Q
: What causes sleep apnoea ?
A
: Anybody can snore , though it tends to get more common as we age . And while obesity is a risk factor for obstructive sleep apnoea , studies show that only around half of snorers are obese .
Obstructive sleep apnoea occurs when the throat closes off many times throughout the night . This can happen up to 100 times per hour of sleep and limits breathing each time it happens .
During obstructive sleep apnoea , sufferers typically encounter an obstruction in the upper airway due to the relaxation of the soft tissues in the throat , such as the tongue and soft palate , that causes the airway to narrow and momentarily cut off airflow .
Obstructive sleep apnoea can be affected by the stage of sleep a person is in , their sleeping position , and the use of drugs , pharmaceuticals , or alcohol . Other risk factors include being male , overweight , and over the age of 40 .
There are two less common causes of snoring than obstructive sleep apnoea . One is central sleep apnoea , which happens when the brain fails to send the appropriate signals that control breathing . Risk factors for this include heart failure and stroke . The other is mixed sleep apnoea , which is a combination of central sleep apnoea and obstructive sleep apnoea .
Q
: How is sleep apnoea diagnosed and treated ?
A
: The vast majority of apnoea patients remain undiagnosed and therefore untreated despite the fact that this serious disorder that can have significant consequences .
A definitive diagnosis can be made with a sleep study . This is conventionally done during an overnight stay at a hospital sleep lab , though home studies can now use devices to send data to physicians .
Continuous positive airway pressure , or CPAP , machines are a common treatment for moderate and severe sleep apnoea . These connect to patients by masks that are worn over the nose during sleep and supply a pressurised air flow that prevents the sleeper ’ s airway from collapsing . Sleep apnoea patients who regularly use these devices tend to feel better and report fewer complications from their condition .
Less cumbersome are oral appliances , which are getting increasingly popular with dozens available now that patients wear while sleeping . They work by holding the jaw slightly forward so that the tongue is stopped from dropping back and blocking the airway .
Surgery is rarely performed , and only on younger patients to move their lower jaws forward . Operating on the tongue and palate can also be done , though this is very rare too .
Q
: Can sleep apnoea be dangerous ?
A
: Frequent choking while sleeping can lead hormonal systems to go into overdrive , which results in high blood pressure levels at night . Low oxygen levels and the stress of waking up many times make people with sleep apnoea more likely to suffer heart attacks and even death during the night .
The disrupted oxygen flow caused by the condition makes it hard to regulate the flow of blood in the arteries and brain , leading to stroke and atrial fibrillation , or an abnormal heart rhythm .
Up to 80 percent of diabetics have some obstructive sleep apnoea . Though studies have not shown a clear link between these conditions , sleep deprivation is known to cause insulin resistance , a precursor to diabetes .
Dementia , impotence , and headaches are also associated with sleep apnoea , as is feeling groggy during the day , even after eight hours ’ sleep . Disrupted sleep can also bring about other damaging consequences , such as job impairment and accidents in motor vehicles or when operating heavy machinery .
Dr Harry Ball
Dr Harry Ball is clinical director of SleepWise Clinic in Melbourne , which specialises in the field of dental sleep medicine .
8 APRIL 2021 GlobalHealthAsiaPacific . com