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Sleep Apnoea Info

What Is Sleep Apnoea?

The Greek word 'Apnoea' means 'Without Breath' which is where the name of the 'condition' called Sleep Apnoea (also spelt Apnea in some countries) is derived from.  Therefore, Sleep Apnoea means stopping breathing whilst sleeping!  People with Sleep Apnoea stop breathing regularly during sleep, and most are unaware of this.

Sleep Apnoea is a medical 'condition' which is only just being widely recognized in the UK.  However, it is a serious 'condition', due to the other illnesses it causes and is linked to, such as:-

  • Heart Attacks and other Cardiovascular Disorders
  • Strokes
  • High Blood Pressure
  • Type 2 Diabetes
  • Driving Accidents (through sleep deprivation)
  • Obesity
  • Anxiety and Depression
  • Hypothyroidism
  • ADHD
  • Brain Confusion + Memory Problems
  • Fibromyalgia
  • Chronic Fatigue Syndrome (CFS)
  • Dementia, particularly Alzheimers
  • Floppy Eyelid Syndrome (FES)
  • Asthma
  • COPD
  • Erectile Dysfunction in Men + Loss of Libido in Women
  • Parkinsons
  • Heartburn and Gastrointestinal Reflux
  • Down's Syndrome
  • Achondroplasia
  • Ehlers-Danlos Syndrome
  • Marfan's Syndrome
  • Chiari Malformation
  • (New research is being undertaken constantly and many more links to other medical conditions are possible)

In most cases, a person with Obstructive Sleep Apnoea will be a snorer, and mostly (unbeknown to them) will stop breathing many times a night, ranging from:-

  • 5-14 AHI   = Mild Sleep Apnoea
  • 15-30 AHI = Moderate Sleep Apnoea
  • 30+ AHI    = Severe Sleep Apnoea 

*** AHI stands for Apnoea/Hypopnoea Index, which is the amount of times a person has an apnoea or hypopnoea PER HOUR!  Apnoeas are when a person totally stops breathing and hypopnoeas are partial lack of breathing events.

The apnoeas/hypopnoeas will happen whilst sleeping, and the brain (thankfully) sends messages to the body to start breathing again.  Unfortunately this cycle will repeat itself throughout the night.  The sufferer will often wake up feeling unrefreshed, but will not put this down to lack of sleep, as they are usually under the impression they have slept well, due to most people being unaware of what has been happening through the night.  Some people do wake up gasping or choking though.  It is normally the bed partner who may notice what is going on, and many have reported of hearing their bed partner snoring, followed by a silent pause when they suspect their partner has stopped breathing (which they have!).  The sufferer will then usually make a snorting, choking or gasping noise, and they will start breathing again, but the cycle will continue throughout the night.

**Incidentally, Kath Hope of Hope2Sleep had no idea she stopped breathing at all during sleep and her AHI (apnoea/hypopnoea index) was 30 which is just in the severe range, and her husband never spotted it!!

Symptoms

A person with undiagnosed sleep apnoea may present some or all of the following symptoms:-

  • Daytime tiredness - often with the need for naps when circumstances permit.
  • Snoring
  • Sudden awakenings from sleep (but not always as many sufferers are unaware of waking up).
  • Lack of concentration, poor work or school performance and possibly memory problems or confusion.
  • Depression, anxiety or irritability.
  • Morning headaches.
  • Dry mouth and/or sore throat on waking.
  • Decreased sex drive.
  • They may already be a diabetic, have heart problems, have had a stroke/TIA or have hypothyroidism.
  • The may already be on medication for high blood pressure.
  • Many other symptoms can be present due to sleep deprivation.

Causes

There are several different causes why a person has Obstructive Sleep Apnoea or how it can be made worse, as follows:-

  • Nasal Blockage, due to deviated septum, narrow passages, congestion, allergies etc.
  • Large Uvula.
  • Large (thick) Neck
  • Obesity.
  • Overuse of Alcohol.
  • Certain Medications, such as tranquillisers etc.
  • Large Tonsils or Adenoids.
  • Large Soft Palate.
  • Receding Jaw.
  • Enlarged Tongue.
  • Smoking.
  • Brain slow to send messages to breathe (this is known as Central Sleep Apnoea and is not as common as Obstructive Sleep Apnoea).
  • Family member with Sleep Apnoea, as there are hereditary factors due to craniofacial issues.
  • Downs Syndrome and Achondroplasia are just 2 conditions which post higher risks and there are many others.

If You Suspect You May Have Sleep Apnoea

There are several routes to take, but the most important one is TAKE ACTION NOW!!

  • Book an appointment to discuss this with your GP, who should refer you to a Specialist to arrange a Sleep Study.
  • Ask your bed partner to observe you sleeping.
  • If possible, record the sound of yourself sleeping, or even a video recording.
  • The Epworth Sleepiness Scale Questionnaire is normally one of the first things you would be asked to fill in.  This will give you a good indication of whether you need further help after adding up your scores.  You could print out your results and take them to your GP.   Many clinicians are also using the STOPBang Questionnaire, and there is also a Sleep Quiz you could fill in and print out.  My advice would be to do all 3!  (Links to these tests are below).
  • You can also hire a Home Sleep Test on this website to screen for the likelihood of you having Sleep Apnoea or to convince your GP you need a referral for a full sleep study.
  • Sleep Apnoea also affects children (possibly at least 1 in 30), and the British Lung Foundation have a special section dedicated to this on their website http://www.blf.org.uk/Conditions/Detail/OSA-in-children

Click Here to go directly to the Epworth Sleepiness Scale

Click Here to go direct to the Berlin Sleep Questionnaire

Click Here to go directly to the STOPBang Questionnaire

Treatments

  • CPAP (Continuous Positive Airway Pressure) where filtered air is delivered from a CPAP Machine via a hose/tube and into a Nasal or Full Face Mask, preventing the airways from collapsing.  There are different forms of CPAP machines, such as APAP, BIPAP, VPAP and your sleep doctor will advise the most appropriate treatment for you.
  • Dental Appliances and Oral Devices can sometimes be a suitable option.
  • Surgery is sometimes a consideration.

Self Help

  • DO NOT drive a vehicle when tired.  The DVLA has strict rules on this.
  • Try to lose some weight.  Even losing as little as 10% of the body weight can reduce the amount of apnoeas.  Many diagnosed sleep apnoea sufferers have reported how much easier it is to lose weight once they are on successful treatment.
  • Try not to drink alcohol or eat within at least 3 hours of going to bed.
  • Stop smoking.
  • Try not to sleep on your back, and if possible, elevate the head of the bed by 4-6 inches.

Statistics

According to the 'American Sleep Apnea Association,' "Sleep Apnea (Apnoea) is as common as adult diabetes, and affects more than 12 million Americans.  However, because of the lack of awareness by the public and even some healthcare professionals, the vast majority remain undiagnosed and, therefore, untreated - despite the fact that this serious disorder can have significant consequences."

According to the 'British Lung Foundation,' "it is estimated that about 110,000 people in the UK suffer from Sleep Apnoea/Hypopnoea.  Prevalence is higher in men than women and higher in those who are overweight.  It affects an estimated 4% of males and 2% of females in the UK, although it is thought to be considerably higher in specific groups and occupations, such as long-distance lorry drivers and shift workers, where the consequences can be fatal or lead to serious injury if left undiagnosed and untreated.  It is also estimated that only 1 in 10 patients with the syndrome have so far been diagnosed and treated.  The rate of treatment in the UK is lower than most other developed countries."

Conclusion

Sleep Apnoea (Apnea) is a serious condition, due to its links with other life threatening illnesses.  Not only will you lower your risks of these other illnesses, but you will start to feel so much better in yourself when you are on successful treatment.  

PLEASE, FOR YOUR SAKE AND YOUR FAMILIES, DO NOT IGNORE YOUR SYMPTOMS, AND SEEK MEDICAL HELP NOW!!

Below is a recent interview of Kath Hope speaking on Radio Croydon about the risks of untreated Sleep Apnoea and to raise awareness.  Incidentally, Dave Etheridge, the radio presenter also suffers from Sleep Apnoea:-

Freephone: 0800 002 9711

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