Sleep apnoea syndrome

Sleep apnoea syndrome

What is apnoea?

The word apnoea means 'want of breath' and obstructive sleep apnoea syndrome refers to a clinical condition where obstruction in the upper airway leads to interruption of the breathing cycle on a frequent basis during sleep leading to various consequences as discussed below.

The obstruction sites are usually at more than one level and include within the nose, behind a bulky soft palate, behind a large base of tongue and due to fat deposition in side walls of the throat. In addition, gravity plays a role especially when the patient lies on their back. Muscles tend to be more relaxed during sleep including the tongue which increases likelihood of the airway closing or partially closing at this time.

What are symptoms of obstructive sleep apnoea syndrome (OSAS)?

During the night:

During the day:

Management

The management of OSAS depends on severity of condition diagnosed on overnight sleep study. There are several hospitals offering this service in Ireland.

The treatment of mild cases is similar to that of simple snorers. In the case of moderate or severe sleep apnoea, the treatment will include life style changes and also the use of nasal CPAP

What is nasal CPAP?

Nasal CPAP (CPAP stands for Continuous Positive Airway Pressure) is a small, quiet, electrical pump which delivers air to the nose at pressure via a long hose and soft plastic mask. The pressure opens up the airway from the nose down, prevents it from closing even to a minor degree and thus eliminates snoring, apnoeas and returns sleep quality to normal. Pressures vary between individuals. The correct pressure is decided by medical team during a short hospital stay, during which the patient becomes accustomed to the device and learns how to use it.

Side effects from CPAP include air leaking from the mask, skin marking on the nose, sneezing /running nose during the day and finally swallowing a lot of air. These problems are usually managed by improving mask fit, humidifying air and altering pressure as necessary.

After an initial settling period the majority of patients use CPAP on a nightly basis with clear benefit to their general well being and that of their partner.

Long-term consequences of OSAS

The main effect of OSAS is on quality of life. Sleepiness can obviously be dangerous at the wheel.

Studies have also shown that OSAS is associated with high blood pressure. There are also associations noted between OSAS and heart disease and stroke. However, these associations may be indirect through other factors such as obesity, high blood pressure smoking and diabetes. Long-term studies are being carried out at present looking at this issue in detail.

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