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Obstructive sleep apnoea: What to know

Amy Gallagher, Lung and Sleep Centre Manager, explains more about obstructive sleep apnoea, including symptoms and treatment options.

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Obstructive sleep apnoea (OSA) is a condition where there is a reduction or a cessation of airflow during sleep. It is a common condition, with an estimated 2.5 million people living with OSA in the UK. Furthermore, OSA is believed to be significantly underdiagnosed; it has been suggested that around 85% of people with the condition are unaware they have it.

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What is obstructive sleep apnoea?

OSA occurs when the walls of the throat relax and narrow. This narrowing can occur for a number of reasons and ultimately results in reduced airflow. During a breathing event, the reduction in airflow results in a drop in the blood oxygenation levels (SpO2). This drop in SpO2 triggers a signal to the brain to ‘wake’ – at which point, the muscle tone increases, and the airway reopens. Breathing then returns to normal, until another event occurs.

Snoring occurs when the soft tissue at the back of the airway vibrates. This is a symptom of OSA; however, it can occur independently of OSA and may lead to further disruption of sleep for both the snorer and any bed partners.

OSA is measured using the apnoea hypopnea index (AHI). An apnoea is when airflow is reduced by 90% or more for 10+ seconds, while hypopnea is when airflow is reduced by 30% or more for 10+ seconds.

AHI determines the severity of OSA using the number of apnoeas and hypopneas occurring per hour of sleep. Severe cases of OSA can have an AHI of 30 events per hour or more.

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Symptoms of obstructive sleep apnoea

The symptoms of OSA include:

  • snoring
  • repeated periods where breathing stops, or is interrupted by gasping or snorting – this may feel like choking
  • daytime tiredness and sleepiness
  • difficulty concentrating and retaining information
  • morning headaches and dry mouth
  • difficulty maintaining sleep and increased trips to the bathroom at night

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Risk factors for obstructive sleep apnoea

You may be more likely to develop OSA if:

  • you are overweight or obese
  • you have type 2 diabetes
  • you have a smoking history and/or COPD
  • you have a cardiac illness, such as hypertension
  • you are male
  • you are over 50 years old
  • you are post-menopause

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What should I do if I think I have obstructive sleep apnoea?

If you think you have sleep apnoea, you should visit a specialist regarding your symptoms. They will review your airways and ask you about your symptoms and general health.

If you are suspected to have sleep apnoea, you will be referred for a sleep study. This typically entails wearing some sensors which measure oxygen levels, airflow, and breathing patterns. Once returned to the sleep clinic, a specialist physiologist will analyse the signals and generate a report which will be reviewed by a specialist consultant.

If OSA is confirmed, your specialist will be able to discuss treatment options.

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Obstructive sleep apnoea treatments

There are many treatment options to reduce or eliminate the impact of OSA on your life.

Options include continuous positive airway pressure (CPAP), mandibular advancement device (MAD), and more. The treatment suggested for you will be based on your clinical diagnosis and symptoms.

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