Sleep apnoea is a sleeping disorder that affects the way you breathe when you sleep. There are two types: Obstructive Sleep Apnoea (OSA) and Central Sleep Apnoea (CSA), and sometimes you can experience a mix of the two types. However, the most common type in OSA; an estimated 1.5 million people in the UK with this condition experience mild to severe symptoms, with only 330,000 currently receiving the treatment they need.
Research conducted by the Office of Health Economics for the British Lung Foundation has revealed that ‘investing more in awareness, diagnosis and treatment of OSA’ is the key to relieving the suffering associated with the condition. There are many misconceptions about sleeping disorders, in particular sleep apnoea, which can delay or prevent diagnosis. This is particularly worrying, due to the fact that sleep apnoea can cause other serious health issues, and can even lead to accidental death (sleepiness contributes to up to 20% of motorway accidents).
The misconceptions about sleep apnoea
As mentioned, sleep apnoea is the subject of many misconceptions. Unfortunately, this may mean that the condition is not taken seriously by some, and there are stigmas attached to it that may make it embarrassing for OSA sufferers to seek treatment. Prolonging the diagnosis of sleep apnoea may make the condition worse, and deteriorate the patient’s physical and mental health. Misconceptions include:
OSA only affects those who are overweight
There is a very common stereotype that OSA only affects those who are overweight. At The Coker Chest Clinic, we see many patients who are slim and suffer from terrible sleep apnoea. In fact, around 20% of adults presenting with OSA have a normal BMI. This is because the condition can be caused by a narrowing of the throat, enlarged uvula, increased tongue size or other cause unrelated to obesity.
Symptoms of OSA can be relieved with weight loss
You may visit your GPs with symptoms of sleep apnoea (snoring, waking up feeling groggy, daytime tiredness), and are subsequently told to lose weight to see if the symptoms disappear.
Unfortunately, for many sleep apnoea sufferers, losing weight is almost impossible due to the fact that sleep apnoea prevents efficient production of the hormone leptin within the body. Leptin aids in the regulation of energy balance by making you feel full, allowing your body to use up fat reserves and keeping you from gaining weight. Without leptin, you begin to get food cravings and start overeating, leading to weight gain. Therefore, you first need treatment for sleep apnoea before you can address your weight.
Sleep apnoea is just a term for snoring
Snoring is a symptom of sleep apnoea, but it is not the only symptom. Other symptoms of sleep apnoea include:
- Daytime tiredness
- Irritability and mood swings
- Waking up with a dry mouth
- Decreased libido
- Sweating during sleep
Snoring should not be dismissed. It is not normal for people to snore while they sleep, and can indicate OSA or another serious underlying medical condition. It can also impact the quality of sleep, and subsequently mental and physical health, of your partner.
If you seek treatment for sleep apnoea, your driving license will be taken away
Tiredness and sleep apnoea can cause a loss of concentration, slower reaction times, and falling asleep at the wheel, which is a reason why you should seek help straight away. It is your responsibility to contact the DVLA to report this condition; however, this does not mean that your license will be instantly revoked. At The Coker Chest Clinic, we treat OSA within 2-3 days, meaning that, by the time the DVLA contacts us to report on your treatment, you will likely have already received successful treatment and there is no need to take any break from driving.
However, regardless of where you receive treatment, the dangers of driving with OSA far outweigh the temporary loss of your license.
Misdiagnosis of sleep apnoea
The misdiagnosis of sleep apnoea can be devastating to your health. Not only can the condition itself lead to long-term health problems ( high blood pressure, heart disease, diabetes, stroke and heart attack, loss of libido and /or impotence due to low testosterone and, in the worst case scenario, death. A patient who is given the wrong treatment may see their symptoms worsen or even develop complications mentioned above as a result. Sleep apnoea is commonly misdiagnosed as:
High blood pressure (hypertension)
35-80% of OSA sufferers also suffer from high blood pressure. Although it is uncertain whether the two conditions are simply associated, or whether there is a causal link, patients presenting with high blood pressure are often not investigated for OSA, and thus only treated for high blood pressure.
If the OSA is not addressed, it is unlikely that you will respond to hypertension treatment as expected, and their blood pressure may remain high. This puts them at a 60% risk of stroke, as well as heart attack and heart disease.
Many patients with OSA are misdiagnosed with depression and are prescribed antidepressants as a treatment. A side effect of some antidepressants is insomnia or disturbed sleep, so for a patient who is already experiencing these symptoms, this treatment can exacerbate the problem.
Ensuring you get the correct diagnosis
Sleep apnoea is not difficult to diagnose. There are three questions that should be asked when diagnosing a patient before referring them to a sleep clinic:
- Are you snoring?
- Are you waking up refreshed?
- Are you generally feeling tired?
If the respective answers to these questions are ‘yes’, ‘no’ and ‘yes, you are likely to be experiencing sleep apnoea, and should be referred.
Once you complete a sleep test and the diagnosis of OSA is confirmed, you can receive the appropriate treatment. OSA patients are given treatment options based on the severity of their sleep apnea syndrome. The treatments include mandibular splints, CPAP therapy or hypoglossal nerve stimulation, which has been established in multiple clinical studies as an effective remedy for this condition. Patients with OSA-induced heart problems and high blood pressure will also see significant improvements, normally within 12 weeks of therapy.