A good night’s rest is more than just an escape from our busy days. Sleep, or lack thereof, profoundly impacts our health, cognition, and overall well-being. One condition that can drastically affect the quality of sleep is sleep apnoea.
However, the term “sleep apnoea” may evoke a cloud of mystery for many. So, what is sleep apnoea? This comprehensive guide delves into its intricacies, its science, and how it can be managed effectively.
A Spotlight on Sleep Disorders: The Fundamentals of Sleep Apnoea
Sleep apnoea is a prevalent sleep disorder characterised by breathing interruptions during sleep. There are two major kinds: Obstructive Sleep Apnoea (OSA) and Central Sleep Apnoea (CSA). OSA is more common and happens when the throat muscles relax excessively, obstructing the upper airway. Central Sleep Apnoea occurs when the brain isn’t sending the right signals to the muscles controlling your breathing.
Symptoms and Risk Factors: When Should You Be Concerned?
People with sleep apnoea often snore loudly, sleep restlessly, and experience excessive daytime sleepiness.
Additional symptoms may include trouble concentrating, waking up with a dry mouth, and, quite distressingly, times when your breathing stops during sleep, which can be reported by a bed partner.
Several factors increase the risk of developing sleep apnoea. These encompass being overweight, advanced age, smoking, and having certain medical conditions, such as high blood pressure and chronic lung diseases.
Furthermore, untreated sleep apnoea increases the risk of serious health problems like stroke or heart disease.
The Sleep Study: Diagnosing Sleep Apnoea
Sleep apnoea is diagnosed via a study that is typically performed at a sleep laboratory or sleep clinic. An overnight sleep study involves monitoring various physiological activities during a full night’s sleep. Doctors look at the frequency of apnoea events – instances when your breathing repeatedly stops – and drops in blood oxygen levels, among other factors.
A home-based sleep test may be conducted if an in-person sleep study is not feasible. It’s less comprehensive but can still help diagnose sleep apnoea by recording your breathing, heart rate, and oxygen levels.
The Consequences of Untreated Sleep Apnoea
Untreated sleep apnoea, unfortunately, has far-reaching consequences. It’s linked to a higher risk of developing conditions like high blood pressure, atrial fibrillation, congestive heart failure, and metabolic syndrome. Further, untreated sleep apnoea can lead to nonalcoholic fatty liver disease and exacerbate existing chronic lung diseases.
Daytime symptoms, like excessive daytime sleepiness and trouble concentrating, can also affect work productivity, academic performance, and overall quality of life. That’s why identifying and treating sleep apnoea is paramount.
Addressing Sleep Apnoea: How Is Sleep Apnoea Treated?
Treating sleep apnoea often involves lifestyle changes, such as losing weight to achieve a healthy weight, avoiding alcohol and sleeping pills, and adjusting the sleep environment to promote healthy sleep. Nasal congestion, if present, may be treated with medication or nasal appliances.
Continuous Positive Airway Pressure (CPAP) therapy’s the go-to treatment for more severe sleep apnoea. This involves a machine delivering air pressure through you wear over your nose while sleeping. It emits just enough to keep your upper airway passages open so that sleep apnoea and snoring are prevented.
Oral appliances meant that keep your throat open can also treat sleep apnoea. These devices, which resemble sports mouth guards, help position your jaw, tongue, and soft palate in a way that keeps your airway open.
However, it’s worth noting that the ideal approach to treat sleep apnoea depends on several factors, including the type and severity of sleep apnoea, the presence of other sleep disorders, and the patient’s overall health condition.
Emerging and Innovative Therapies
In some cases of central sleep apnoea, Treatment-Emergent Central Sleep Apnoea (TECSA) may occur, where obstructive events are mitigated, but central sleep apnoea syndromes persist. If CPAP therapy is not suitable or preferred, other treatments, like adaptive servo-ventilation, bilevel positive airway pressure, or supplemental oxygen, can be considered.
Moreover, advances in medical technology have introduced new methods of treating sleep apnoea, such as hypoglossal nerve stimulation, a surgery involving implanting a device that stimulates a nerve to keep the airway muscles open.
The Biology Behind Sleep Apnoea
To truly understand “what is sleep apnoea?”, we must delve into the biological processes at play. During healthy sleep, our body cycles through several stages, including deep and rapid eye movement (REM) sleep. These stages are crucial for memory consolidation, muscle repair, and immune function.
When obstructive sleep apnea occurs, the relaxation of throat muscles causes a physical block in the airway. This leads to apnea events where the individual literally stops breathing, resulting in lowered oxygen levels in the blood. Sensing this reduction, the brain sends a wake-up call, causing the individual to wake up briefly and resume breathing, often with a gasp.
Central sleep apnoea, however, stems from a different issue. Here, the brain fails to send signals to the breathing muscles during sleep, leading to pauses in breathing. Central sleep apnoea syndromes may result from conditions such as heart failure and stroke.
Both types of sleep apnoea disrupt the normal sleep cycle, preventing the individual from reaching or maintaining the deeper stages of sleep. This disruption often results in excessive daytime sleepiness and can seriously affect cognitive function, causing attention, memory, and concentration difficulties.
Delving Deeper: The Impact on Mental Health
Sleep and mental health are closely interwoven. Chronic sleep disturbances, such as those caused by sleep apnoea, can contribute to mental health disorders, including depression and anxiety. There’s a reciprocal relationship at work – while sleep apnoea can contribute to mental health problems, these disorders can, in turn, exacerbate sleep disturbances.
The Influence of Lifestyle Choices and Underlying Health Conditions
Lifestyle choices and underlying health conditions play a pivotal role in sleep apnoea. Obesity is a considerable risk factor for OSA, with fatty tissue in the throat area contributing to airway obstruction. Losing weight is generally considered the first-line treatment for mild sleep apnoea.
Additionally, certain behaviours, such as alcohol consumption and smoking, can exacerbate sleep apnoea. Alcohol relaxes throat muscles, increasing the risk of airway obstruction while smoking causes inflammation in the upper airway, potentially aggravating OSA symptoms.
Underlying health conditions can also influence the presence and severity of sleep apnea. People with chronic nasal congestion have a higher risk of developing sleep apnea. Furthermore, medical conditions, such as chronic lung diseases, congestive heart failure, and other disorders, can increase the likelihood of central sleep apnoea.
Sleep Apnoea and Children: A Not-So-Obvious Concern
While sleep apnea is commonly associated with adults, particularly those middle-aged or older, it’s also a significant concern for children. Kids with enlarged tonsils or adenoids often snore loudly and may suffer from obstructive sleep apnea. The consequences for children can be severe, including growth problems, learning difficulties, and behavioural issues.
Personalising Treatment: Not a One-Size-Fits-All Approach
While CPAP is often the first line of treatment for sleep apnoea, not everyone tolerates it well. Others may find lifestyle changes sufficient in managing mild sleep apnoea. Ultimately, treating sleep apnoea effectively requires a personalised approach, considering the patient’s preferences, severity and type of sleep apnoea, and overall health profile.
For those who struggle with CPAP, alternatives such as oral appliances or positional therapy can be considered. In more severe cases, or when other treatments fail, surgical options may be explored, including throat surgeries, oral surgeries, or even nerve stimulation surgery.
In cases of central sleep apnoea, treatment often involves addressing the underlying condition, whether heart failure or opioid use. Specific therapies designed to treat central sleep apnoea, such as adaptive servo-ventilation, may also be considered.
How Is Sleep Apnea Diagnosed?
Identifying sleep apnoea requires a comprehensive evaluation involving a detailed personal and family history, physical examination, and sleep studies. Often, a bed partner’s report of snoring, gasping, and breathing interruptions can provide the initial clues.
Sleep studies, such as nocturnal polysomnography, play an instrumental role in diagnosing sleep apnoea.
Conducted in a sleep laboratory, this overnight sleep study involves monitoring the activity of the brain, lungs and heart, blood oxygen levels, breathing patterns, and body movements while you sleep.
Home sleep testing is another option. It involves fewer parameters than polysomnography, but it’s easier to arrange and typically costs less. Your physician can use the results to determine whether you have sleep apnoea and its severity.
The Risk Factors and Consequences of Untreated Sleep Apnoea
Several risk factors predispose people to obstructive and central sleep apnea. Age and obesity are two significant predictors of OSA, whereas heart disorders and the use of opioid medications are strongly linked to CSA.
There’s a crucial need to recognise and treat sleep apnea, as untreated sleep apnea can lead to many health issues. High blood pressure, metabolic syndrome, diabetes, liver problems, and even nonalcoholic fatty liver disease have been associated with this sleep disorder.
Furthermore, undiagnosed sleep apnoea can increase the risk of severe health complications, including heart attacks, strokes, and atrial fibrillation, which is a kind of irregular heartbeat. It can also complicate pre-existing chronic diseases.
The increased daytime sleepiness associated with sleep apnoea also raises the risk of accidents, including motor vehicle crashes and work-related accidents. The cost of untreated sleep apnoea to public safety and the broader health system is significant.
The Role of Healthy Lifestyle Habits in Sleep Apnoea Management
Healthy lifestyle habits are integral to managing sleep apnoea effectively. This includes maintaining a healthy BMI, regular exercise, a balanced diet, good sleep hygiene, and avoiding alcohol, smoking, and sleeping pills.
These measures not only help in treating sleep apnea but can also prevent its occurrence in those at risk. Lifestyle changes can be particularly effective in cases of mild sleep apnea, often eliminating the need for other, more complex treatment options.
A Deeper Look: Sleep Apnoea and Its Connection to Oral Health
While sleep apnoea has far-reaching impacts on various aspects of health, its connection to oral health often goes unnoticed. Dental professionals play a crucial role in identifying possible symptoms of sleep apnoea. For instance, a condition called bruxism, characterised by teeth grinding during sleep, can be an indirect indicator of the disorder. The clenching and grinding may occur as the body’s way of reopening a closed airway, thus linking it to sleep apnoea.
Over time, untreated bruxism can lead to various dental issues such as tooth wear and breakage, TMJ disorders, and gum disease. Additionally, the morning headaches and facial pain that often accompany bruxism could indirectly result from disrupted sleep due to apnoea events.
Considering Surgery: An Alternative Treatment Pathway
For some, lifestyle changes or appliances might not be enough to manage sleep apnoea effectively. In such cases, surgical options can be considered. Different types of surgeries are available, depending on the root cause of sleep apnoea.
Surgery could aim to remove excess tissue from the throat, reposition the facial bones, or implant plastic rods into the soft palate. A more recent development in sleep apnoea treatment is hypoglossal nerve stimulation, where a small device akin to a pacemaker is implanted under the skin. The device stimulates a nerve to control tongue movement, preventing it from blocking the airway during sleep.
The Sleep Environment: A Crucial Yet Overlooked Aspect
The sleep environment can significantly influence sleep quality. Ensuring the bedroom is dark, quiet, and at a comfortable temperature can enhance sleep quality and may help manage sleep apnoea symptoms. Using hypoallergenic pillows and bedding can also reduce potential irritants that might interfere with breathing.
Furthermore, the position one sleeps in can impact sleep apnoea. Many people with sleep apnoea find that symptoms decrease when sleeping on their side instead of their back, as this position can prevent the collapse of the throat’s soft tissues. Various products are available to encourage side sleeping and might be a helpful adjunct in managing sleep apnoea symptoms.
Sleep Apnoea: A Condition Not to be Ignored
Indeed, sleep apnoea happens. However, being equipped with the right information, we can better recognise its signs, understand its risks, and seek appropriate treatment. Remember, healthy sleep is not a luxury; it’s a vital part of our well-being.
If you’re experiencing sleep apnoea symptoms or another sleep disorder, consider contacting a professional. Your journey towards healthier sleep can start with a single step.
Are you ready to take that step? Are you tired of feeling tired? Melbourne Dental Sleep Clinic is here to guide you on your journey to better rest and improved health. Our team is well-versed in diagnosing and treating sleep disorders. Don’t let sleep apnoea control your nights and days. Book a consultation with Melbourne Dental Sleep Clinic today and take the first step towards reclaiming your sleep.
Footscray: (03) 9068 5357
Niddrie: (03) 9068 5316
Caulfield North:(03) 9068 5355
References
Sleep apnea, psychopathology, and mental health care – PMC
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5560422/
Oral health problems linked to obstructive sleep apnea are not always recognized within dental care; As described by dental professionals – PMC
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8874038/
Sleep apnoea – Better Health Channel
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/sleep-apnoea
