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Obstructive Sleep Apnoea (OSA)

What is obstructive sleep apnoea (OSA)?

Normally when we are asleep, the muscles in our body relax but our airway stays open, allowing us to breathe normally. However, for some people, the airway doesn’t stay open – often because there is pressure from fat around the neck – which stops them breathing (apnoea, pronounced ap-nee-a) or, if their breathing is only partly blocked, the airflow is reduced (hypopnoea, pronounced hi-pop-nee-a). This is what doctors call obstructive sleep apnoea. Often, this interruption of a person’s breathing will cause them to wake up repeatedly through the night, gasping for air. The most common sign of obstructive sleep apnoea or hypopnoea is loud, irregular snoring – the sound made as air passes through the narrowed throat and windpipe (the airway) – and long pauses when the person doesn’t seem to be breathing at all.

SYMPTOMS IN OBSTRUCTIVE SLEEP APNOEA

Common:

  • Loud snoring
  • Excessive daytime sleepiness
  • Feelings of choking or shortness of breath at night
  • Restless sleep
  • Unrefreshing sleep
  • Changes in personality
  • Repetitive nocturnal urination

Less common:

  • Reduced libido
  • Spouse worried by pauses in breathing
  • Nocturnal sweating

Rare:

  • Recurrent arousals/ insomnia
  • Nocturnal cough
  • Symptomatic oesophageal reflux (heartburn).

Are some people more likely to develop obstructive sleep apnoea?

Some people may be more likely to develop obstructive sleep apnoea or hypopnoea than others, for example:

  • if a person is overweight and, in particular, if they have a lot of
    flesh or fat around the neck, this can put pressure on the airway and make it easier for it to collapse during sleep
  • some people may have an unusually shaped jaw, or a receding chin; this means there is less room left for the airway and, again, makes it easier for it to collapse during sleep.

Does obstructive sleep apnoea run in families?

Obstructive sleep apnoea often runs in families as narrowing can be caused by the way your bones and muscles grow to form your face, throat and airways, and this can be inherited from your parents.

Does anything make obstructive sleep apnoea worse?

  • Sedatives and alcohol can make the problems worse, by relaxing the airway muscles.
  • In old age, the airway tissues become more limp, increasing the likelihood of obstructive sleep apnoea.
  • Being overweight makes it more likely that your airway will be softer and fleshier, so it will be easier for it to collapse during sleep.
  • Having a cold or hay fever causes swelling of the lining of your airway and makes it easier for it to close during your sleep.
  • Unrelenting snoring can, over time, reduced the ability of the muscles to keep the upper airway open.

Is having OSA dangerous?

Frequent apnoeas or hypopnoeas mean the body repeatedly doesn’t get enough oxygen and this – and the effort to breathe – can lead to higher blood pressure and heart problems. Patients who already have heart or lung problems are, obviously, most at risk.

Anybody who suffers from uncontrolled excessive daytime sleepiness or lack of sleep may be at risk through falling asleep in dangerous situations, such as when driving or operating machinery.