Sleep Apnoea

Most Australians enjoy a restful sleep after a long day of commuting, working, or finishing errands. Unfortunately, many people with obstructive sleep apnoea may not sleep well. 

Obstructive Sleep Apnoea (OSA) is more than snoring; it occurs when an airway is fully or partially blocked during sleep. This obstruction forces the diaphragm and chest muscles to work harder to open the airway, so a person can breathe normally. It can cause uncomfortable muscle spasms throughout the night and severely disrupt sleep.

If you suffer from sleep apnoea, your partner may complain you snore during the night. Your breathing may become shallow and stop for short periods. You may wake up several times throughout the night with a loud gasp. These brief, wake-sleep cycles repeat throughout the night. Most people don't remember them when they wake up, and they don't understand why they didn't get a good night's rest.

If you have OSA, you may wake up tired with a morning headache. You could stay drowsy throughout the day and fall asleep during inappropriate moments. Additionally, you might be unable to concentrate during the day.

OSA can also impact your health when left untreated. This health condition can lower the flow of oxygen to your organs and cause uneven heart rhythms. If you suffer from these symptoms, speak with your General Medical Practitioner. Your doctor can refer you for a sleep study that will help cure your condition.

A dentist can help treat your OSA if the sleep study confirms your condition is mild to moderate, by constructing an appliance called a Mandibular Advancement Splint. These appliances work by ensuring that your lower jaw stays forward during the night. They prevent the tissues at the back of your throat from collapsing and blocking your airway. National Dental Care dentists make these appliances using custom-made bite impressions and models.

You can use these devices along as part of your holistic health plan to treat this illness.


What are the causes of Obstructive Sleep Apnoea?

OSA occurs when the muscles in the back of your throat relax too much to allow for normal breathing. The throat's muscles support structures in your mouth, including your tongue, soft palate, uvula, and tonsils.

Once these muscles relax, your airway narrows or closes. This results in inadequate breathing for 10 seconds or longer. The lower level of oxygen in your blood can cause a buildup of carbon dioxide.

Your brain will sense your impaired breathing and briefly rouse you from sleep so that your airway can reopen. This awakening occurs quickly, so you may not remember what happened.

You can awaken with shortness of breath that corrects itself quickly within two deep breaths. You may make a snorting, choking, or gasping sounds.

The pattern may repeat itself five to 30 times each hour, all night long. The disruptions can impair your ability to sleep well. You won't have deep and restful periods of sleep. You'll probably feel drowsy throughout the day during your waking hours.

Patients with obstructive sleep apnoea may not be aware that their sleep was interrupted. Many people with this type of sleep apnoea, think they've slept well at night.


Risk factors for Obstructive Sleep Apnoea

Any person can develop obstructive sleep apnoea, but several factors can place individuals into an increased risk category. These include:

  • Excessive Weight - Some people with obstructive sleep apnoea are overweight. Fat deposits around the upper airway can obstruct their breathing. Medical conditions associated with obesity include hypothyroidism, polycystic ovary syndrome, and other conditions. Not everyone who is overweight will suffer from OSA. Thin people can also suffer from the disorder.
  • Narrowed Airway - You can inherit naturally narrow airways through your genes. Your tonsils or adenoids may become enlarged, which can block the airway.
  • High blood pressure (hypertension) - OSA is common in people who have hypertension.
  • Chronic nasal congestion - OSA occurs twice as often in those who have consistent nasal congestion at night, regardless of the cause. Narrowed airways may cause this issue.
  • Smoking - People who smoke are more likely to develop OSA.
  • Diabetes - Obstructive sleep apnoea may be more common in individuals with diabetes.
  • Sex - Men are twice as likely to develop OSA. The frequency of obstructive sleep apnoea also increases in women after menopause.
  • Neck structure - People who have large or thick necks can also suffer from this condition.

Obstructive Sleep Apnoea symptoms

If you're not getting a good night's sleep, you may have sleep apnoea. Most patients with OSA symptoms suffer from:

  • A dry mouth or sore throat in the morning
  • Excessive drowsiness during the daytime
  • Loud, habitual snoring that's bothersome to other people. However, not every person who snores loudly has OSA.
  • Awakening without feeling refreshed.
  • Observed episodes of stopped breathing during sleep
  • Abrupt awakening accompanied by gasping or choking
  • Morning headaches
  • Difficulty concentrating during the day
  • Experiencing mood changes, such as depression or irritability
  • High blood pressure
  • Night sweats
  • Low libido
  • Gastroesophageal reflux disease (GERD)
  • Insomnia (restless sleep) with frequent tossing and turning during the night.

If you share a bed with someone, they may notice you have sleep apnoea before you do.


Childhood symptoms of Obstructive Sleep Apnoea

Adults are not the only ones who can suffer from OSA; children can have this issue too. Their symptoms differ slightly from adults. They include:

  • Bedwetting
  • Choking or drooling
  • Night sweats
  • Inward-moving ribcage as they breathe
  • Learning and behavioural problems
  • Issues at school
  • Sluggishness or sleepiness (often seen as laziness)
  • Snoring
  • Teeth grinding
  • Restlessness in bed
  • Breathing that pauses or stops
  • Unusual sleeping positions, such as sleeping on their hands and knees, or with their neck bent far back.

Other medications can cause these symptoms. Please check with your General Medical Practitioner to rule them out.


Obstructive Sleep Apnoea treatments

If you suffer from obstructive sleep apnoea, there are several possible treatments to help your condition. Some steps include:

  • Weight loss - Losing ten per cent of your body weight can make a difference in sleep apnoea
  • Not drinking alcohol or sedatives - Avoiding alcohol and sleeping pills help your airway close during sleep. It can keep you breathing for longer periods
  • Sleeping on your side - This can help if you only have mild sleep apnoea when you sleep on your back
  • Nasal sprays - These can treat sinus problems if nasal congestion makes it harder to breathe while you sleep

Many patients with sleep apnoea will require more treatment beyond these simple steps.

  • Oral appliances worn at night - Do you have mild or moderate sleep apnoea? National Dental Care can create a custom-made dental appliance, or "oral mandibular advancement" device. These appliances keep your tongue from blocking your airway as you sleep. Our experts can decide which ones may be right for your OSA
  • Continuous Positive Airway Pressure (CPAP) via a nasal mask - These devices can include masks that you wear over your nose, mouth or both. An air blower forces constant air through your nose or mouth. The air pressure is just enough to keep your upper airway's tissues from relaxing too much while you sleep. A similar device is the BPAP which has two levels of airflow that change when you breathe in and out. CPAP machines are the most effective treatment for OSA, reducing daytime sleepiness and improving sleep quality. However, some people with OSA find the mask or feeling of pressure difficult to tolerate
  • Surgical Treatment - Doctors rarely use surgery to treat OSA. Some treatments include the uvulopalatopharyngoplasty (UPPP). This procedure removes some of the throat's soft tissues that collapse the airway during sleep. Although it's effective at reducing snoring, it doesn't always treat obstructive sleep apnoea.

FAQ

Obstructive Sleep Apnoea requires medical treatment to prevent health complications. Speak with your General Medical Practitioner if you or your partner has the following symptoms:

- Snoring loud enough to disturb your sleep or that of others during the night.
- Waking up gasping or choking
- Excessive daytime drowsiness. You may fall asleep while working, watching television, or driving on the road.

Some people don't believe snoring is a sign of something potentially serious, and not every person that snores has obstructive sleep apnoea.

Talk to your doctor if you experience loud snoring, especially those marked by periods of silence. With obstructive sleep apnoea, snoring is loudest when you sleep on your back and quiets when you sleep on your side.

Ask a medical professional about any sleep problem that leaves you chronically tired, drowsy, and irritable. Other disorders, such as narcolepsy, can cause excessive daytime drowsiness.
Your doctor will give you a physical examination and ask you about your sleep habits and patterns. They may also want to ask people closest to you about these issues.

You may need to spend a night at a sleep lab to complete a sleep study or have one done at your home. You'll need to wear special apparatus that will monitor:

- Air flow
- Blood oxygen levels
- Breathing patterns
- Electrical activity in your brain
- Eye movements
- Heart rates or rhythms
- Muscle activity and movement of your arms and legs

A technician will track how many problems you had breathing problems you had during this study.
OSA may have serious consequences if it's not treated. It can lead to cardiovascular problems due to periods of poor oxygenation during sleep and the stress of the body trying to re-start breathing. These issues can result in heart failure, arrhythmias (abnormal heart rhythms), hypertension (high blood pressure). It can also cause poor sleep when a person with OSA frequently wakes up during the night. It may result in daytime sleepiness, personality changes, memory losses, and intellectual impairment.
Most patients with obstructive sleep apnoea don't realise their health condition not only prevents them from getting a good night's sleep, but it can also lead to other serious health issues. These may include:

- Sleepiness during the day and trouble concentration - Adults with sleep apnoea can have a higher risk of accidents
- Cardiovascular Issues - These individuals may develop issues such as heart attacks, high blood pressure, unusual heart rhythms, or strokes.
- Eye problems - Obstructive sleep apnoea can lead to eye issues, such as glaucoma and dry eye.
- Metabolic disorders - These patients can develop chronic insulin resistance and Type II diabetes.
- Pregnancy problems - Pregnant women that have OSA can end up with gestational diabetes or low-weight babies.
- Complications after surgery - Some OSA patients can experience more problems after surgery. The condition may prolong their recovery times.
 

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