Sleep Apnoea Symptoms, Causes and Treatment

Sleep Apnoea is a common sleep disorder that causes breathing to stop and start repeatedly during sleep. The breathing interruptions reduce airflow and blood oxygen levels, which can have numerous effects on the body.

The condition affects millions worldwide; when left untreated, it causes loud snoring, headaches, and chronic daytime tiredness.

This article will explain the types of Sleep Apnoea, its causes, and its diagnosis.

Obstructive Sleep Apnoea (OSA) is the most common form of Sleep Apnoea, caused by a blockage in the airway while you sleep. Studies estimate that between 4% and 50% of the population have OSA (1).

The blockage is caused by soft tissue in the mouth and throat relaxing too much, causing an obstruction. These obstructions prevent air from passing through normally and cause shallow breathing and breathing pauses. The breathing pauses reduce the amount of oxygen reaching your brain, which can cause your body to wake up to breathe suddenly, and in many cases, you will experience choking and gasping for air.

There are various symptoms of Sleep Apnoea, and not all of them are experienced by everyone. Many sufferers snore, but just because you snore doesn’t mean you have Obstructive Sleep Apnoea. However, it remains one of the critical indicators of the condition.

Central Sleep Apnoea (CSA) occurs when your brain doesn’t send the right signals to the muscles that control breathing. This means your body forgets to breathe for short periods while you’re asleep. It can disrupt your sleep and lead to feeling tired during the day.

Complex Sleep Apnoea is a combination of OSA and CSA.

The cause of Sleep Apnoea, depends on the type and the individual. OSA is caused by a narrow airway so traits that can hinder airflow such as large tonsils and obesity can cause it.

CSA is caused by anything that can interfere with your brain’s control of your breathing; these can include hormonal changes and other health conditions.

Complex Sleep Apnoea is caused by both types coming together.

Age: It is more common in older adults as the muscles in the throat may weaken, increasing the risk of airway blockages during sleep.

Body weight: Carrying extra weight, especially around your neck, can make your throat muscles more likely to collapse during sleep.

Being male: Studies have found that men are more likely to develop Sleep Apnoea. A review of various studies found an average prevalence of 22% in males and 17% in females (1).

Smoking: Smoke irritates the throat and lungs, increasing the likelihood of airway blockages.

Family history: If someone in your family has Sleep Apnoea, you might be at a higher risk.

Hormonal differences: Your hormone levels can impact how you breathe during sleep.

Congestion: Problems with nasal passages, such as allergies, frequent congestion, or a deviated septum, can make breathing through the nose harder.

Medications: Certain medications can relax the muscles and increase the risk of airway blockages during sleep, contributing to Sleep Apnoea.

Alcohol: Alcohol can relax the throat muscles, making them more likely to collapse during sleep.

Other medical conditions: Conditions such as diabetes, stroke, heart failure, high blood pressure and hormonal conditions can increase the risk.

The risk factors for OSA and CSA do overlap; however, some factors are directly linked to Central Sleep Apnoea:

Brainstem problems: If there’s any issue with the part of your brainstem that regulates breathing, it can lead to CSA.

High altitude: Being at high altitudes with less oxygen in the air can sometimes trigger CSA, especially if you’re not used to it.

These factors can disrupt the brain’s signals to the muscles that control breathing during sleep, leading to episodes of interrupted breathing.

The symptoms of each type of Sleep Apnoea overlap; common warning signs and symptoms include:

• Gasping or choking during sleep
• Loud snoring
• Breathing pauses during sleep
• Feeling excessively tired during the day
• Anxiety
• Depression
• High Blood Pressure
• Lack of interest in sex
• Irritability
• Short temper
• Poor memory and concentration
• Frequent toilet visits during the night
• Morning headaches
• Teeth grinding
• Impotence in men

Overnight oximetry is like a sleep test. You wear a small device, usually on your finger or ear, while you sleep. This device measures the oxygen in your blood and your heart rate throughout the night.

It helps doctors check if your body is getting enough oxygen while you sleep and if there are any issues with your breathing or heart.

Doctors use overnight oximetry to check for conditions that affect oxygen levels, including Sleep Apnoea, COPD, and heart issues.

Not only does taking a sleep test lower the risk of developing other health conditions, it can also improve other aspects of your life. Here are some examples:

• Better Sleep: OSA disrupts your sleep by causing repeated pauses in breathing during the night. This means you’re not getting the restful sleep you need, which can lead to feeling tired and groggy during the day.
• Safety: OSA can make you excessively tired during the day, increasing the risk of accidents, especially while driving or operating machinery. Testing can help identify if you have Sleep Apnoea and require treatment to stay safe. You can read more about the risks of driving fatigue here.
• Quality of Life: Treating OSA can improve your quality of life by helping you feel more alert, energetic, and focused during the day.
• Cognitive Function: One of the signs of OSA is memory loss due to the reduced oxygen to the brain. Treating the condition improves your memory and helps reduce cognitive decline.
• Relationships: Snoring loudly and stopping breathing at night can disturb your partner’s sleep. Getting tested and treated can help you and your loved ones sleep better.

Sleep Apnoea treatment is necessary to reduce breathing pauses and improve sleep to manage the disorder. Treatment is dependent on the type of Sleep Apnoea and the severity; the most common treatment types are:

CPAP Therapy

Continuous Positive Airway Pressure (CPAP) Therapy keeps the airway open by providing continuous airflow. The pressurised air is pumped from a Sleep Apnoea machine through a tube and delivered through a face mask.

Mandibular Advancement

Mandibular Advancement Devices (MADs) are mouthguards that gently pull the tongue and lower jaw forward. This motion creates more space at the back of the throat to increase airflow and prevent breathing from stopping. MADs use a boil-and-bite method to create a customised and comfortable fit. These devices are also effective anti-snoring devices.

Positional Therapy

Positional therapy is designed for those who only experience an apnoea event when sleeping on their back. This happens as the throat muscles drop back, causing a blockage. Positional therapy helps by encouraging the user to roll over onto their side to keep the airway open.

Lifestyle Changes

The majority of people with Sleep Apnoea will be asked to make changes in their day-to-day lives to help reduce their symptoms. These changes may include:

• Limiting alcohol consumption
• Quitting smoking
• Losing weight
• Creating a bedtime routine
• Practising relaxation techniques
• Clearing your sinuses

It is important to note that these changes will also be paired with the recommended treatment method.

Many wonder if OSA can cause them to choke to death or suffocate from repeated breathing pauses. It is unlikely for this to happen. However, when Obstructive Sleep Apnoea is left untreated, the risk of side effects and other long term health conditions developing increases.

Many people with Obstructive Sleep Apnoea develop high blood pressure (hypertension), which can increase the risk of heart disease. When Sleep Apnoea is left untreated, your body’s oxygen levels repeatedly drop, triggering your body to release stress hormones and increase your heart rate and blood pressure. This puts you at a higher risk of cardiovascular conditions, including:

• Heart attack
• Stroke
• Atrial Fibrillation
• Heart failure
• Heart disease

Other complications include:

• Complications with medications and surgery: Sleep Apnoea is also concerned with certain medications and general anaesthesia. Medications, such as sedatives, narcotic analgesics, and general anaesthetics, relax the upper airway and can worsen the sleep disorder.
• Eye problems: Some research has found a connection between Obstructive Sleep Apnoea and certain eye conditions, such as glaucoma.
• Alzheimer’s: There is a close link between untreated Sleep Apnoea and the development of Alzheimer’s due to cognitive decline and memory loss.
• Type 2 diabetes: The oxygen deprivation associated with the condition can worsen insulin resistance and lead to difficulty regulating blood sugar levels.

These health comorbidities mean Sleep Apnoea itself won’t kill you, but the conditions that develop can.

For over twenty years, we have helped thousands of patients get back the sleep they need and lead healthier lives. We understand how simple tasks are made difficult due to lack of sleep and how detrimental it is to overall well-being. Our mission is to help as many people as possible with our reliable in-home sleep testing and effective treatment options.

We are here every step of the way, from OSA confirmation to treatment. We are at hand to guide you to comfortable and effective sleep therapy with our expert advice and support.

Please note that we specialise in testing for and treating Obstructive Sleep Apnoea in adults only. We cannot advise on Sleep Apnoea in those under 18 or other sleep conditions, such as insomnia.

If you have any questions about Sleep Apnoea, your symptoms or how to get tested, please contact us. Our friendly team can offer you the help and support you need.