OBSTRUCTIVE SLEEP APNOEA
What is obstructive sleep apnoea?
Obstructive sleep apnoea is a debilitating sleep and breathing disorder
defined as the cessation of breathing for 10 seconds or more (an apnoea) at
least five times per hour of sleep. During sleep, the body's muscles relax,
which can cause excess tissue to collapse into the upper airway (back of the
mouth, nose and throat) and block breathing. When breathing is interrupted by
an obstruction in the airway, the body reacts by waking enough to start
breathing again. These arousals may occur hundreds of times each night but do
not fully awaken the patient, who remains unaware of the loud snoring, choking
and gasping for air that are typically associated with obstructive sleep
apnoea. Obstructive sleep apnoea sufferers never get "a good night's
sleep" because repeated apnoeas and arousals deprive patients of REM and
deep-stage sleep, leading to chronic daytime exhaustion and long-term
cardiovascular stress.
What are the health implications of obstructive sleep apnoea?
Obstructive sleep apnoea has a profound impact on an individual's health.
Excessive daytime sleepiness caused by disruption of normal sleep patterns
leads to a significant increase in the rate of accidents for obstructive sleep
apnoea patients, including a sevenfold increase in automobile accidents. Over
the long term, obstructive sleep apnoea is associated with greater risk of
hypertension and cardiovascular disease and the National Commission on Sleep
Disorders Research estimates that 38,000 cardiovascular deaths due to sleep
apnoea occur each year.
In addition, loud snoring and intermittent breathing interruptions can
affect the quality of sleep of the obstructive sleep apnoea patient's
bedpartner. Witnessing an apnoea can be a frightening experience because the
obstructive sleep apnoea patient appears to be suffocating. Frequently, it is a
sleep-deprived bedpartner who convinces the apnoeic patient to seek medical
help.
Who suffers from obstructive sleep apnoea?
Twenty-four percent of adult men and nine percent of adult women are
estimated to have some degree of obstructive sleep apnoea. Of these, around one
in three are estimated to have cases severe enough to warrant immediate
therapeutic intervention. However, obstructive sleep apnoea was not well
understood or recognised by physicians and general practitioners until
recently, and only a fraction of obstructive sleep apnoea patients have been
diagnosed and treated.
With increased awareness in the doctor and patient communities, a growing
number of new patients are expected to be identified for treatment in the next
few years.
While obstructive sleep apnoea is commonly associated with obesity and male
gender, it affects a broad cross-section of the population. Other risk factors
include habitual snoring, which is often a precursor of more serious upper
airway disorders such as obstructive sleep apnoea. In fact, results from a
recent study indicate that one in three men and nearly one in five women who
snore habitually suffer from some degree of obstructive sleep apnoea.
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