Obstructive sleep apnoea (OSA)

Symptoms of obstructive sleep apnoea

Obstructive sleep apnoea (OSA) may lead to regularly interrupted sleep.

This can have a big impact on quality of life and increases the risk of developing certain conditions.

Symptoms include:

• excessive daytime sleepiness
• loud snoring
• poor concentration
• noisy and laboured breathing while you sleep
• repeated short periods where breathing is interrupted by gasping or snorting
• mood swings, personality changes or depression

The symptoms of OSA are often first spotted by a partner, friend or family member who notices problems while you sleep.

Some people with OSA may also experience night sweats and may wake up often during the night to urinate.

There may be a loss of libido (desire for normal sexual activity).

During an episode, the lack of oxygen triggers your brain to pull you out of deep sleep, either to a lighter sleep or to wakefulness, so your airway reopens and you can breathe normally.

These repeated sleep interruptions can make you feel very tired during the day.

You'll usually have no memory of your interrupted breathing, so you may be unaware you have a problem.

When to seek medical advice

You should see your GP if you think you might have OSA.

They can check for other possible reasons for your symptoms.

They can also refer you to hospital for investigation and an assessment of your breathing while you sleep.

As someone with OSA may not notice they have the condition, it often goes undiagnosed.

Causes of OSA

It's normal for the muscles and soft tissues in the throat to relax and collapse to some degree while sleeping. For most people this doesn't cause breathing problems.

In people with OSA, the airway has narrowed as the result of a number of factors, including:

• being overweight 
• being male 
• being 40 years of age or more – although OSA can occur at any age, it's more common in people who are over 40
• having a large neck – men with a collar size greater than around 43cm (17 inches) have an increased risk of developing OSA
• taking medicines with a sedative effect – such as sleeping tablets or tranquillisers
• having an unusual inner neck structure 
• drinking alcohol, particularly before going to sleep, can make snoring and sleep apnoea worse
• smoking 
• the menopause (in women) 
• having a family history of OSA 
• nasal congestion – OSA occurs more often in people with nasal congestion

Treating OSA

OSA is a treatable condition, and there are a variety of treatment options that can reduce the symptoms.

Treatment options for OSA include:

• lifestyle changes – such as losing excess weight, cutting down on alcohol and sleeping on your side
• using a continuous positive airway pressure (CPAP) device – these devices prevent your airway closing while you sleep by delivering a continuous supply of compressed air through a mask
• wearing a mandibular advancement device (MAD) – this gum shield-like device fits around your teeth, holding your jaw and tongue forward to increase the space at the back of your throat while you sleep

Surgery may also be an option if OSA is thought to be the result of a physical problem that can be corrected surgically, such as an unusual inner neck structure.

For most people surgery isn't appropriate and may only be considered as a last resort if other treatments haven't helped.

Preventing OSA

It's not always possible to prevent OSA, but making certain lifestyle changes may reduce your risk of developing the condition.

These include:

• losing weight if you're overweight or obese
• limiting how much alcohol you drink and avoiding alcohol in the evening
• stopping smoking if you smoke
• avoiding the use of sleeping tablets and tranquillisers

• Sleep apnoea