Sleep Apnoea: Symptoms, Causes and Treatment

In an earlier Mattress & Pillow Science blog, we discussed the related issues of snoring and sleep apnoea, but sleep apnoea in itself is such a common and potentially debilitating health disorder that it deserves more detailed attention. Sleep apnoea is suffered by many, and in its more severe forms, sleep apnoea can lead to heart problems, high blood pressure and stroke. Sleep apnoea can range from being only slightly troublesome, possibly affecting the sleeping partner more than the sufferer, to being severe, with the sufferer waking up literally hundreds of times a night. Naturally, in its most severe form, sleep apnoea can cause serious fatigue and have other long term negative health impacts.

Sleep apnoea occurs when the walls of the upper airways collapse and shut off the upper airways, dramatically cutting the oxygen supply. This forces the individual to very briefly wake up in order to breathe again. In most cases the person does not even realise that they are waking up, however partners of those with sleep apnoea will report that the individual snores, gasps and chokes repeatedly throughout the night. Understandably, this can be distressing for both parties.

Sleep apnoea is not to be confused with snoring. Many people snore, but don’t suffer the repeatedly broken sleep or reduced oxygen intake that those with sleep apnoea experience. However, snoring is a common symptom of the condition. Of course, daytime fatigue does not mean that you suffer from sleep apnoea, as this can be a symptom of many different sleep habits or health problems.

Four of the most common sleep apnoea symptoms
The four most common sleep apnoea symptoms to look out for are:

• choking episodes while sleeping,
• persistent and loud snoring,
• fatigue and poor concentration during the day, and
• headaches in the morning

Sleep apnoea is measured by degrees of severity.  With complete apnoea, the individual stops breathing for a 10 second period, while partial apnoea, also known as hypopnoea, is characterised by a 10 second period in which ventilation is reduced by at least 50%.

The experience of sleep apnoea, particularly in its more severe forms, is very draining for the sufferer, who is likely to report fatigue, grogginess, irritability and general moodiness due to lack of sleep. A lack of libido may also occur, due to interference with hormone regulation. In fact, in extreme cases, the hormone controlling urine production is affected, causing individuals to wake often in the night to urinate. This condition, known as nocturia, adds insult to injury, making it even harder to experience uninterrupted sleep.

What causes sleep apnoea?
Like snoring, sleep apnoea is a condition that can affect anyone; however, there are several factors that could potentially put you at greater risk of eventually suffering from the condition.

• Body weight – Being obese puts you at risk of developing this condition. Fatty deposits around the neck increase tension around the airway and interrupt breathing. Of course, slimmer people have also been known to suffer from the condition, but obesity is a definitely a contributing factor.

• Neck circumference – Those with a thicker neck seem to be more predisposed to developing sleep apnoea than others. Surprisingly, it is thought that this could be due to those with larger necks having narrower airways. Generally speaking, neck circumferences measuring less than 37 cm indicates a lower risk of sleep apnoea, while more than 48 cm gives a higher risk.

• Deformities and abnormalities – Enlarged tonsils, deformities of the nose or abnormalities of the soft palate may increase chances of sleep apnoea. Even those who have trouble breathing through their nose during the day are more likely to develop the condition.

• Age – Individuals over the age of 60 are at increased risk of developing sleep apnoea.

• Alcohol and drug use – Alcohol and drugs are sedatives. All sedatives relax the muscles in your body, including your throat, causing them to work less effectively. Sedatives also inhibit the breathing centre in your brain.

• Smoking – As well as increasing your risk of developing cancer, heart disease and stroke, one of the other detrimental side effects of smoking is the way it causes phlegm and fluids to build up in your lungs and airways. This build up can no longer be cleared automatically; instead, you need to cough to physically move the fluids. When sleeping, breathing becomes more difficult. In fact, smokers are three times more likely to suffer sleep apnoea than non-smokers. The good news is that if you quit smoking, your chances of developing the condition reduce substantially.

• Family history – There is a hereditary factor with sleep apnoea. If you have a family member that suffers from the condition, you are more likely to develop it. It is thought that this is due to inheriting physical characteristics that make you more prone to suffering from sleep apnoea.

• Gender – Men are more predisposed to sleep apnoea than women and are twice as likely to suffer from the condition. The risk for women starts to increase after they have gone through menopause.

What to do if you have sleep apnoea
If you think you may be developing sleep apnoea, it is recommended that you seek medical advice. The severity of your condition will influence the treatment options, however, addressing any health issues is a good start. Your doctor may advise you to lose weight, drink less alcohol at night, and get help to stop smoking if you’re a smoker. But if your sleep apnoea is more serious you may be referred to a sleep specialist who can evaluate your symptoms and help you find the most effective treatment.

Sleep apnoea treatment options
Those suffering acutely from sleep apnoea will be advised of several medical treatment options such as intraoral devices, the use of airway pressure devices and if all other treatments fail, surgery.

The nasal continuous positive airway pressure machine (CPAP) has received the most clinical support, however it could be considered quite an invasive option by some. A facial mask, attached to an air flow generator, is worn overnight, which delivers gentle air pressure into the airways to keep them open. This pressure encourages the individual to breathe through their nose rather than the mouth. The good news is that CPAP technology is advancing and there are now alternatives for the facial mask such as a device that fits over the nostrils and is smaller and less intrusive than the traditional CPAP.

There are also some other adjustable airway pressure devices that a sleep specialist may recommend such as the bi-level positive airway pressure device (BPAP) which automatically adjusts the pressure while you are sleeping and detects if you haven’t taken a breath for a couple of seconds. An adaptive servo-ventilation device (ASV) stores information about your regular sleep pattern and provides automatic air pressure to prevent pauses in your breathing while you are asleep.

Most individuals who have severe sleep apnoea will need to have lifelong therapy in order to sleep well.

Pillows and sleep apnoea
Fortunately, there are many good pillows on the market that help reduce the severity of sleep apnoea. The correct therapeutic pillow will help support the curve of your neck, which is more likely to keep the airways open. There are also special pillows on the market suitable for side sleepers who suffer from sleep apnoea.

It is helpful to know that expert advice and a large range of pillows is available from Mattress & Pillow Science, so finding a pillow to support you while you sleep and reduce your sleep apnoea symptoms will be easy. Mattress & Pillow Science stock the best in latex pillows, gel pillows, memory foam pillows, polyester pillows and feather pillows, available in a variety of different heights and comfort densities so you can be sure to find one to suit your needs.

Check out our range of pillows now or visit us in-store for a free consultation with one of our expert sleep consultants.

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