- 1. What is Obstructive Sleep Apnoea?
- 2. Symptoms of Obstructive Sleep Apnoea?
- 3. Who has Obstructive Sleep Apnoea? (also covers children)
- 4. This could be me, what should I do?
- 5. Are there any regulations about driving if you have OSA?
- 6. How do I travel with CPAP?
- 7. How do I found out more?
People with Obstructive Sleep Apnoea (OSA) are unable to sleep properly. Their sleep is constantly disrupted by snoring and obstructed breathing to the extent that they briefly stop breathing. This can happen several hundred times each night. Sufferers often fall asleep during the day even whilst working or driving.
Obstructive Sleep Apnoea is caused by excessive narrowing of the throat during sleep. Anything that makes the throat narrower to start with (for example enlarged tonsils or a set-back lower jaw) means that it is easy for the throat to close off a bit more and block the airway. A partially blocked nose generates lower pressures in the throat whilst taking a breath in, which tends to suck the walls of the throat together.
Probably the most important factor is being overweight with a big neck. Extra fat in the neck squashes the throat from outside, particularly when the throat muscles become floppier with sleep.
Central Sleep Apnoea is slightly different, in this variant the brain forgets to breath during sleep.^ TOP
Q. 2. Symptoms of Obstructive Sleep Apnoea?
Because sleep can be so disrupted by the body having to wake up briefly to reverse the upper airway obstruction, sufferers experience severe daytime sleepiness. To start with this occurs only during potentially boring activities such as reading, watching television or driving on motorways. However, when the sleepiness gets worse it begins to interfere with most activities, with patients falling asleep talking or eating. Poor work performance can lose the sufferer his job and of course sleepiness whilst driving can be fatal (sleep apnoea sufferers are about seven times more likely to have car accidents). Snoring will usually have been present for many years, and have gone well beyond a joke within the family.
There are many other symptoms that one would predict in someone seriously sleep deprived (irritability for example) but the twin symptoms of snoring and daytime sleepiness are the best pointers to the diagnosis.^ TOP
Q. 3. Who has Obstructive Sleep Apnoea? (also covers children)
It is estimated that up to 13% of adult men (20 to 70) and 6% of adult women (20 to 70) in the UK suffer from Obstructive Sleep Apnoea (OSA). That is 4 million people. They are mostly (but not all) men, mostly (but not all) overweight, especially around the neck, and they all snore. They feel tired and sleepy during the day and at night are often observed to stop breathing.
The sort of person we see most commonly with heavy snoring and sleep apnoea is a middle aged man, usually taking a size 17″ collar or more. However, there are many patients with sleep apnoea who are not particularly overweight. In some patients we simply do not understand why they have sleep apnoea.
Sleep apnoea and heavy snoring, severe enough to interfere with sleep quality, is probably much more common than is realised.
OSA and CHILDREN
If you suspect your child has sleep apnoea, the Great Ormond Street Hospital for Children has excellent information for parents on its website and you can reach it by clicking here.
In children the commonest cause is enlarged tonsils. Nowadays sleep apnoea is a common reason for recommending that a young child has a tonsillectomy.
Q. 4. This could be me, what should I do?
There are two self assessment forms you can use.
The first, STOP BANG identifies if there is likelihood you may have obstructive sleep apnoea. If you score is over 3 or over you are at risk of having obstructive sleep apnoea. Take the STOP BANG to your GP and discuss a referral to a Sleep Clinic
Stop Bang Questionnaire Jan 2019
The second , the Epworth Sleepiness Scale (ESS), identifies if you may be suffering from excessive sleepiness during waking hours, a common symptom of a sleep disorder. If your score is 10 or over take the ESS to your GP and discuss referral to a specialist sleep clinic.^ TOP
Q. 5. Are there any regulations about driving if you have OSA?
Yes there are – these are dealt with in more detail on our Driving and Sleep Apnoea page but If you have been diagnosed as a sufferer of Obstructive Sleep Apnoea Syndrome (where syndrome is the symptom of excessive sleepiness liable to interfere with your ability to drive safely), the DVLA must be informed. It is the legal responsibility of the licence holder to inform the DVLA, and if they fail to do so they are committing an offence. But please follow our advice on informing the DVLA, only do it in writing with a letter and also follow the advice of your Sleep Clinic. If you have any doubts, please call the SATA on 0800 025 3500 and ask for advice. Please also remember that your insurance company is entitled to request medical details for any condition currently under treatment, as are the police following severe accidents. If undeclared, your insurer may refuse to support any claim.^ TOP
Q. 6. How do I travel with CPAP?
An explanatory letter from your Sleep Clinic should accompany the machine to show to Customs or Security officials.
Always check the electrical details of the countries you are visiting in advance. Some Sleep Clinics have multi-voltage machines available on loan or hire so please check in plenty of time. Remember, you may need an extra-long extension lead, spare fuses can also be helpful.
When flying, the CPAP machine should always be carried as hand luggage and must not be stored in the hold. Try and use a suitable case.
For more information about the individual airlines flying out of the UK click this link.^ TOP
Q. 7. How do I found out more?
If you would like to learn more contact the Sleep Apnoea Trust direct. Our contact page tells you how.