tone allows opening of the throat, increased breathing effort and resumption of breathing again.  As sleep deepens again this leads to continued airway collapse and the cycle continues. Individuals may stop breathing from 10 to 60 seconds or more at a time, with these events occurring multiple times during sleep.

Symptoms of OSA may include:

• Snoring; usually loud, continuous or intermittent with occasional spluttering or snorting
• Waking up during the night gasping or with a sense of choking
• Disturbed or restless sleep
• Headaches on waking in the morning
• Dry mouth or sore throat on waking in the morning
• Waking unrefreshed
• Poor memory and concentration
• Depression, anxiety or mood behaviour changes
• Disturbance of partner’s sleep
• Excessive daytime sleepiness

Effects of untreated OSA may include:

• Increased risk cardiovascular disease – cardiac arrhythmia eg: atrial fibrillation, accelerated coronary artery disease
• Increased risk of stroke
• High blood pressure
• Depression
• Cognitive impairment
• Weight gain
• Impotence
• Poor memory
• Increased risk of motor vehicle accidents

OSA can be treated successfully and effectively.  Treatment of OSA should always be tailored to each individual in consultation with your specialist Sleep Physician and should involve a sleep study.  Whilst there are numerous options available for the treatment of OSA the most appropriate treatment will depend on several factors:

• Severity of OSA
• Anatomical features
• Severity of symptoms
• Alcohol consumption
• Presence of nasal obstruction
• Presence and condition of teeth

Some of the treatments options may include:

• Continuous Positive Airway Pressure (CPAP)
• Mandibular Advancement Splint (MAS) – Dental device
• Positional therapy (avoid sleeping on your back)
• Weight loss (generally requires at least 5 kgs of weight loss)
• Decreased alcohol consumption
• Decreased sedative and analgesic usage