Sleep apnea, sometimes known as Obstructive Sleep Apnea (OSA), is a fairly common condition where the walls of the throat narrow during sleep and cause an interruption of normal breathing. There are two characteristic types of breathing interruption with sleep apnea. The first is apnea, where the muscles and soft tissues in the throat relax and collapse sufficiently to cause a total blockage of the airway. It is characterised as an apnea when the airflow is blocked for 10 seconds or more. The second is hypoapnea, which is a partial blockage of the airway resulting in an airflow reduction of more than 50% for 10 seconds or more.
Those with sleep apnea can experience repeated episodes throughout the night, with severe cases occurring every one or two minutes. Symptoms are often first spotted by a partner or family member, as they will notice issues while the sufferer is asleep. They can include loud snoring, laboured breathing and repeated short bursts where breathing is interrupted by snorting or gasping. When the airway becomes constricted, the lack of oxygen causes the brain to pull the sufferer out of deep sleep – to either waking up or lighter sleep – so that the airway reopens and breathing goes back to normal.
There are a number of factors that can cause OSA. These include:
Being male – OSA is more common in men than women, with some research suggesting this is due to different patterns of body fat distribution.
Being over 40 – Although it can occur at any age, OSA is more common in those over 40.
Being overweight – Having excessive body fat increases the bulk of soft tissue in the neck and this can place a strain on the throat muscles. In addition, excess stomach fat can cause breathing issues, which can make OSA worse.
Family history – Some research suggests that there may be inherited genes that make people more susceptible to OSA.
Nasal congestion – OSA is more common in those with nasal conditions, such as a deviated septum or nasal polyps.
Alcohol and smoking – The risk of OSA is increased in those who smoke or drink alcohol – particularly before going to bed.
Menopause – Changes in hormone levels can cause the throat muscles to slacken and relax more, raising the risk of OSA.
Unusual inner neck structure – Those with a narrow airway, large tonsils, adenoids or tongue, or a small lower jaw can also raise the risk of OSA.
Large neck – Men with a collar size greater than 17 inches are at a higher risk of OSA.
If left untreated, OSA can cause a multitude of problems such as developing hypertension (high blood pressure), having a stroke or heart attack, developing an irregular heartbeat and developing type 2 diabetes. Research also shows that those who are sleep deprived because of OSA are up to 12 times more likely to be involved in a car accident.
OSA is fortunately a treatable condition and symptoms can be controlled. To start with, basic lifestyle changes can be made such as losing any excess weight, cutting down on alcohol and trying to sleep on your side. Two devices are also helpful in treating OSA. A mandibular advancement device (MAD) is a gum shield that fits around the teeth. It holds the jaw and tongue forward in order to increase the space at the back of the throat whilst people sleep. The other device is a continuous positive airway pressure device (CPAP), which prevents the airway from closing by delivering a continuous supply of compressed air through a mask. Surgery can also be an option if there is a physical problem such as an unusual inner neck structure.
For further information and help with Sleep apnea, visit the British Snoring & Sleep Apnea Association