Health Watch: Sleep Apnoea by the Numbers

Obstructive Sleep Apnoea (OSA) is a health condition that causes interrupted breathing during sleep. The breathing interruptions could be either apnoea (complete blockages) or hypopnoea (partial blockages) of the airways.

OSA is thought to affect 3 to 4 percent of women and 5 percent of men, conservative estimates since many people do not realize they have the condition. Nearly 5 percent of the adult population has undiagnosed OSA.

Sleep is an essential component of health, both body and mind. Adults are advised to get seven to eight hours of sleep every night. 15 to 25 percent of these hours of sleep are spent in slow-wave sleep, the deepest phase of sleep.

The onset of OSA is particularly common in people between ages 35 to 54 years. 60 percent of people over age 65 have OSA. However, OSA can affect people across all ages and even children.

The Risk Factors for OSA

a)      Being male

b)      Having a large neck

c)      Diabetes

d)      Menopause

e)      Being 40 years and above

f)       Being overweight

g)      Smoking

h)      Alcohol consumption

i)        Family history of OSA

j)        Nasal congestion

k)      Use of sedatives

Symptoms of OSA

Even though you may not have memory of interrupted breathing; the apnoea-hypopnoea episodes are often visible by a sleeping partner. Symptoms are:

          i         Snoring

        ii          Fatigue

      iii           Sleepiness during the day

       iv          Headaches

         v         Poor memory

       vi          Concentration problems

     vii           Sore and dry throat in the morning

   viii            Irritability

       ix          Impotence in men

         x         Depression and anxiety

       xi          Frequent awakening to urinate

Complications associated with OSA

Undiagnosed and untreated sleep apnoea is associated with adverse health outcomes as well as challenges with poor sleep such as:

·         Increased risk of automobile crashes

·         Impaired judgment and decision making

·         High blood pressure

·         Obesity

·         Type 2 diabetes

·         Stroke

·         Chronic fatigue

·         Heart attack

·         Arrhythmia

·         Heart failure

Diagnosis of OSA

A doctor will carry out a battery of tests including physical examination and blood tests to exclude presence of other conditions.

It will be followed by polysomnography, a test requiring the patient to spend a night at the sleep lab for monitoring. It is the main investigation to help determine the treatment for OSA.

Treatment for OSA

The common treatment methods for OSA are:

1.      Lifestyle changes: quitting smoking, losing excess weight, getting moderate exercise and consuming less alcohol.

2.      Continuous positive airway pressure (CPAP) therapy: the moderate and severe forms of OSA are treated through CPA therapy. CPAP is usually a mask worn over the nose and through it compressed air is pushed through using a small pump. The continuous pressurized air supply keeps the airway from collapsing. Recent versions of the CPAP have a humidifier to increase moisture and reduce nasal dryness and sore throat.

Patients often find CPAP therapy to be uncomfortable, which makes them abandon treatment altogether. Other side effects of CPAP therapy are flatulence, nasal congestion, headaches, and earaches.

3.      Mandibular advancement devices are similar to a mouth guard but is designed to hold the jaw and the tongue forward to reduce the narrowing of the airway.

4.      Surgery is a last option since it has been shown not to be effective as CPAP therapy. The most common surgical procedures to help people with OSA are tonsillectomy, tracheostomy, adenoidectomy, and uvulopalatopharyngoplasty.

Read the full story here

http://www.reuters.com/article/us-healthwatch-apnoea-numbers-idUSKCN0ZG2SG

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