Whether it’s the soft gurgle from air making its way through a relaxed windpipe, or a full-blown window-rattling commotion that lasts from dusk ‘til dawn, we’re all familiar with the concept of snoring and the levels of severity.
And because it's so common, snoring is easy to brush off as a minor concern, or someone else’s problem, but chronic snoring could actually be a symptom of something far more serious than simply sleeping with your mouth open.
Sleep apnoea, for example, is an incredibly common sleep disorder that can have severe consequences later in life if left untreated.
So what exactly is sleep apnoea?
There are three types of sleep apnoea, all of which cause the walls of your throat to contract and block the airways while you sleep. The most common type is called Obstructive Sleep Apnoea.
Sleep apnoea means that you actually stop breathing—for anywhere from ten seconds through to a full minute, whilst asleep.
These interruptions can occur over thirty times an hour.
Sleep apnoea sounds scary because it is.
The brain will eventually register the lack of oxygen and send a slight wake-up call. You might snort and gasp, but your airways should reopen, and you will drift off back to sleep without even realising.
This pattern can continue throughout the night, literally repeating itself hundreds of times.
You wake up in the morning feeling like shit and are left wondering what you’ve done to deserve it.
Dr. Meghna Dassani, an expert in screening and treating Obstructive Sleep Apnoea, the most common form of the disorder, tells us that over time, “Untreated sleep apnoea can lead to chronic pain, poor performance at work, mental fogginess, and an impaired ability to relate to friends and family.”
While no evidence suggests anyone has died as a direct result of sleep apnoea, it’s a known factor of heart disease, which does kill tens of thousands of people each year.
There’s plenty of data to back that up.
Who experiences sleep apnoea?
Whether you’ve heard of this condition or are just considering its unusual spelling for the first time, sleep apnoea is quite common.
The Australian Sleep Health Foundation says one in three men over the age of 30 experience sleep apnoea to some degree. That’s almost one-third of the entire adult male population.
It’s also three times more prevalent in men than in women.
If you’re now curious about the likelihood of experiencing sleep apnoea yourself, Dr. Dassani says: “The common signs and symptoms to look out for are snoring, choking or gasping for breath, daytime drowsiness and fatigue, high blood pressure, and clenching or grinding of the teeth.”
Some of these symptoms are easy to identify, while others are trickier and will likely rely on a partner, flatmate, or family member to point out. It’s easy to see why nine out of 10 cases remain undiagnosed.
What causes sleep apnoea?
It can be the result of certain medical conditions, but most of the time, it’s the usual culprit: a rich, indulgent lifestyle that’s doing the damage.
Many, but not all, who experience Obstructive Sleep Apnoea, are overweight.
Excess fat can narrow the throat, and a large waistline can reduce the size of your lungs, forcing the airways to work harder.
Of course, smoking can be a major factor too, as it obviously affects both the lungs and the throat. The same goes for alcohol; drinking in the evening relaxes the throat muscles and slows the brain’s ability to reopen the airways.
Sleeping pills, sedatives and other medications can have a similar effect.
Sleep apnoea can be the result of something as simple as the shape of your face, size of your muscles, sleeping on your back, or suffering from a cold or flu.
With all these factors at play, it’s easy to see how it can affect so many men.
What are the treatments for sleep apnoea?
Before 1980, Surgeons would perform a tracheostomy on someone suffering from the sleep disorder (that’s the one where they make an incision in the windpipe so breathing can bypass the mouth and throat).
Pretty extreme, however you look at it.
Thankfully, modern treatments are far less “medieval”, with special masks, mouthguards and machines considered for mild to severe cases of sleep apnoea.
Dr. Dassani says before treatment, there needs to be a diagnosis via a sleep study.
“During the sleep study, a variety of body functions such as eye movement, heart rate, brain waves, and blood oxygen levels that occur during sleep are recorded and monitored,” she says.
“The sleep study can help the doctor point to the actual sleep disorder affecting the person.”
Assuming a sleep study discerns sleep apnoea to be the issue, the first line of treatment should be lifestyle-related. Consider diet and exercise to lose that excess weight and cut back on the booze and smoking.
It’s also important to make sure that you have a regular sleep pattern—the same bedtime and eight hours sleep each night—you know the drill.
If changes to your lifestyle fail to alleviate the symptoms, or the condition is the result of an underlying medical condition, it’s recommended that you consult a GP.
In Australia, GPs are able to refer directly for a sleep study, though in extreme cases, an otolaryngologist (that's an ear, nose, and throat, or "ENT" surgeon) might be brought in if surgery is required.
A sleep physician will also be able to look at mandibular advancement splints, which can be fitted by a dentist (if recommended) and are usually trialed before more serious avenues are explored.
There are medications and counselling options, too, although Dr. Dessani warns that they can be temporary fixes: “A lot of times these options act as Band-Aids—they address the symptoms short-term, leaving the cause of sleep apnoea untreated,” she says.
The more effective long-lasting treatments can involve masks worn while sleeping to increase air pressure to the throat and prevent it from collapsing. This is called “Nasal Continuous Positive Airway Pressure” (CPAP).
Another possible treatment is a specially made mouthguard that works by holding your lower jaw slightly forward and naturally supporting the airways. Anyone with a background in sports should find this treatment a breeze.
The key is finding a mask, machine or mouthguard that matches your needs. A quick Google search will reveal an overwhelming number of over-the-counter options, with prices scaling from around AUD$30 to AUD$300—be aware that many in the medical profession don't think that these machines are much use, especially without a doctor's consultation first.
You should always consult a GP or specialist before making any risky purchases.
If all other therapies fail, surgery to the palate or base of the tongue may be required. Another solution involves surgery to remove the tonsils.
These are only performed in severe cases, and it’s your otolaryngologist who specialises in sleep-related surgery.
So, if you’re waking up feeling fatigued, or have a partner that complains about your snoring, you may be experiencing some degree of sleep apnoea.
Have a chat with a GP, even if it’s only for peace of mind,—it might just be the consultation that drastically improves your quality of life.
Or at the very least, makes your mornings a whole lot more enjoyable.