The importance of sleep
What is obstructive sleep apnoea (OSA)?
Obstructive sleep apnoea occurs when your upper airway (the part between your nose and Adam’s apple), narrows and shuts during sleep.
This can result in apnoeas - when the airway closes completely, and hypopnoeas – when the airway partially closes.
Apnoeas and hypopnoeas can last as long as 45 seconds at a time and happen many times during the night resulting in very disturbed sleep.
People usually ask for medical help because of a partner’s concern or because they feel very sleepy at inappropriate times (for example when driving the car or during a meal).
The DVLA has published a very helpful leaflet ‘Tiredness can kill’ and there is more information about when to contact the DVLA below. Please read this information very carefully.
What are the symptoms of OSA?
Loud snoring.
Pauses in breathing (confirmed by partner).
Restless sleep.
Feeling unrefreshed on awakening, headaches, loss of concentration.
Excessive daytime sleepiness.
Could I have sleep apnoea?
Do an Epworth Sleepiness Scale test below.
What causes OSA?
In approximately 50% (about half) of people with OSA weight is a factor.
OSA is considered to be more common in men and in the over 50s.
For women the risk increases after the menopause.
Occasionally it may be due to a problem with the upper airway such as enlarged tonsils.
How do I get tested for Sleep Apnoea?
We can offer home sleep apnoea screening tests (the kit is fitted when you attend Albyn Hospital but you go home and your sleep is analysed overnight).
A video below shows the kit we use. A test costs £210 (price correct as of Feb 2023). The fee for this is paid to Albyn.
Can OSA be treated?
Yes. Continuous Positive Airways Pressure (CPAP) which involves using an air pump and a mask is the most effective way to treat OSA.
CPAP works by delivering pressure to your upper airway which pushes the airway open to prevent it collapsing.
It’s the best treatment for moderate to severe sleep apnoea.
For mild sleep apnoea devices which pull your lower jaw forward and take the tongue away from the back of your mouth can help. These are called mandibular repositioning devices are fitted over your teeth.
If I need treatment what happens next?
We contact a company called ResMed and CPAP therapy is provided by them directly to you. A machine is sent to you and training provided to you how to use it. Using technology they can remotely assess how well the treatment is working. They have an excellent website which you can link to here explaining more.
What does CPAP therapy feel like?
When you use CPAP for the first time you will notice the pressure when breathing in and out and may feel you need to consciously push the air out. This is normal and as you get used to the therapy it will subside.
Tip: When you are just starting CPAP, try using it when you are distracted by something such as a TV programme. In this way you will gradually become used to the feeling of having a mask on your face with some pressure.
Modern CPAP machines are designed to adjust the pressure automatically so you get just the right amount to keep your airway open at any time.
Ramp - This is used to keep the pressure at minimum for a short period after you turn the machine on to give you time to fall asleep.
Humidification - Some people find CPAP makes their mouth and throat very dry. If it doesn’t settle down a humidifier can be added to the CPAP machine that puts some moisture into air before you breathe it in.
What are the guidelines around driving and the DVLA?
The latest DLVA guidelines discuss what to do - it is your legal responsibility to let them know if you have moderate or severe sleep apnoea (given the increased risk of road traffic accidents). Please also read their leaflet ‘Tiredness can kill’ which provides more useful information.
