Definition & Overview

Obstructive sleep apnoea is a common form of apnoea, which is defined as the cessation of breath while sleeping.

The muscles in the body relax during sleep. However, if the muscles at the back of the throat become too relaxed and collapse, they block air from entering the lungs causing oxygen deprivation. When the brain senses that the body lacks oxygen, it will force you to gasp or snort, waking you up in the process and enabling you to breathe normally. Some people may experience this condition only once or twice a night. This condition is referred to as sleep apnoea. Others may experience it numerous times causing them to lack sleep and feel tired in the morning, which is called obstructive sleep apnoea.

Obstructive sleep apnoea deprives the organs in your body from the oxygen they require, which causes complications such as irregular heart rhythms. However, with the right form of treatment, these complications can be avoided.

Cause of Condition

Babies, children, and adults can develop obstructive sleep apnoea. In babies and children, the most common cause is swollen tonsils. In adults, obstructive sleep apnoea develops when the tonsils become enlarged and block the airway. If there is too much tissue at the back of the throat, such as the uvula and soft palate, it is also possible to develop the condition. Other causes are a larger than average tongue or deviated septum.

While there are known causes of sleep apnoea, there are also factors that can place a person at a higher risk of developing the condition, such as:

  • Hereditary – If a person inherits a narrow airway, then the risk of developing the condition is high.
  • Hypertension
  • A thick neck – If your neck has a circumference that is greater than 17 inches for men, or 16 inches for women, there is a possibility that you’ll develop obstructive sleep apnoea. A thick neck will usually mean a narrow airway.
  • Smoking
  • Age – Even though people of any age can develop obstructive sleep apnoea, the condition is known to be more common in those aged 18 to 60.
  • Family History
  • Nasal Congestion
  • Gender – Obstructive sleep apnoea is more common in males than in females.

If left untreated, complications are more likely to develop. These can include fatigue during the day, heart problems, complications with medications and surgical procedures that require general anesthesia, and eye problems.

Key Symptoms

Obstructive sleep apnoea normally displays a wide variety of symptoms with loud snoring being the most common. Another common symptom is the lack of sleep, which results in excessive daytime sleepiness, morning headaches, mood changes, irritability, and even depression.

Many people aren’t concerned about their condition, but they should be. Obstructive sleep apnoea typically leads to numerous medical problems, some of them can be life-threatening. If you experience any of the symptoms mentioned above, consulting a general practitioner or a family doctor is highly recommended.

Who to See & Types of Treatment Available

Patients who are suspected of suffering from obstructive sleep apnoea must consult a family doctor or GP who can provide a diagnosis or make a referral to a sleep specialist, depending on the extent of the condition. To diagnose the condition, a physical examination, which includes checking the back of the throat for abnormalities, will be performed. The patient’s blood pressure, weight, and neck circumference will also be assessed.

Following the physical examination, the doctor will focus on determining the extent of the condition by conducting a Polysomnography, a test that records heart rate and breathing, oxygen level in the blood, brain waves and leg and eye movement.

Once the condition has been confirmed, the doctor will formulate an individualized treatment plan or in the case of a blockage in the throat or nose, refer the patient to an ENT specialist.

The most common forms of treatment of obstructive sleep apnoea are devices such as continuous positive airway pressure (CPAP), a mouthpiece, and medications that reduce sleepiness during the day.

If these fail to improve the condition, a surgery procedure will be recommended. The most common forms of surgery are Uvulopalatopharyngoplasty (the removal of the tissue at the back of the throat), jaw surgery (involves moving the jawbones forward) and Pillar procedure (involves placing tiny implants in the soft palate or creating a surgical opening in the neck). A Pillar procedure will only be performed if other surgical procedures fail to improve the condition and if obstructive sleep apnoea has developed into a life-threatening condition. Also called a tracheostomy, this involves inserting a metal or plastic tube through an opening in the neck so that air bypasses the blocked portion of the throat.

References:

  • Aurora RN, Casey KR, Kristo D, et al. Practice parameters for the surgical modifications of the upper airway for obstructive sleep apnoea in adults. Sleep. 2010;33:1408-1413.
  • Epstein LJ, Kristo D, Strollo PJ Jr., et al. Adult Obstructive Sleep Apnoea Task Force of the American Academy of Sleep Medicine: Clinical guideline for the evaluation, management, and long-term care of obstructive sleep apnoea in adults. J Clin Sleep Med. 2009;5:263-276.
  • Kasai T, Bradley TD. Obstructive sleep apnoea and heart failure: pathophysiologic and therapeutic implications. J Am Coll Cardiol. 2011;57:119-127.
  • McArdle N, Singh B, Murphy M, et al. Continuous positive airway pressure titration for obstructive sleep apnoea: automatic versus manual titration. Thorax. 2010;65:606-611.
Share This Information: