Preventing long term health concerns by understanding and treating sleep apnoea
If you have sleep apnoea, your breathing is obstructed, partially or entirely, while you sleep. Understanding and treating sleep apnoea is essential as, apart from being challenging to cope with on a daily basis, it also increases your risk of health conditions in the long term, such as type 2 diabetes and heart disease.
Sleep apnoea can be categorized into two types, central sleep apnoea, and obstructive sleep apnoea (OSA), with the latter being the more common type.
In the UK, the British Lung Foundation suggests that OSA is very common, affecting an estimated 1.5 million adults, and yet up to 85% are undiagnosed, therefore untreated.
OSA is most common in those who are male, middle-aged and elderly, and over-weight.
What is obstructive sleep apnoea?
Obstructive Sleep Apnoea (OSA) is caused when your tongue falls on the area located at the top of the throat at the back of the mouth. This is commonly known as the soft palate area. This soft area fully or partially blocks the airway by pushing to the back of the throat. There have been long term poor health outcomes that have been associated with OSA. A few health complications risks are heightened by OSA, such as stroke, depression, high blood pressure, heart attack, and early death.
Symptoms of obstructive sleep apnoea
OSA’s more common symptoms include trouble getting a sound sleep all night, being sleepy during the day due to interrupted sleep at night, headaches in the morning, snoring loudly, choking sensation during the night. Some people will experience increased blood pressure as a result of OSA.
You should consult with your doctor if you are experiencing these symptoms. The doctors will use a sleep study to try and diagnose sleep apnoea. Your breathing is monitored during this study and will measure apnoeas where your breath is obstructed for at least 10 seconds, and hypopnea is where you have restricted breathing for about 10 seconds each time. The doctor will diagnose you with sleep apnoea if you have more than five apnoeas or hypopneas in an hour.
You will be considered to be suffering from severe sleep apnoea if you have more than 30 apnoeas per hour.
Sleep apnoea and narcolepsy
Sleep apnoea should not be confused with narcolepsy. Although both are chronic sleep conditions that can cause excessive daytime sleepiness, and it is possible for an individual to have both conditions, there are important differences.
In the UK, Modafinil is a prescription-only medication licensed only for the treatment of narcolepsy. However, it has been touted as a so-called “smart drug” that can help brain performance and is reportedly very popular among university students. In some countries, it is also used as a treatment for sleep apnoea.
You can buy Modafinil UK and many other medications online but, as stressed by the NHS, just because you can do so does not mean you should as, like many prescription drugs, there can be side effects.
Fully understanding and treating sleep apnoea appropriately is absolutely essential.
Treatment for sleep apnoea
Sleep apnoea may not need treatment if it is mild, but if you have been diagnosed with severe sleep apnoea, you will have to work with your doctor to determine the best treatment for you.
Treatments and lifestyle changes include:
There is a close correlation between sleep apnoea and obesity. Almost 70% of the people who are suffering from sleep apnoea also suffer from obesity.
Studies have shown that you can reduce OSA symptoms by 20% if you can manage to lose 10% of your body weight.
Many people use a device called a CPAP machine – a continuous positive airway pressure machine.
A CPAP is essentially a mask that will fit over your face while you sleep and will blow air into your soft palette very lightly. As OSA causes your airways to close, this gentle pressure helps to keep them open.
Most patients are known to experience a better quality of sleep by using CPAP. This is currently arguably the best treatment for people with OSA, but many people do not use it as they find the machine to be uncomfortable or bothersome.
You will be given a CPAP for free on the NHS if you need it.
Changing the position in which you sleep
It is a good idea to avoid sleeping flat on your back horizontally so that your airway is kept clear to aid in OSA treatment.
Sleeping on your side is recommended. If this is not your normal sleeping position, you could purchase a special pillow or bed wedge, or even try taping a tennis ball to the back of your sleepwear.
You should also keep your upper body and head elevated while sleeping, as they are known to work as short-term solutions to improve your condition.
Drinking Less Alcohol
Alcohol consumption increases the risk of sleep apnoea, especially if taken close to bedtime. If you can cut back on alcohol, it can help reduce OSA symptoms and prevent it from getting worse.
You are supposed to wear these oral appliances like a retainer or a mouthguard while you sleep. These oral appliances push your lower jaw forward, which in turn helps to keep the airway open.
NICE (National Institute for Health and Care Excellence) has approved many such appliances for the treatment of sleep apnoea. Your doctor can guide you as to which appliance to choose and how to get them fitted. However, some patients complain about discomfort wearing these appliances while trying to sleep.
Treating sleep apnoea with surgical treatments is generally only offered to people who have severe cases of sleep apnoea and/or are uncomfortable with oral appliances or the CPAP machine.
For children, the surgical treatment of sleep apnoea usually involves the removal of the tonsils. Surgery for this purpose is much less common in adults and is usually done when all other treatments have failed.
In adults, surgery involves repositioning the tissue or removing it, so the airway is opened further. Some of the common options for surgeries are:
Upper Airways Surgeries
Extra tissues are removed from the upper airways, and a tonsillectomy removes the tonsils. These surgeries’ efficacy depends on the patients with a 30% to 80% chance of success.
Lower Laryngeal and Pharyngeal Procedures
These procedures involve mandibular advancements, epiglottis replacement, or tongue advancement or reduction. These procedures work by changing the palate’s structure and the mouth so that the blockage to the airway can be prevented. Usually, more than one procedure is required for this to work with a success rate of 35% to 65%.
This procedure makes a hole in the throat so that the lungs can access air through it by bypassing the airways. This surgery is only attempted for people suffering from the most severe sleep apnoea cases and is a very extreme surgery.
If you want to protect your health in the long term, understanding and treating sleep apnoea as soon as possible is essential.
If you feel that you are suffering from sleep apnoea, consult your doctor and devise a treatment plan together to avoid more serious health issues such as heart disease and high blood pressure.
As we have already stressed, sleep apnoea is generally a condition that can be treated with many options available from simple lifestyle changes to surgery at the extreme. The benefits of a solid, restful night’s sleep, including how it affects your immune system, should not be underestimated.