Whether it’s the soft gurgle from the 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.
It’s common — 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 one of the most common sleep disorders that is often accompanied by snoring and can have severe consequences later in life if left untreated. Here's everything you should know about the condition.
What is sleep apnoea?
Sleep apnoea means that you actually stop breathing — anywhere from 10 seconds through to a full minute, whilst asleep. These interruptions can occur over 30 times an hour.
It sounds scary because, well, it is.
The brain will eventually register the lack of oxygen and send you 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.” [1]
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 — and there’s plenty of data to back that up [2].
What are the different types of sleep apnoea?
There are 3 main types of sleep apnoea [3]:
1. Obstructive sleep apnoea
Obstructive sleep apnoea (OSA) is the most common type of apnoea and it happens because of a blocked airway, which leads to pauses in your breathing. Your throat muscles relax and as a result, air can't flow into your lungs.
2. Central sleep apnoea
Not as common as OSA, central sleep apnoea indicates a problem in your nervous system. It happens when your brain doesn't transmit the right signals to the muscles that control your breathing patterns, causing regular stops to occur.
3. Complex sleep apnoea
Complex sleep apnoea combines both obstructive and central sleep apnoea. Though we're not certain what causes it, with complex sleep apnoea, an airway collapses and your brain stops sending the correct signals to your breathing muscles.
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 and can affect anyone.
The Australian Sleep Health Foundation says 1 in 3 men over the age of 30 experience sleep apnoea to some degree — that’s almost 1/3 of the entire adult male population [4].
The condition is 3 times more prevalent in men than in women, it happens more often in older adults and if you have family members who struggle with sleep apnoea, your odds of having it are also higher.
What are the symptoms of sleep apnoea?
If you’re curious about the likelihood of experiencing sleep apnoea yourself, Dr Dassani says: “The common signs and symptoms to look out for are loud 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 them out. It’s easy to see why 9 out of 10 cases remain undiagnosed.
What causes sleep apnoea?
Sleep apnoea 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 affects both the lungs and the throat. The same goes for alcohol; drinking in the evening makes the throat muscles relax and slows the brain’s ability to reopen the airways. Sleeping pills, sedatives and other medications can have a similar effect.
Additionally, sleep apnoea can be the result of something as simple as the shape of your face, the 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.
How long does sleep apnoea last?
Apnoea is a long-term, chronic sleep disorder, meaning there's no real cure for it. There are, however, ways to manage and even reverse common symptoms, which we'll get to shortly.
How is sleep apnoea treated?
Before 1980, surgeons would perform a tracheostomy on someone suffering from sleep apnoea, meaning they would make an incision in the windpipe so breathing can bypass the mouth and throat.
Pretty extreme, we know.
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, there are a few treatment options to consider.
Lifestyle changes
The first line of treatment should be lifestyle-related. Consider diet and exercise to lose that excess weight and cut back on booze and smoking.
It’s also important to make sure that you have a regular and healthy sleep pattern — the same bedtime every day, 8 hours of 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, we recommend that you see a doctor.
See a sleep specialist
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 trialled before more serious avenues are explored.
With Pilot's clinical sleep treatment, you get access to ongoing care and support from an Aussie practitioner, who will create a treatment plan that is personalised to you and your individual needs. Whatever questions or concerns you have, you can always chat with a specialist from the comfort of your own home.
Medications, masks, and mouthguards
There are medications and counselling options, too, although Dr Dessani warns that they can often 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, which 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 — but 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 sleep specialist before making any risky purchases.
Surgery
If all other therapies fail, surgery to the palate or base of the tongue may be required, while another solution involves surgery to remove the tonsils.
These are only performed in severe cases and should be recommended by your otolaryngologist who specialises in sleep-related surgery.
Can you prevent sleep apnoea?
As we mentioned before, sleep apnoea often happens as a result of lifestyle habits. So the best way to prevent it is simply by leading a healthy lifestyle: eating a balanced diet, moving your body regularly, losing weight if necessary, ditching the ciggies, and avoiding alcohol and certain medications.
If you’re waking up feeling fatigued, experience symptoms like excessive daytime sleepiness, 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.
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