Sleep Apnoea: Causes, Symptoms, and Treatment Options

Sleep Apnoea: Causes, Symptoms, and Treatment Options

Sleep is essential for overall health, yet millions of people worldwide struggle with sleep disorders that disrupt their rest and impact their well-being. One of the most common and serious of these sleep disorders is sleep apnoea. This condition, characterised by repeated interruptions in breathing during sleep, can lead to a range of health complications if left untreated. Understanding the causes, symptoms, and treatment options for sleep apnoea is crucial for those affected by the disorder.

What Is Sleep Apnoea?

Sleep apnoea is a disorder in which breathing repeatedly stops and starts during sleep. These pauses in breathing, known as apnoeas, can last from a few seconds to minutes and can occur 30 or more times per hour. As a result, the body and brain are deprived of oxygen, which can lead to a variety of health issues, including fatigue, cardiovascular problems, and cognitive impairment. There are three main types of sleep apnoea:

  • Obstructive Sleep Apnoea (OSA): The most common form of sleep apnoea, OSA occurs when the muscles in the back of the throat relax excessively, leading to a blockage of the airway.
  • Central Sleep Apnoea (CSA): This type occurs when the brain fails to send the proper signals to the muscles that control breathing.
  • Complex Sleep Apnoea Syndrome: Also known as treatment-emergent central sleep apnoea, this condition occurs when someone has both obstructive and central sleep apnoea.

Causes of Sleep Apnoea

The causes of sleep apnoea vary depending on the type, but certain risk factors can increase the likelihood of developing the condition:

Obstructive Sleep Apnoea (OSA) Causes

OSA occurs when the muscles in the back of the throat relax too much, leading to a narrowing or closure of the airway. Factors that contribute to OSA include:

  • Excess Weight: Obesity is a significant risk factor for OSA as excess fat around the upper airway can obstruct breathing.
  • Age: OSA is more common in older adults, as muscle tone decreases with age.
  • Narrowed Airway: Some people have naturally narrow airways or enlarged tonsils/adenoids that can block the airway.
  • Family History: A family history of OSA increases the risk of developing the condition.
  • Alcohol and Sedative Use: These substances relax the muscles in the throat, increasing the likelihood of airway obstruction.
  • Smoking: Smoking can increase inflammation and fluid retention in the upper airway, leading to OSA.

Central Sleep Apnoea (CSA) Causes

CSA occurs when the brain fails to send the correct signals to the muscles that control breathing. Factors that contribute to CSA include:

  • Heart Conditions: Conditions such as congestive heart failure are commonly associated with CSA.
  • Stroke: Damage to the brainstem, which controls breathing, can result in CSA.
  • High Altitude: Sleeping at high altitudes can cause CSA due to lower oxygen levels.
  • Opioid Use: Certain medications, particularly opioids, can disrupt the brain’s ability to regulate breathing.

Complex Sleep Apnoea Syndrome Causes

The exact cause of complex sleep apnoea syndrome is not well understood. However, it is believed to be related to the factors that contribute to both OSA and CSA.

Symptoms of Sleep Apnoea

Sleep apnoea symptoms can vary depending on the severity of the condition and the type of apnoea. However, common symptoms include:

Loud Snoring

Loud, persistent snoring is one of the most common symptoms of obstructive sleep apnoea. The sound results from the partial obstruction of the airway, causing vibrations as air tries to pass through.

Gasping or Choking During Sleep

People with sleep apnoea may wake up abruptly, gasping for air or choking, due to the temporary pauses in breathing. This can happen multiple times during the night, often without the person being fully aware.

Excessive Daytime Sleepiness

Because sleep apnoea disrupts the sleep cycle, individuals often feel excessively tired during the day. This excessive daytime sleepiness can impact work, school, and daily activities, leading to decreased productivity and an increased risk of accidents.

Morning Headaches

Frequent headaches upon waking can be a symptom of sleep apnoea. These headaches are often caused by low oxygen levels or the disruption of sleep.

Difficulty Concentrating

Cognitive symptoms such as difficulty concentrating, memory problems, and irritability can result from the poor sleep quality associated with sleep apnoea.

Dry Mouth or Sore Throat in the Morning

Waking up with a dry mouth or sore throat is common in individuals with sleep apnoea, particularly those who breathe through their mouths during sleep.

Restless Sleep

Individuals with sleep apnoea often experience restless sleep, characterized by frequent awakenings, tossing and turning, and an inability to stay asleep through the night.

Diagnosing Sleep Apnoea

If you suspect you have sleep apnoea, it’s essential to seek medical advice. Sleep apnoea is typically diagnosed through a sleep study, also known as polysomnography. During a sleep study, various bodily functions such as brain activity, eye movement, heart rate, and breathing patterns are monitored overnight to identify any abnormalities. In some cases, a
home sleep apnoea test may be recommended. This test involves wearing monitoring equipment at home to track your breathing and oxygen levels while you sleep.

Treatment Options for Sleep Apnoea

Treatment for sleep apnoea varies depending on both the severity of the condition and the type of apnoea. The goal of treatment is to keep the airway open during sleep and ensure regular breathing patterns.

Lifestyle Changes

For mild cases of obstructive sleep apnoea, lifestyle changes may be sufficient to manage the condition. These changes include:

  • Weight Loss: Losing weight can reduce fatty tissue around the airway, decreasing the likelihood of obstruction.
  • Exercise: Regular physical activity can help improve sleep quality and reduce the severity of sleep apnoea.
  • Sleep Position: Sleeping on your side rather than your back can prevent the tongue and soft tissues from collapsing into the airway.
  • Avoiding Alcohol and Sedatives: Reducing or eliminating the use of alcohol and sedatives can prevent excessive relaxation of throat muscles.

Continuous Positive Airway Pressure (CPAP) Therapy

CPAP therapy is the most common, familiar, and effective treatment for moderate to severe obstructive sleep apnoea. It involves wearing a mask over the nose and/or mouth during sleep, which delivers a continuous stream of air to keep the airway open.

Oral Appliances

Oral appliances are custom-fitted devices worn in the mouth during sleep. They work by repositioning the jaw or tongue to keep the airway open. These devices are typically used for mild to moderate obstructive sleep apnoea.

Surgery

Surgical options are considered when other treatments are not effective. Surgery may involve:

  • Uvulopalatopharyngoplasty (UPPP): Removal of tissue from the back of the throat to widen the airway.
  • Genioglossus Advancement: Repositioning of the tongue muscle to prevent airway obstruction.
  • Maxillomandibular Advancement: Surgery to move the upper and lower jaw forward, creating more space behind the tongue and soft palate.
  • Implants: In some cases, implants may be used to stiffen the soft palate and prevent collapse.

Adaptive Servo-Ventilation (ASV)

ASV is a treatment option for central sleep apnoea and complex sleep apnoea syndrome. This device monitors your breathing patterns and adjusts the pressure to maintain regular breathing.

Medications

While medications are not typically the first line of treatment for sleep apnoea, certain drugs may be prescribed to address underlying causes or manage symptoms. For example, medications may be used to treat associated conditions like narcolepsy or to reduce daytime sleepiness.

 

Sleep apnoea is a serious condition that can have far-reaching effects on your health and quality of life. If you suspect you may have sleep apnoea, it’s essential to seek medical advice and explore the appropriate treatment options. By addressing the issue early and effectively, you can reduce the risk of complications, improve your sleep quality, and enhance your overall well-being.

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