Managing obstructive sleep apnoea

Obstructive sleep apnoea (OSA) is a condition that affects your breathing while you sleep. It’s a common problem that’s estimated to affect 1.5 million people in the UK. It affects men more than women and usually occurs in people aged over 40.

As OSA interrupts your sleep, it can leave you feeling tired during the day and cause poor concentration, as well as other side effects of sleep deprivation.

How does OSA affect you?

OSA happens when your throat closes up while you are asleep, temporarily blocking your airways. Your throat can close partially (hypopnoea) or fully (apnoea).

This interruption to your breathing pulls you from your deep sleep and sometimes briefly wakes you up fully. It usually happens repeatedly, which prevents your body from getting the quality of sleep it needs to function properly.

If you regularly don’t get enough sleep, you can develop a variety of short and long-term health problems, including low energy, poor concentration, heart disease, poor immunity and mental health issues.

How do you know if you have OSA?

As OSA happens while you’re asleep, you might not know that you have it. However, you or your partner may notice symptoms, such as loud snoring, suddenly waking up in the middle of the night, feeling excessively tired in the daytime, difficulty concentrating and having headaches in the morning.

If you suspect you have OSA, your doctor can carry out a type of sleep test called a polysomnography. During the test, your heart, lung, and brain activity, body movements, oxygen levels and breathing patterns will be monitored while you are asleep.

Sometimes an apneagraph is used to diagnose OSA. An apneagraph measures how much oxygen is in your blood while you sleep. A small tube containing sensors is placed through your nose and into your throat. The tube is connected to a recorder that collects the oxygen measurements. You’ll have the apneagraph fitted and can then go home and sleep with it in place.

The results of these tests will allow your doctor to diagnose your sleep problems and advise the best course of treatment.

How can you manage OSA?

If you are diagnosed with OSA, a number of lifestyle changes can help reduce its effects and help you sleep better. These include:

• Avoiding sleeping on your back
• Maintaining a healthy weight and taking regular exercise
• Not taking sleeping pills or other sedatives
• Stopping drinking alcohol or cutting back
• Stopping smoking
• Using a nasal decongestant before you go to sleep

What if lifestyle changes don’t help?

If you’ve made lifestyle changes and your condition still hasn’t improved, there are treatments available that can help regulate your breathing while you sleep. The treatments use equipment to help you breathe and keep your airways open.

A continuous positive airway pressure (CPAP) device is a type of mask that fits over your mouth or nose and increases the pressure of the air that you breathe while you sleep. The constant raised air pressure helps keep your airways open. It can help prevent both OSA and snoring.

If you find the constant air pressure delivered by a CPAP device difficult to manage, a bilevel positive airway pressure (BPAP) device might be recommended. It’s similar to a CPAP device, but it delivers two different levels of air pressure — one when you breathe in and another when you breathe out.

While these devices are very effective at keeping your airways open, the masks can feel uncomfortable at first and can take a bit of time to get used to.

If you only have moderate OSA, you might not need a positive airway pressure device. In less severe cases, mouthpieces can be effective at keeping your airways open. They work by either bringing your jaw forward or by changing the position of your tongue.