What is Obstructive Sleep Apnoea (OSA)?
Obstructive sleep apnoea (OSA) and other breathing conditions are common for many people who have COPD and other chronic lung conditions.
People who suffer from OSA reduce or stop their breathing for short periods while sleeping because in deep sleep, the muscles of the throat relax and this may reduce the space at the back of the tongue, through which air must pass to reach the lungs. Normally this doesn’t cause any problems with breathing. In OSA, however, complete relaxation of the throat muscles may cause blockage of the upper airway so that breathing stops temporarily. Such an episode is called an apnoea.
This can happen many times during the night. These breathing stoppages interrupt sleep which results in poor sleep quality with excessive sleepiness during the day. Because these events occur during sleep, a person suffering from OSA is usually unaware of them and is often the last one to know what is happening.
In OSA, the breathing stoppages can last for ten or more seconds and the cycle of apnoeas and broken sleep is repeated hundreds of times per night in severe cases. Most sufferers are unaware of their disrupted sleep but awaken unrefreshed, feeling tired and needing more sleep.
What are the symptoms of Obstructive Sleep Apnoea (OSA)?
A person with OSA may not be aware of the many arousals from deep sleep caused by their condition. Symptoms of OSA include:
- A perception of poor quality sleep despite long periods of time spent in bed.
- Difficulty maintaining concentration during the day.
- Poor memory.
- Excessive daytime sleepiness.
Other symptoms of OSA include:
- Morning headache.
- Short temper.
- Personality change.
- Loss of interest in sex.
- Impotence in males.
If you are concerned about your sleep, discuss this with your doctor. Your doctor may ask you a series of standard questions to determine whether you require further investigations in order to make a diagnosis of obstructive sleep apnoea.
What other problems can develop from OSA?
OSA can be life-threatening. It is a risk factor for high blood pressure, heart attack, heart failure, and stroke. All these conditions occur more frequently in people with OSA.
OSA-associated poor concentration and daytime sleepiness have been associated with an increased risk of accidents in the workplace and on the road.
How is OSA assessed and treated?
In a person suspected of having OSA, their doctor will need to ask questions about waking and sleeping habits. Reports from the sleeping partner or other household members about any apnoeas are extremely helpful.
Referral to a sleep disorders specialist and an overnight sleep study will assist with the diagnosis of OSA and measurement of its severity.
- In an overweight person, weight loss is an important part of treatment. Even a small loss of weight can lead to improvement in symptoms of OSA.
- Avoiding alcohol up to two hours before going to sleep and not using any sleeping tablets or tranquillisers can also help.
- Nasal obstruction may respond to nasal decongestant sprays and smoking cessation.
- For the patients whose sleep apnoea is worsened by lying on their back, positioning devices such as special pillows, rubber wedges and tennis balls attached to pyjama backs encourage sleep in other positions but are of limited value in very severe OSA.
Specific Treatment Options
Continuous positive airway pressure
A CPAP pump is the most common treatment for OSA and is very effective in many cases. A CPAP pump delivers air to the upper breathing tubes or airways via a plastic tube attached to a close-fitting nose or face mask.
Other non-surgical treatments
- Individually designed oral appliances or mouth splints made by dentists may help patients with snoring or apnoea.
- Tongue retainer devices may be useful in those who no longer have their own teeth.
- Specially designed ‘mouth plates’ may help patients who have a narrow maxilla (e.g upper jaw bone).
Surgery options and more OSA information
Further information about OSA including surgical options can be found in the Lung Foundation’s Obstructive Sleep Apnoea Fact Sheet.