Nights are hardly restful if you have sleep apnoea, a chronic and sometimes dangerous condition in which your breathing literally--and repeatedly--stops during sleep. A few lifestyle changes and a simple machine may be all you need to control it.
It's estimated that 10 percent of the adult population have sleep apnoea yet far fewer than this actually know it. Here's why: if you have sleep apnoea, you'll breathe normally during the day. It's only at night, when you fall alseep, that your breathing stops--sometimes for 10 seconds, sometimes for a minute or more. You may snore loudly or even struggle for air when the level of oxygen in your blood starts to fall. In response, you wake only briefly--so briefly in fact that you don't remember in the next morning--then you immediately fall back to sleep. This cycle can repeat itself many times a night (as frequently as 100 time an hour in some cases), preventing deep sleep and leaving you exhausted the next day.
The consequences go beyond a little fatigue. With sleep apnoea, you're two to three times more likely to have car accidents than those who sleep normally. Worse yet, the build-up of carbondioxide in your blood can put you at risk for high blood pressure and other health threats, including a heart attack or stoke.
The most common form of the disease, obstructive sleep apnoea (OSA), occurs when tissues in the airway relax and 'collapse' during sleep, blocking the flow of air (see illustration at right). Anyone who is seriously overweight is particularly prone to this condition, as are men and those over age 65. If you sleep apnoea, you also have an increased chance of developing it. Far fewer people have another form called central sleep apnoea (CSA). Although it has the same symptoms as OSA, it is thought to occur when the brain fails to send 'breathing signals' to your respiratory muscles.
LIKELY FIRST STEPS
What is happening
It's estimated that 10 percent of the adult population have sleep apnoea yet far fewer than this actually know it. Here's why: if you have sleep apnoea, you'll breathe normally during the day. It's only at night, when you fall alseep, that your breathing stops--sometimes for 10 seconds, sometimes for a minute or more. You may snore loudly or even struggle for air when the level of oxygen in your blood starts to fall. In response, you wake only briefly--so briefly in fact that you don't remember in the next morning--then you immediately fall back to sleep. This cycle can repeat itself many times a night (as frequently as 100 time an hour in some cases), preventing deep sleep and leaving you exhausted the next day.
The consequences go beyond a little fatigue. With sleep apnoea, you're two to three times more likely to have car accidents than those who sleep normally. Worse yet, the build-up of carbondioxide in your blood can put you at risk for high blood pressure and other health threats, including a heart attack or stoke.
The most common form of the disease, obstructive sleep apnoea (OSA), occurs when tissues in the airway relax and 'collapse' during sleep, blocking the flow of air (see illustration at right). Anyone who is seriously overweight is particularly prone to this condition, as are men and those over age 65. If you sleep apnoea, you also have an increased chance of developing it. Far fewer people have another form called central sleep apnoea (CSA). Although it has the same symptoms as OSA, it is thought to occur when the brain fails to send 'breathing signals' to your respiratory muscles.
- Lose weight by exercising more and eating a healthy diet. Obesity is the main cause of sleep apnoea.
- Avoid alcohol or sedatives at bedtime to prevent the throat muscles from relaxing too much.
- Sleep on your side or stomach, not on your back, to keep airways clear.
- Use a CPAP machine to improve breathing while you sleep.
QUESTIONS TO ASK
- Does my heavy-duty snoring mean I have sleep apnoea?
- Will my apnoea get worse if I ignore it?
- Is apnoea the reason that I can't stay awake until the end of a movie or could I have another problem?
Treatments
Once you've answered a few questions, your doctor will have a pretty good idea of whether or not you have sleep apnoea. But you'll still need a specialised test to determine what kind of apnoea it is. The main test for sleep apnoea, polysomnography, takes place in a sleep laboratory. For one or two nights, a technician monitors such
things as your pattern of breathing, oxygen levels, face and leg movements and brain waves. These readings are then studied to determine scientifically how well you're sleeping.
If you're like the vast majority of people with apnoea, you'll probably have the obstructive form. While it's possible that you might need surgery to remove air-blocking tissue from your airways, you'll most likely be advised to make a few lifestyle changes and try a home device called a CPAP machine that makes it easier for air to get into your lungs.
Once you've answered a few questions, your doctor will have a pretty good idea of whether or not you have sleep apnoea. But you'll still need a specialised test to determine what kind of apnoea it is. The main test for sleep apnoea, polysomnography, takes place in a sleep laboratory. For one or two nights, a technician monitors such
things as your pattern of breathing, oxygen levels, face and leg movements and brain waves. These readings are then studied to determine scientifically how well you're sleeping.
If you're like the vast majority of people with apnoea, you'll probably have the obstructive form. While it's possible that you might need surgery to remove air-blocking tissue from your airways, you'll most likely be advised to make a few lifestyle changes and try a home device called a CPAP machine that makes it easier for air to get into your lungs.
Treatment Options
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Lose weight Just a 10% loss can have great benefits.
----------------------------------------------------------------------------------------------------------------------------------------------
Watch sedatives Alcohol and sleeping pills increase apnoea.
---------------------------------------------------------------------------------------------------------------------------------------------- Change sleep position Sleep on your side, not on your back.
----------------------------------------------------------------------------------------------------------------------------------------------
CPAP machine Keeps windpipe open; use every night.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Uppp & ablation Remove tissues surgically to widen airways.
---------------------------------------------------------------------------------------------------------------------------------------------
Tracheostomy For life-threatening cases only.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Lose weight Just a 10% loss can have great benefits.
----------------------------------------------------------------------------------------------------------------------------------------------
Watch sedatives Alcohol and sleeping pills increase apnoea.
---------------------------------------------------------------------------------------------------------------------------------------------- Change sleep position Sleep on your side, not on your back.
----------------------------------------------------------------------------------------------------------------------------------------------
CPAP machine Keeps windpipe open; use every night.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Uppp & ablation Remove tissues surgically to widen airways.
---------------------------------------------------------------------------------------------------------------------------------------------
Tracheostomy For life-threatening cases only.
MEDICATIONS
----------------------------------------------------------------------------------------------------------------------------------------------- Antidepressant Protiptyline can improve symptoms.
----------------------------------------------------------------------------------------------------------------------------------------------- Sinus medication Steroids and decongestants clear airways.
TAKING CONTROL
----------------------------------------------------------------------------------------------------------------------------------------------- Sinus medication Steroids and decongestants clear airways.
TAKING CONTROL
- Elevate the head of your bed 10 to 15 cm using bricks or fat books. Doing so helps to prevent heartburn, a common apnoea trigger.
- Get hay fever under control, either by avoiding allergens or using nonsedating antihistamines to reduce congestion. Allergy symptoms often cause an increase in apnoea and snoring.
- Avoid a heavy meal near bedtime because it can make breathing problems worse.
- Watch out for LAUP. Often recommended to decrease snoring, laser-assisted uvulopalatoplasty(LAUP) uses a laser device to eliminate tissue in the back of your throat. While it does work for snoring, LAUP does not eliminate sleep apnoea. Because your snoring is gone after the procedure, you may inadvertently fail to realise that you have apnoea. This could be life threatening for some, so ask your doctor whether you need to have an apnoea test.
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