Sleep apnoea
Published by Bupa's health information team, July 2008.
This factsheet is for people who have sleep apnoea, or who would like information about it.
Sleep apnoea is a condition that causes you to briefly stop breathing while you sleep. If you snore heavily, you are more likely to have sleep apnoea.
Sleep apnoea or heavy snoring that disturbs sleep is thought to affect at least three in 1,000 people.
- About sleep apnoea
- Causes of sleep apnoea
- Symptoms of sleep apnoea
- Diagnosis of sleep apnoea
- Treatment of sleep apnoea
- Further information
- Questions and answers
- Related topics
- Sources
About sleep apnoea
When you're awake, muscles in your nose, mouth and throat keep your airways open. This allows you to breathe freely.
However, when you're asleep, your muscles relax. This means the airways can sometimes close up, preventing air from getting in or out easily. When this happens and you try to breathe, the soft tissue in your mouth, nose and throat vibrates, making noise; this is what we call snoring.
Tissues that can affect snoring and sleep apnoea
Sometimes the airway at the back of your tongue (behind the uvula) collapses completely, which stops you from breathing. If your breathing stops, your brain senses this, and you wake up and start breathing again. This is called sleep apnoea. Usually you will fall asleep again immediately and won't remember these episodes.
Sleep apnoea can leave you feeling exhausted in the day because you keep waking up at night. This makes it difficult to concentrate and make decisions, and increases the risk of having a motor vehicle accident. Sleep apnoea may also cause high blood pressure. Some research suggests that it might make stroke, heart disease and heart failure more likely.
Causes of sleep apnoea
Physical factors
Certain physical characteristics make you more likely to snore and develop sleep apnoea, for example:
- a receding lower law, which causes an overbite
- a blocked nose, caused by congestion, catarrh, nasal polyps or damage to the nose
- having a large uvula or enlarged tonsils
- being male
- being elderly - muscle tone reduces as you get older, which raises the risk of airways collapsing
- having low levels of thyroid hormone (hypothyroidism)
- being in the menopause is linked with snoring
Lifestyle factors
There are certain lifestyle factors that make you more likely to snore and therefore more likely to have sleep apnoea.
- If you're overweight you're more likely to snore. This is thought to be due to the excess fat around your neck. This makes your airways more likely to collapse.
- Alcohol causes your muscles to relax more than usual during a normal night's sleep so you are more likely to snore. It also irritates the nasal lining which can make breathing more difficult.
- Sedatives, like alcohol, make your body's muscles relax more than usual, causing you to snore. If you're worried about how a sedative is affecting your sleep, talk to your GP about it. There may be a non-sedative alternative. Don't stop taking prescribed medicines without talking to your doctor.
- Smoking cigarettes causes swelling, inflamation and irritation to your nostrils and throat, making snoring more likely. Even passive smoking can make snoring worse.
- If you suffer from allergies you are likely to have a blocked, itchy and runny nose. The lining of the nose and throat may also be swollen. This may interfere with sleep and make snoring more likely.
Symptoms of sleep apnoea
If you have sleep apnoea, your partner may notice periods when you stop breathing while you are asleep, and that you snore heavily.
Sleep apnoea causes extreme tiredness and sleepiness during the day. You need sleep to keep your body and mind in good health. If you have long periods of disturbed sleep, it can have a serious affect on your overall wellbeing. At first you will only feel sleepy during inactive moments such as reading, watching television, or driving on the motorway. However, this will get progressively worse and you may start to fall asleep at any time during the day. After several nights of disturbed sleep, you may:
- struggle to concentrate
- struggle to make decisions
- start to feel depressed
Diagnosis of sleep apnoea
If you or anyone you live with is concerned about you snoring or having sleep apnoea, talk to your GP about it. He or she will ask about your symptoms and examine you. Your GP may also ask you about your medical history. It's often useful if your partner attends the appointment as they can describe the pattern and duration of the snoring.
Depending on what your GP thinks is causing your snoring, he or she will give you advice on what to do. If this doesn't help, he or she may refer you to an ear, nose and throat (ENT) specialist or recommend that you see a dentist (See Treatment).
If your GP thinks you have sleep apnoea you might be referred to a specialist at a sleep clinic. These are centres where you are monitored while you sleep, to help diagnose sleeping disorders. The test monitors things such as your heart rhythm, brain waves, the amount of oxygen in your blood, whether or not you are snoring while you sleep, or if your breathing is interrupted. With this information he or she can find out if you have sleep apnoea.
Treatment of sleep apnoea
Self-help
If your snoring and sleep apnoea aren't severe there are several changes you can make to your lifestyle that may help.
- If you're overweight, make changes to your lifestyle so that you can lose some weight. This means eating a healthy balanced diet and doing more exercise.
- Don't drink alcohol before you go to bed.
- Stop smoking. Your GP can give you advice on this.
- Change your sleeping position. When you lie flat on your back your tongue is more likely to fall back into your throat and block your airway. By sleeping on your side, or by having your head and shoulders slightly tilted upwards, you're less likely to snore.
- Use only one thick pillow (or two thin ones) to increase airflow.
- Elevate your mattress at the end where your head rests by putting pillows underneath it - having your head at a slight angle may help reduce nasal congestion.
- If you have any allergies, do what you can to reduce contact with allergens (things you are allergic to) may help reduce your risk of snoring, although more research is needed in this area.
Snoring treatments
Your GP may recommend treatments for snoring which may also help mild sleep apnoea.
Mouth guards
A type of mouth guard that pushes your lower jaw forward (mandibular advancement device) can be very effective at reducing snoring for some people. They work by improving the air flow when you sleep, making snoring less likely, and may help mild sleep apnoea. Your GP or dentist will be able to give you more advice.
Nasal sprays
If your GP thinks that a consistent blocked nose is part of the problem, you may be prescribed a nasal spray to help reduce congestion.
Hormone replacement therapy (HRT)
If your GP thinks the menopause has brought on your snoring, he or she may discuss HRT with you (see Related topics).
Treatment for hypothyroidism
If your GP thinks you have hypothyroidism (very low levels of thyroid hormone) he or she will refer you for some blood tests. If you have hypothyroidism you will be given the hormone thyroxine, which you need to take daily (see Related topics).
Sleep apnoea treatments
Continuous positive airway pressure (CPAP)
If you have sleep apnoea, the best treatment is CPAP. This is a device which helps you breathe while you sleep. You wear a mask that covers your nose and is attached to a pump by a tube. The pump maintains the air pressure in your throat, stopping it from collapsing and cutting off your breathing. CPAP devices don't use oxygen or oxygen cylinders, so there is no fire risk.
Research shows that CPAP greatly improves sleep, and helps reduce the associated high blood pressure, which sleep apnoea causes.
Although it may be slightly awkward to use, CPAP can greatly improve your quality of life if you have sleep apnoea. You will usually have a much better night's sleep and won't feel tired in the day anymore.
Further information
- Sleep Apnoea Trust
0845 60 60 685
www.sleep-apnoea-trust.org
Related topics
Sources
- Guidelines for GPs and other doctors. www.sleep-apnoea-trust.org, accessed 14 March 2008
- Snoring and Sleep Apnoea. British Lung Foundation. www.lunguk.org, accessed 14 March 2007
- Who gets sleep apnoea? The Sleep Apnoea Trust. www.sleep-apnoea-trust.org, accessed 14 March 2007
- Sleeping Well. Royal College of Psychiatrists. www.rcpsych.ac.uk, accessed 14 March 20078
- Snoring. RJ Parker, M Hardinge, C Jeffries. BMJ 2005; 311: 1063. www.bmj.com
- Malhotra A, White DP. Obstructive sleep apnoea. The Lancet 2002; 360: 237-245
- Sleep apnoea. BMJ Clinical Evidence. www.clinicalevidence.com, accessed 14 March 2007
- Physical features of snoring. British Snoring and Sleep Apnoea Association. www.britishsnoring.co.uk, accessed 14 March 2007
- Kalra M, LeMasters G, Bernstein D et al. Atopy as a risk factor for habitual snoring at age 1 year. Chest. 2006;129:942-946. www.chestjournal.org
- Frayling TM, Timpson NJ, Weedon MN et al.,A common variant in the FTO gene is associated with body mass index and predisposes to childhood and adult obesity. Science 2007; 316 (5826): 889-894
- Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2005: 401
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Dr James Quekett, Bsc, MB, ChB, MRCGP, DRCOG, DFFP, General Practitioner (GP) and GP Appraiser, Gloucestershire, and by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: July 2008.
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