What is Obstructive sleep apnoea (OSA)?

Apnoea – a temporary pause in breathing – is caused by tissues in the back of the throat relaxing during sleep and pressing on the airway. This narrowing of the airway causes snoring.

Risk Factors:

Excess weight, large neck size, increased age, Gender – men are more likely to suffer from sleep apnoea, hypertension, family history.

Signs and symptoms:

Excessive daytime sleepiness – Monitored using the Epworth sleepiness scale, Feeling un-refreshed after a full night’s sleep, Difficulty concentrating, snoring, morning headaches.

How OSA is diagnosed?

OSA is diagnosed using an overnight home oximiter or grey-flash. These are battery powered devices which monitor blood oxygen saturation, pulse, body positioning, snoring and nasal oxygen flow rate. These devices are taken home with the patient and are returned the next day, the information is downloaded and a diagnosis can be made.

Types of OSA:

The severity of OSA is determined by how often your breathing is affected over the course of an hour. These episodes are measured using the apnoea-hypopnoea index (AHI). Severity is measured using the following criteria:

• Mild – an AHI reading of 5 to 14 episodes an hour
• Moderate – an AHI reading of 15 to 30 episodes an hour
• Severe – an AHI reading of more than 30 episodes an hour

Current evidence suggests treatment is most likely to be beneficial in people with moderate or severe OSA.

Treatment:

Lifestyle Changes:

Losing weight- neck size 17.5 inches and under are less likely to suffer from OSA.

Stopping smoking and limiting alcohol consumption.

Reducing sedative medications.

Medical intervention:

People with moderate to severe OSA usually need to use a continuous positive airway pressure (CPAP) device.

This is a small pump that delivers a continuous supply of compressed air through a mask that either covers your nose or your nose and mouth. The compressed air prevents your throat closing.

A mandibular advancement device (MAD) is a dental appliance, similar to a gum shield, sometimes used to treat mild OSA.

A MAD is worn over your teeth when you’re asleep. It’s designed to hold your jaw and tongue forward to increase the space at the back of your throat and reduce the narrowing of your airway that causes snoring.

There are a number of surgeries that can be used to treat OSA however surgery is usually only considered as a last resort when all other treatment options have failed, and also if the condition is severely affecting your quality of life.