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Find out more about Obstructive Sleep Apnia

What is Obstructive Sleep Apnia?

Obstructive Sleep Apnia (OSA), pronounced ap-nee-ah, is a common disorder in which complete or partial obstruction of the airway during sleep causes loud snoring and frequent arousals. As a result affected persons don't get a restful sleep and suffer excessive daytime sleepiness. The precise cause of this condition is unknown, however research has shown that being overweight and male does seem to increase the risk of developing OSA. However, OSA is also seen in individuals that are not overweight, and in this instance a naturally small lower jaw is often the cause.

Why does it happen?

Whether it is excess weight, especially around the neck, or a reduced lower jaw size, the effect is the same. The airway passages in the neck are supported by soft flexible cartilage and tissue, and this is perfect for flexibility, swallowing and talking. However, upon lying down gravity takes effect, and the tongue and soft palate will naturally drop backwards onto the pharynx (the cavity at the back of the nose and throat). The resulting extra weight pushes on the airways and restricts airflow. This is the mechanism responsible for snoring, as the airway narrows tissues are pushed together and vibrate upon breathing in. Falling asleep further relaxes the surrounding tissues and further reduces the airway passage. You could think of it much like a garden hose, if you press on it the water flow is slowed down, if you press harder the water flow will cease, this is what happens in OSA. The lack of airflow into the lungs alerts the brain that more oxygen is needed, so the brain stirs you just a little from your sleep so that breathing is corrected. This sequence can go on all night, and sleep disturbances can range from around five times an hour up to one hundred times an hour in severe cases.

How do I know if I have OSA?

Sufferers of OSA are often oblivious to the waking episodes and the only symptom may be extreme tiredness upon waking in the morning, or a partner complaining of very loud snoring! Of course, badly broken sleep increases daytime sleepiness, which can become embarrassing or even dangerous if a person doses off, for example, whilst driving. This condition can often go unrecognised, unless detected by a witness to the apnoea episodes during sleep. Indeed, it is often the partners of OSA sufferers that alert the person to the fact they have these brief periods of breathing cessation. The loud snoring that accompanies OSA can disturb a partner's sleep, and they may become aware of the breathing problems. If you suspect you suffer from OSA, it could be worthwhile asking your partner to watch you whilst you are asleep. If you discover, or already know this is happening don't worry, there is an effective safe treatment called continuous positive airway pressure, or, CPAP.

What is CPAP treatment?

Continuous positive airway pressure, as the name suggests, involves applying a continuous, steady, low positive air pressure to the upper airway to keep it open. If we refer back to the analogy of the hosepipe mentioned above it may become clearer how CPAP works. If you can, imagine a pump attached to the end of our collapsing hosepipe. As positive pressure from the pump is forced into the hose whilst the negative obstructive pressure remains, the positive pressure will force the hose to open. You can see that a blockage is far less likely to occur. This is the basis of CPAP treatment, with the force of air being very carefully controlled with special equipment. The effects can be life changing, with many users getting a full night sleep for the first time in years. Success rates for curing sleep apnia using CPAP are around 85 - 95%, reflecting the value of this natural treatment for a condition that many suffer from, often in silence.

References

Victor LD (1999) Obstructive Sleep Apnia. American Family Physician 60 [text only]

Malhotra A & White DP (2002) Obstructive sleep apnia. The Lancet 360, 237-245

The correct spelling for this condition is sleep APNOEA, or APNEA in the US. However, we are aware that many people search for 'sleep apnia', or 'sleepapnia' in Google and other search engines. So, for those people looking for information about sleep apnia or sleepapnia, here's your chance.