Unlock the Secret to Overcoming Obstructive Sleep Apnoea: Symtoms and Management

Understanding Obstructive Sleep Apnoea/Hypopnoea Syndrome

Obstructive sleep apnoea, also known as obstructive sleep apnea, or OSA, is a condition characterized by the temporary cessation of breathing for at least 10 seconds during sleep due to the collapse of the pharyngeal airway. This disorder affects individuals of all genders, ages, weights, and ethnicities. There are various factors that can predispose individuals to sleep apnoea:

1. Obesity: Individuals with a body mass index (BMI) greater than 25 are at a higher risk due to increased peripharyngeal and central adiposity, which can lead to airway collapse during sleep. This is often exacerbated by reduced neuromuscular activity during sleep.
2. Macroglossia: Conditions such as acromegaly, hypothyroidism, and amyloidosis can contribute to the enlargement of the tongue, further obstructing the airway.
3. Large tonsils: Enlarged tonsils can obstruct the airway, especially during sleep.
4. Large neck: A neck circumference greater than 17 inches in men and greater than 16 inches in women can be a predisposing factor for obstructive sleep apnoea.
5. Recessed chin: A recessed chin can contribute to airway obstruction during sleep.
6. Smoking, Alcohol, or Sleeping Pills: These substances can relax the muscles of the throat, increasing the risk of airway collapse during sleep.
7. Marfan’s Syndrome: Individuals with Marfan’s syndrome may be at an increased risk due to anatomical factors.

Symptoms of Sleep Apnea

Partners of individuals with obstructive sleep apnoea often complain of excessive snoring, gasping for air during sleep, and excessive daytime sleepiness. and may witness periods of apnoea during sleep. .

Sleep Disordered Breathing Consequences

Obstructive sleep apnoea can have serious consequences, including:

• Daytime somnolence, irritability, and decreased concentration
• Morning headaches
• Decreased job performance
• Increased risk of automobile accidents
• Reduction in REM (Rapid eye movement) sleep due to multiple apnoeic events during the night
• Hypertension, increased risk of stroke, and heart attacks
• Activation of proinflammatory pathways, endothelial dysfunction, and enhanced platelet activity and aggregation
• Impaired glucose tolerance and insulin resistance, increasing the risk of developing diabetes

Assessment ofSleepiness

• Assessment tools such as the Epworth Sleepiness Scale questionnaire, completed by the patient and/or their partner. You can find out ESS scale here: Epworth Sleepiness Scale
• Multiple Sleep Latency Test (MSLT), which measures the time taken to fall asleep in a dark room using EEG criteria, are commonly used.

Diagnostic Tests

Sleep studies, including polysomnography, range from monitoring pulse oximetry at night to full polysomnography, which measures various physiological factors including EEG, respiratory airflow, thoraco-abdominal movement, snoring, and pulse oximetry.

Obstructive Sleep Apnoea Management

Several management and treatment strategies for obstructive sleep apnoea include:

• Weight loss: Obesity is a significant risk factor, and weight loss can help reduce symptoms.
• Continuous Positive Airway Pressure (CPAP): CPAP therapy, a form of non-invasive ventilation, is the first-line treatment for moderate to severe OSAHS. This device keeps the airway open by delivering a continuous flow of air through nasal passages at high pressure.
• Intra-oral devices: Mandibular advancement devices may be used if CPAP is not tolerated or for patients with mild OSAHS who do not experience daytime sleepiness.
• Surgical treatments: Surgical interventions such as septoplasty, tonsillectomy, and uvulopalatopharyngoplasty may be considered in certain cases.
• Informing the DVLA: Individuals experiencing excessive daytime sleepiness due to OSAHS should inform the DVLA (Driver and Vehicle Licensing Agency).
• Pharmacological agents: There is limited evidence supporting the use of pharmacological agents in the management of obstructive sleep apnoea.

Common Drugs and Potential Side Effects

Sedatives, analgesics, and anesthetic agents can induce, unmask, or exacerbate obstructive sleep apnoea symtoms. Therefore, caution is advised when using these medications. Treatment of depression or mood disorders may also be necessary.

Herbs, Botanicals, and Supplements

While there are no clinical trials proving the efficacy of herbs or botanicals in treating sleep apnoea.

Nutrition Education and Counseling

Nutrition education and counseling can play a role in managing the severe sleep apnoea condition.

• Avoiding tobacco, alcohol, sedatives, and medications that relax the airway is recommended.

• Additionally, regular exercise and weight management are effective.

• Sleep apnoea sufferers are advised to avoid sleeping on their back, if possible. Using pillows and other devices that help the patient sleep in a side position may help.

• The relationship between obstructive sleep apnoea and hypertension, stroke, and cardiovascular diseases should be discussed with healthcare professionals.