What is Sleep Apnoea?
Getting a Sleep Apnoea diagnosis is really important but it can also be reassuring
Sleep Apnoea explained in brief
Sleep Apnoea is an involuntary pause in breathing during sleep for at least 10 seconds. Obstructive Sleep Apnoea (OSA) is the most common type, caused by an obstruction of the airways in the throat region (1,2) and happens when the muscles relax during sleep.
Airflow is obstructed or reduced, causing vibrations that result in snoring during sleep and a drop in oxygen levels. The brain senses this lack of oxygen and responds with sudden, unconscious "micro-awakenings" that do not last long, called resuscitative snoring to restore breathing. The repeated occurrence of frequent interruptions of breathing during the night breaks the sleep pattern, which means sleep ceases to be a restorative activity.
Signs and Symptoms of Sleep Apnoea
Sleep apnoea is commonly associated with loud snoring, but not all snorers suffer from apnoea (4). For 75% of people with sleep apnoea, the first sign is when your bed partner complains about it (4), or when he/she notices that you are gasping, snorting, making choking noises or breathing abnormally, and they therefore also have a restless nights sleep (5). This lack of sleep has a significant impact on your overall quality of life. During the day, other common signs is excessive sleepiness, such as feeling tired in the morning after a full night's sleep or wanting to take a nap later during the day. (5)
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Waking up with a headache
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Lack of concentration
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Lack of energy
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Irritability
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Feeling suffocated while sleeping
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Reduced Libido
Health risks and consequences of sleep apnoea
If left untreated, sleep apnoea can cause several complications, mainly cardiovascular (10) and metabolic (11) in the long term.
Obstructive sleep apnoea (OSA) and your heart
The combination of sleep disturbances and lack of oxygen can lead to the development or worsening of cardiovascular problems, such as (10, 11, 13):
- Hypertension (high blood pressure)
- Arrhythmia (heart rhythm disorder)
- Cerebrovascular accident (stroke)
- Myocardial infarction (heart attack) (14)
- Heart failure (when the heart no longer pumps enough blood to meet the body's needs)(15)
Obesity, diabetes and sleep apnoea: a close link
Medical research has confirmed the link between sleep apnoea and type 2 diabetes. Approximately 15-30% of people with sleep apnoea also have type 2 diabetes (11).
Sleep fragmentation also has a negative impact on eating habits, as it increases the feeling of hunger and reduces satiety (feeling full) (11). Obesity is a risk factor for type 2 diabetes and an aggravating factor for obstructive sleep apnoea syndrome (11).
On average, depression and anxiety affect 35% and 32% of patients with the condition, respectively (12). It is important to address each of these factors and make regular appointments with a doctor.
Sleep Apnoea: Am I at Risk?
We may all have suffered from snoring, feel tired during the day… But could this be sleep apnoea?
Some factors predispose people to develop this chronic and evolutionary disease: being male, being overweight, being over 50 years of age, having a wide neck, a thin nose, a small jaw, and having a family history of sleep apnoea(18). With this simple test, known as the Berlin Questionnaire, we can help you assess your risk of suffering from sleep apnoea.
Remember that the result of this test is not a diagnosis. Share the result with your doctor.
Do you snore?
>Take the full test
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References
1. The World Health Organization. Chronic respiratory diseases www.who.int/gard/publications/chronic_respiratory_diseases.pdf viewed 21/05/2015
2. Rules for Scoring Respiratory Events in Sleep: Update of the 2007 AASM Manual for Scoring of Sleep and Associated Events – Journal of Clinical Sleep Medicine, Vol. 8, No. 5, 2012
3. Sleep breathing disorders – European Respiratory Society White Book (chapter 23)
4. Obstructive sleep apnoea, Sleep Health Foundation, 2011
5. American Academy of Sleep Medicine (AASM)- Sleep disorders-Sleep Apnea, Consulted 12/08 /2021@ https://sleepeducation.org/sleep-disorders/sleep-apnea
6. Obstructive sleep apnoea, Sleep Health Foundation, 2011
7. Sleep breathing disorders – European Respiratory Society White Book (chapter
8. Terán-Santos J., Jiménez-Gómez A., & Cordero-Guevara, J. (1999). between sleep apnea and the risk of traffic accidents. N Engl J Med., 340(11), 881-3.
9. Somers VK et al. Circulation. 2008 Sep 2;118(10):1080-111
10. Reutrakul S et al. Obstructive Sleep Apnea and Diabetes: A State of the Art Review. Chest. 2017 Nov;152(5):1070-1086
11. Garbarino S et al. Association of Anxiety and Depression in Obstructive Sleep Apnea Patients: A Systematic Review and Meta-Analysis. Behav Sleep Med. 2020 Jan-Feb;18(1):35-57
12. Bonsignore MR et al. Obstructive sleep apnea and comorbidities: a dangerous liaison. Multidiscip Respir Med. 2019 Feb 14;14:8
13. American Heart Association. Heart and stroke encyclopedia. Coronary thrombosis
14. American Heart Association. Heart and stroke encyclopedia. Heart failure
15. Obstructive Sleep Apnoea – A guide for GPs – British Lung Foundation (NHS)
16. Benjafield Adam V et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med. 2019;7(8):687-698. doi:10.1016/S2213-2600(19)30198-5
17. Tufik S, Santos-Silva R, Taddei JA, Bittencourt LRA. Obstructive sleep apnea syndrome n the Sao Paulo epidemiologic sleep study. Sleep Med 2010;11:441–6.
18. Heinzer R, Vat S, Marques-Vidal P, et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Resp Med 2015;3:310–8.
19. Sleep breathing disorders – European Respiratory Society WhiteBook (chapter 23)