Obstructive Sleep Apnoea (OSA) is a condition that affects many people and which can be treated but often remains undiagnosed. Specialist sleep nurse Beccy Mullins explains.
OSA is a condition that affects breathing during sleep due to a partial or total closure of the airway. This results in disturbed sleep and although most people are unaware of the disturbance, their bed partner may hear the tell-tale signs. OSA leads to symptoms such as excessive daytime sleepiness and often more serious health problems. So if you, or someone you know, are experiencing symptoms it’s important to get a diagnosis so that you can receive this treatment.
What happens in people with OSA?
The soft tissue at the back of the throat relaxes during sleep, causing the airway to become narrow and floppy. Floppy airways can vibrate producing a sound common in people with OSA: snoring. If the airway continues to collapse it can become totally obstructed, causing an apnoea.
After a while, the person will wake up just enough to open up their airway, breathe again, and then fall back to sleep. These pauses in breathing will be in excess of 10 seconds each and, in people with OSA, can happen from a few to hundreds of times each night.
Usually they don't remember waking to resume breathing.
- Each obstruction deprives the body of oxygen
- When oxygen drops, the body sets off alarms so the brain wakes the sleeper and breathing resumes
- Most people don't remember these interruptions to sleep
- These obstructions increase heart rate, raise blood pressure, and have serious health consequences on the body
- Continued disturbance to sleep results in sleep deprivation
What are the signs and symptoms?
- Extreme sleepiness
- Frequent loud snoring
- Stopping breathing during sleep
- Choking episodes during sleep
- Morning headaches
- Frequent trips to the bathroom during the night
- Waking with a dry mouth/sore throat
- Waking feeling un-refreshed despite a night's sleep
- Difficulty concentrating
- High blood pressure
If left untreated, OSA can cause serious health risks. Recent research shows that snoring and OSA are associated with several other serious health risks if left untreated. It is a contributing risk factor to Obesity, Diabetes, Hypertension, Stroke, Cardiovascular Disease (CVD) and Depression. (References.)
What to do if you suspect you may have OSA
If you still believe you may have the condition, make an appointment to see your GP. You may find it useful to run off the details from the website to take with you and to highlight the symptoms that you are displaying. You can take a simple test, the Epworth Sleepiness Score test on the Real Sleep site to confirm diagnosis.
What is the treatment?
Once diagnosed, OSA can be easily treated using a system called continuous positive airway pressure (CPAP). This involves using a ﬂow generator and a mask that is worn during sleep to gently and quietly provide the individual with air, acting as a stent, to ensure the airway remains open. Most people feel the beneﬁts of treatment within two weeks, but patients need good support in the early days to help them persevere with it.
CPAP is the most consistently safe and effective treatment for OSA and has been recommended by the National Institute for Health and Clinical Excellence (NICE) as the preferred treatment option.
How to drive safely with OSA
Many people including professional drivers have OSA but are totally unaware. Research found a fifth of motorway collisions are caused by drivers falling asleep at the wheel and one in ten crashes on all of Britain's roads - around 23,300 a year are also linked to fatigue.
Once diagnosed drivers must inform the DVLA that they have OSA. However, once treated, driving can resume. There is no loss of driving licence. However, if left undiagnosed and untreated, OSA can lead to a serious accident, leading to injury and even death of the driver or others on the road.
According to research carried out as part of the Sleep 4a Healthy Life programme, run by ResMed in the USA (references):
- 28% of drivers have untreated OSA
- These drivers are six times more likely to be in an accident
- These drivers are twice as likely to have a heart attack or stroke
- Companies spend twice as much on their medical expenses
Other effects of OSA
OSA is linked to higher rates of heart disease, stroke, diabetes, severe headaches and depression.
As well as untreated OSA being dangerous for those who drive or use machinery, tired people are less productive - and OSA sufferers are always tired. As an employer you can be confident that your investment in diagnosis and treatment will deliver results.
For more information:
- Sleep Apnoea Trust
- Real Sleep run by ResMed UK Ltd
- Clinical guidelines from Scottish Intercollegiate Guidelines Network
Beccy Mullins, RGN is the Business Manager for Patient Services at ResMed UK Ltd. She is a Registered Nurse and has specialised in sleep medicine for 15 years, previously working at the Oxford sleep unit with Professor John Stradling as a clinical nurse specialist. OSA graphic by Habib M'henni.
Page created on February 17th, 2012
Page updated on February 21st, 2012