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Sleep Apnea… what is it?

Obstructive Sleep Apnoea (OSA) is a sleep related respiratory condition, leading to repeated temporary cessations of breathing because of a narrowing or closure of the upper airway during sleep. Core symptoms of OSA include excessive daytime sleepiness, snoring, and witnessed apnoea’s or hypopnoeas (blockages or partial blockages of the airway leading to breathing cessations).

Does sleep apnea affect everyone?

OSA can affect anyone, but is more common in some people, such as those who are male, middle aged, elderly, and over-weight.

What are the symptoms of sleep apnea?

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  • Excessive daytime sleepiness (EDS).
  • Loud snoring.
  • Witnessed apnoea’s / Irregular breathing by your bed partner.
  • Poor concentration.
  • Poor memory.
  • Frequent night time urination.
  • Morning headaches.

Are some people more likely to get it than others?

OSA can affect anyone, some more than others, people with the following conditions are a greater risk:

  • Overweight or Obesity – overweight people are at greater risk of developing OSA, usually the heavier the person, the worse the OSA, although it is possible to have OSA without being overweight.
  • Neck size – people with a neck size >43 mm.
  • Anatomy – Small upper airways, large tongues, recessed chins, large tonsils.
  • Snoring – snoring means a person is more likely to develop OSA, particularly if they become overweight.
  • Age – although anybody can develop OSA, it is more prevalent in people over 50, particularly in men and woman past menopause.
  • Gender – OSA is more common in men than woman.
  • Intermittently stop breathing when sleeping.

How do I know if I have sleep apnea?

Determining whether you have OSA start with completing a simple questionnaire, complete the STOPbang form, and The Epworth Sleepiness Scale form. Follow the instruction on the forms.

 

If you score high in both forms, you are encouraged to visit you GP, taking your forms with you. Sleep studies can now be done in the comfort of your own home. Once you have completed the study, and determined that you are suffering from OSA, you will undergo 3 nights of titration in the comfort of your own home. Once completed, your GP will discuss best treatment options with you and refer you if needed.

Can it be treated?

Yes! it can be treated very successfully with continuous positive airway pressure or CPAP. A mask is connected to a CPAP device via a tube. The machine blows air through this tube into the mask opening the airways allowing the person to breath normally during sleep and avoiding oxygen desaturation. This allows for deep refreshing sleep to occur thereby relieving the excessive daytime sleepiness.

  • Excessive daytime sleepiness (EDS).
  • Loud snoring.
  • Witnessed apnoea’s / Irregular breathing by your bed partner.
  • Poor concentration.
  • Poor memory.
  • Frequent night time urination.
  • Morning headaches.

Benefits of CPAP Treatment

By using your CPAP device regularly (at least 4 hours per night) you will get the refreshing sleep you need. For patients with moderate to severe symptoms it is a life changing treatment.

 

To experience the full benefits of the CPAP, it must use every night to the week for the duration of your sleep, resulting in:

  • Improved health, as untreated OSA can lead to high blood pressure, heart attacks and/or strokes.
  • Less daytime sleepiness
  • Fewer awakenings at night, less interruptive sleep.
  • Relief from morning headaches
  • Improved memory
  • Improved concentration
  • More alertness
  • More motivation
  • Better work performance
  • Less snoring
  • Less accidents or incidents
  • Your bed partner will benefit from a good night sleep as well.

Are there side effects or risks from using CPAP?

As with any treatment, side effects can occur, however the side effects associated with CPAP are rarely severe and easily resolved. The most common reason people do not use their CPAP machine is poor comfort.

 

Common side effects and issues:

  • Mask seal problems – If the mask does not fit properly, small leaks will result, rendering treatment ineffective or partially ineffective. Your medical practitioner will assist you in making the correct mask selection and fitting to optimise your sleep.
  • Soreness on the nasal bridge – soreness on the bridge of the nose is an indication that the mask is too tight at the top or is a poor fit to the patient. The mask either need refitting or replacing as the soreness can become worse over time.
  • Throat dryness – a dry mouth is quite common when using a CPAP, particularly with a mask that covers the mouth. Usually, a glass of water next to the bed will relieve this, alternatively a humidifier is available to reduce or eliminate this event.
  • Nasal problems – It is common to experience some discomfort with nasal stuffiness, sneezing and/or running nose at the start of your treatment. This should subside and settle on its own. Suffering from flu, cold or blocked nose will make it difficult to use your CPAP machine for a night or two.

Alternative Treatment

There are other options for treating OSA, including:

  • Weight loss – weight loss can improve the severity of OSA, even to the point where treatment (such as a CPAP) may no longer be required. Patients with excessive weight are always encouraged to lose weight.
  • Surgery – This involves the removal of large portions of soft tissue at the back of the throat. It is highly invasive and represents the biggest risk to the patient. Unfortunately, there is a poor success rate for OSA and snoring.
  • Intra oral devices (IOD) – This is a device that fixes inside the mouth and holds the lower jaw in a forward position. It is less invasive than surgery, but causes aching in the jaw, with a moderate success rate.

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