- 1. What is Obstructive Sleep Apnoea?
- 2. Symptoms of Obstructive Sleep Apnoea?
- 3. Who has Obstructive Sleep Apnoea?
- 4. This could be me, what should I do?
- 5. Are there any regulations about driving if you have OSA?
- 6. Is Obstructive Sleep Apnoea (OSA) a disability (under the equality Act 2010)?
- 7. How do I travel with CPAP?
- 8. 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?
It is estimated that 5% of the population are affected by Obstructive Sleep Apnoea (OSA). 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.
In children the commonest cause is enlarged tonsils. Nowadays sleep apnoea is a common reason for recommending that a young child has a tonsillectomy.
Sleep apnoea and heavy snoring, severe enough to interfere with sleep quality, is probably much more common than is realised. At least three in every thousand men have severe sleep apnoea.^ TOP
Q. 4. This could be me, what should I do?
Speak to your GP who will be able to refer you 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 Helpline on 0800 025 3500 choose option 1 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. Is Obstructive Sleep Apnoea (OSA) a disability (under the equality Act 2010)?
Untreated, obstructive sleep apnoea can be very disabling. But it is not a disability as the condition can be treated by a simple painless non-surgical approach available entirely free of charge on the NHS.
For most patients, the treatment, using a CPAP machine, is wonderfully effective and dramatic.
Many users experience a return to energy levels that they have not enjoyed for many years.
The main symptoms such as constant and excessive sleepiness, memory impairment, mood swings, irritability and under performance at work are quickly eliminated.2
Longer term benefits are still being intensively researched, but the 20% reduction in life expectancy3, if not diagnosed and treated, is rapidly mitigated
The best treatment for OSA on the NHS is continuous positive airway pressure (CPAP).
This involves wearing a mask over the nose (or nose and mouth) during sleep, connected to a quiet pump beside the bed. It supplies slightly pressurised air to keep the throat open. The mask allows the breathing to return to normal during sleep and usually ends the snoring!
Many partners enjoy sleep that they have not experienced for even longer, as they are not disturbed by their partner’s snoring any more.
When successfully treated, any concerns about driving while sleepy disappear, and no driving restrictions are imposed by the DVLA.
2 https://www.nice.org.uk/guidance/ta139/chapter/1-Guidance plus the results of many clinical trials carried out all over the world, hence the NHS Treatment Path
3 https://www.gov.uk/government/news/motorists-warned-about-dangers-of-untreated-obstructive-sleep-apnoea- syndrome
Q. 7. 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.^ TOP
Q. 8. 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.^ TOP