Almost all of us would have to admit to snoring at some point in our lives, whether it’s been from extreme fatigue, a few too many drinks, or perhaps whenever we’re on our backs. For some, though, frequent, loud snoring is pretty much a constant during sleep, and this frequently becomes apnoea – or the temporary cessation of breathing during sleep. When it’s untreated, the breathing will pause for 10 or 20 seconds at a time, which can be concerning for others within earshot, but often goes completely unnoticed by the sufferer. This interruption to normal, rhythmic breathing may not last for long, but its consequences, over time, can be serious.
Why do people have sleep apnoea?
There are two main types of apnoea affecting around 5% of Australians, but by far the most common is obstructive sleep apnoea, which is characterised by the fleshiest part of the throat relaxing to the point that it blocks off the airway. The other effect of this relaxation is snoring. Common causes of this type of apnoea include heavy smoking, alcohol, certain medications (particularly sedatives), obesity, sinus congestion, inflammatory conditions of the throat such as tonsillitis (particularly in children) and uvulitis, diseases of the thyroid, and congenital abnormalities of the face and jaw.
The other kind of apnoea is central sleep apnoea, and his results from an abnormality in the central nervous system, which fails to control the muscles that aid breathing. Snoring is far less common with this type of apnoea, though a combination of the two types is considered to be complex sleep apnoea.
What’s the damage?
As a result of the frequent interruptions to sleep, the sufferer will spend considerably less time in deep sleep than their non-suffering counterparts, and as a first consequence will feel fatigued, mentally sluggish and possibly less productive the next day. Ever heard the gasp or choking sound of a person trying to resume breathing in their sleep? That’s the sound of someone being pulled out of deep sleep as the oxygen levels in their blood fall too low. How exhausting!
Their reflexes and concentration will also take a hit, which means an increased risk of accidents on the job or behind the wheel. Over time, these relatively minor symptoms grow to very serious disease risks, and this is motivation to seek help if nothing else. Apnoea is linked to diabetes, hypertension, heart disease, obesity and stroke.
How do I know if I have apnoea?
The biggest problem with apnoea is recognising it exists and seeking treatment, which many don’t realise is widely available. You might think a person being regularly yanked from sleep because they are starving of oxygen would know about it, but you’d be wrong. Often the sleep state is lightened just enough to resume breathing, and no more. If you can kick your legs in your sleep, you can also tighten the throat muscles a little. There’s no reason to remember it ever happened.
That’s why you might need to employ some help. A partner is in the perfect position to do this, but single people can ask a relative or even use a smartphone app to monitor their sleep state. Another option is a recording device, but it might make for dull listening. If your breathing audibly pauses at any time during sleep, and is followed by a sharp intake of breath after 10 to 60 seconds, this is a pretty good indication you have apnoea. You’ll also probably be aware of the symptoms we’ve discussed – the fatigue, which will be present throughout the day, as well as feeling irritable, foggy, moody and unable to concentrate. Headaches are a fairly common complaint. You also might find that you fall right into sleep as soon as you relax on a couch or chair.
What are my treatment options?
The biggest factors for improving your sleep cycle will be the ones you can directly change yourself. Because obesity is such a major cause of the condition, losing even 5 to 10 kilograms can have an impact on apnoea. Reducing the fleshiness in the throat, if that is the origin of the apnoea, is key to improving the severity over the long term. Your medical doctor can discuss lifestyle options suitable to you. Alcohol use and abuse is another factor that is within your power to change. Drinking late at night or having more than a couple will affect your sleep negatively even without apnoea, so combining the two further erodes your sleep and recovery. Getting enough sleep helps as well. If you’re cutting your time in bed to the bare bones, you’re scraping away even more of the deep stuff. If you want to figure out a new routine, we’ve developed an easy-to-use sleep calculator that helps you quickly identify what time you should be going to bed in order to wake up feeling refreshed. Try it and see if it helps you!
It’s worth finding out if you have an underlying medical condition, such as thyroid dysfunction or enlarged tonsils. It’s possible that you may need medicine or even surgery to correct this type of diagnosis, and will experience relief immediately. In certain cases, a specialist (called an otolaryngologist) may determine that surgery on the tongue or the palate (the back of the throat) would be beneficial over other methods of management. Surgery and specialist appointments can be expensive. To avoid waiting lists and to start benefiting from their policies, compare private health insurance before committing to mounting costs. For others, the problem is one of management, and that’s where medical devices are used.
The CPAP stands for continuous positive airway pressure, and consists of a face mask and a small tank which pushes air into the throat and ensures it doesn’t collapse. Although some people find it difficult to adjust to the CPAP, they are likely to report feeling refreshed and energised after wearing it – not surprising when you think at how radically different their sleep patterns would be. For less severe cases, a mouthguard is worth trying. Called an oral appliance or mandibular advancement splint, they work by holding the jaw in a forward position during sleep, which helps to prevent the throat from closing. It’s often a good first step before moving to a CPAP.
Remember, your doctor should be your health’s best friend, and sleep apnoea is too serious to leave up to chance. It makes no sense to leave a known condition untreated, so seize the day and get down to your nearest clinic, sleep studies centre or relevant specialist and don’t spend another day in the fog.