Everything you need to know about sleep apnoea
Do you or a loved one suffer from sleep apnoea? Here's everything you need to know anout the disorder and staying safe while you sleep
By Jaume Palau of Airmony
Sleep apnoea is a serious disorder which stops your breathing every few seconds during sleep, and it’s also associated with medical conditions such as arrhythmia, high blood pressure and increased risks of strokes, heart attacks and heart failure. So, without seeking medical advice and taking action to treat it, sleep apnoea can, in the long-term, be life-threatening.
I was diagnosed 25 years ago and it can also be deeply unpleasant; despite going to bed early each night, I was constantly exhausted, suffered from ill-health, and was even diagnosed with depression.
I have used a number of methods to alleviate the symptoms and help myself to get a good night’s sleep since then. I’ll run through some of the benefits and drawbacks to each in a moment. Firstly though, I think it’s important to understand how widespread sleep apnoea is.
The growth of sleep apnoea
Sleep apnoea is estimated to affect 3-6 per cent of the world’s adult population and as many as 100 million people in Europe and the US alone. This number is also growing.
The number of tests carried out by the NHS England to diagnose people with sleep apnoea has doubled in the last decade. NHS Digital data also shows that the number of hospital admissions of children and teenagers with a primary diagnosis of sleep apnoea has shot up over the past four years.
According to doctors and charities, the rise of sleep apnoea is in part due to increased awareness, which is prompting those with a suspected sleep disorder to seek diagnosis. An increase of obesity is also thought to be contributing to the rise in sleep apnoea among young people.
The managing secretary of the Sleep Apnoea Trust, Chris Rogers, told the Guardian that sleep apnoea was growing among all ages, and is a bigger issue than reflected in “out of date” NHS statistics. “The current estimate that there are 1.5 million who have sleep apnoea is inadequate—the figure now is more like 3.9 million”, he said.
The good news, though, is that, as the syndrome becomes more widely-known and understood, more and more solutions will arise.
Here are some existing ways to tackle it:
Continuous Positive Airway Pressure (CPAP) devices apply constant pressure on your airways, keeping them open and helping you to breathe during sleep. CPAPs are the most popular assistive breathing devices and are pretty essential for most sleep apnoea patients.
When first using a CPAP device, it really helped to transform my life, allowing me to finally get a decent night’s sleep. I did, however, find a few downsides.
CPAPs are bulky, noisy, tabletop devices that require a plug connection and come with a long tube, making them unsuitable for travelling. In short, they’re pretty outdated for the modern world.
Other Assistive Breathing Devices
Expiratory positive airway pressure (EPAP) devices are a lot more discreet than traditional CPAP devices. These single-use, disposable devices attach to your nostrils to keep your airways open but are ineffective for even moderate cases of sleep apnoea.
Bilevel Positive Airway Pressure (BiPAP) devices are like CPAPs, but more suited for people who need high pressure to support their breathing. BiPAPs have two pressure settings: both for inhaling and exhaling.
Adaptive servo-ventilation (ASV) devices are a bit more intuitive—they record data on your normal breathing patterns and use an algorithm to regulate your breathing during sleep.
Wearing a mandibular advancement/repositioning device—essentially a gum shield—during sleep will hold your jaw and tongue forward, increasing the space at the back of your throat and allowing for better breathing. A similar result can be achieved with tongue retainer, but such devices are not effective treatments for moderate-to-severe cases.
Also, wearing these devices can be sore and uncomfortable and, in the long-term, can permanently shift the position of your jaw.
A pacemaker system that stimulates muscles to keep airways open during sleep has been developed in the US. This could provide an interesting new solution to alleviating sleep apnoea but is suitable only for mild cases and it’s likely to be some time before it’s available in the UK.
Surgery should be a last resort when no other alternatives have worked but it may be able to fix the problem in some causes of sleep apnoea.
A deviated septum—an uneven divide between your nasal cavities—or having excess tissue on the back of your nose or throat can block your airways and cause sleep apnoea, for instance.
Similar problems can be caused by the size of tonsils and glands which can also be removed to cure or diminish sleep apnoea.
Sleep apnoea is exacerbated by many factors associated with an unhealthy lifestyle. Even if lifestyle changes don’t cure your sleep apnoea, they can certainly make it more bearable.
Smoking is bad for circulation and breathing in general. Add the fact that nicotine is a stimulant and you can see why it doesn’t promote good sleep.
Drinking alcohol is also known to disrupt sleeping patterns. And as it relaxes your muscles, drinking in the evening is not a great idea for those with sleep apnoea—sufferers already struggle with their throat muscles relaxing and obstructing breathing! The same is true of sleeping tablets and sedatives.
Obesity can also exacerbate sleep apnoea. So, reaching a healthy weight can lead to remarkable improvements—the most obvious route to this is more exercise and yoga in particular—which promotes sleep, muscle flexibility and improved circulation.
Lastly, avoiding caffeine in the afternoon and bright screens and heavy meals in the evening will all help to improve sleep.
If you, or someone you know, may have sleep apnoea, but are yet to seek diagnosis, please make sure you see a doctor as soon as you can. It’s important to know not only whether you have sleep apnoea, but also how severe your breathing difficulties are and what may be causing them.
With raised awareness and the right devices and treatments available, I’m sure that everyone with sleep apnoea will be able to have a good night’s sleep, every night.
About the Author
Jaume Palau is the creator of Airmony, a next generation sleep apnoea device. Portable, light and tubeless, Airmony pushes a continuous flow of air to help sleep apnoea patients breathe during sleep. It includes sensors for e-health tech, allowing patients and their doctors to monitor sleep patterns.