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Home » Columns » Do You Or Anyone You Snore A Lot? You May Have Obstructive Sleep Apnoea (Part 1)

Do You Or Anyone You Snore A Lot? You May Have Obstructive Sleep Apnoea (Part 1)

Publishing Date : 10 October, 2017

DR BOIMA
HEALTH ISSUES



Obstructive sleep apnoea (OSA) is a relatively common condition where the walls of the throat relax and narrow during sleep, interrupting normal breathing.


This term is made up of two major words; obstructive which means the breathing difficulty is due to an obstruction (partial or complete) of the airway and apnoea which means cessation of breathing for 10 seconds or more. OSA leads to regularly interrupted sleep, which in most cases have a big impact on one’s quality of life and increases the risk of one developing other conditions. Some people know that they snore a lot or their breathing is not normal at night, but may be unaware that this is a medical problem that is causing them harm. Fortunately, good treatments are available.

Symptoms of OSA

The symptoms of OSA are often spotted and reported by a partner, friend or family member who notices problems while the sufferer is sleeping. The major signs and symptoms include;

Loud snoring - air that squeezes past a narrowed or blocked airway is the cause of the loud snoring. The snoring is usually loud enough that is disturbs one’s sleep or that of others

Laboured breathing – when the airway closes, the diaphragm and chest muscles are forced to work harder to open the obstructed airway and pull air into the lungs

Night sweats -  the laboured breathing can cause a lot of sweating that can even drench the sheets

Apnoea - episodes where one stops breathing for some time before the breathing starts again

Gasping, snorting or choking - breathing usually resumes with a loud gasp, snort, or even body jerk

Disrupted sleep – when the breathing stops for a short time, blood oxygen levels fall as a result, triggering the brain to pull one out of deep sleep – either to a lighter sleep or to wakefulness – so the airway reopens and one breathes normally to replenish the oxygen supply. The episodes of obstruction may happen many times – even hundreds of times overnight

Fatigue - the repeated sleep interruptions can make it difficult for one to wake up in the morning and when they do they would feel very tired during the day

Daytime somnolence - because of the disruptive effects of OSA on sleep, one  may struggle to stay awake as the day goes on, leading to daytime sleepiness

Headache – especially in the morning from lack of sleep

Decreased libido

Psychological – sleep deprivation also leads to trouble concentrating, forgetfulness, grumpiness  or even depression

Who is at risk of OSA?

It is normal for the muscles and soft tissues in the throat to relax and collapse to some degree while sleeping causing a bit of a snore. For most people this does not cause breathing problems. But in OSA, the obstruction is so severe that it causes symptoms. Overweight –overweight or obesity is the highest risk factor for OSA. Overweight people usually have a fat and short neck with lots of fatty tissue surrounding the throat which can compress it during sleep. Also, having a pot belly or large waistline can push the chest upwards during sleep, making it difficult for breathing or air exchange to take place in the lungs


Male gender – OSA is more common in men than in women though the reason is not really known, but it may be related to different patterns of body fat distribution.  However, women may catch up on the risk after menopause
Advanced age – though OSA can happen in all age groups, it is more common in people who are over 40 years

Family history – there may be genes inherited from parents that can make one more susceptible to OSA
Structural abnormalities – OSA is more likely in people who have smaller airways in their nose, throat, or mouth due to different conditions like enlarged adenoids and tonsils, the hanging uvula and soft palate that block the trachea, a larger-than-average tongue as well as a deviated septum in the nose or nasal congestion


Certain medications – taking medications with a sedative effect  such as sleeping tablets can make OSA worse
Alcohol - drinking alcohol, particularly before going to sleep, can make snoring and sleep apnoea worse
Smoking – smokers are at more risk of developing OSA than non-smokers
High blood pressure - Obstructive sleep apnea may be more common in people with  hypertension
Diabetes – most diabetic patients tend to have a comorbidity of OSA
Asthma - recent research has found an association between asthma and the risk of obstructive sleep apnea

How is OSA diagnosed?


People with OSA may not notice they have the condition, and so it can often go undiagnosed. However, if you or any of your family members have the symptoms mentioned above, see a health professional for a proper assessment and formal diagnosis. The reliable investigation to perform in someone suspected of having OSA (having most of the signs and symptoms) is with an overnight sleep study called polysomnography. This measures one’s sleep, breathing and oxygen levels overnight. Your GP may also may refer you to an ENT specialist to rule out any structural abnormalities in the ear, nose and mouth that may predispose you from having OSA.

Next week we will be discussing the effects OSA can have on one’s life and how it can be prevented and successfully treated. For comments or questions please email agboima@yahoo.com

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