Q& A

Irish Independent - Health & Living - - HEALTH MATTERS -

WMy part­ner has long com­mented on how I “give her a fright” when I’m sleep­ing. I snore which can some­times be a prob­lem for her, but she has reg­u­larly stated that I of­ten stop breath­ing in my sleep en­tirely and for very long pe­ri­ods be­fore re­sum­ing again, while other times I ap­pear to be strug­gling for breath. This is con­sid­er­ably worse, ap­par­ently, on oc­ca­sions I have been drink­ing al­co­hol. Re­cently, on

men­tion­ing this to a rel­a­tive, I was told that it might be sleep ap­noea. An un­cle of mine has been di­ag­nosed with it and sleeps wear­ing an oxy­gen mask. This is be­gin­ning to worry me. What can you

tell me about my symp­toms and might it be dan­ger­ous? I am a man in my mid-40s. hen we sleep, the mus­cles in our throat be­come more floppy. In most peo­ple this is not a prob­lem. How­ever, in those with ob­struc­tive sleep ap­noea (OSA), the mus­cles are so floppy that they cause the air­way to nar­row or col­lapse com­pletely. This blocks off the air­way caus­ing breath­ing to stop (ap­noea) or episodes of very shal­low breath­ing (hy­pop­noea). Clas­si­cally these episodes cause grunt­ing, gasp­ing or missed breaths dur­ing sleep. The af­flicted per­son is un­aware but their part­ner will hear them and may find these episodes fright­en­ing. Many will of­ten worry that the next breath may never come.

Re­duced air­flow leads to a fall in oxy­gen lev­els in the blood. The brain re­sponds by in­creas­ing the ef­fort to breathe, usu­ally caus­ing the per­son to gasp, grunt or wake briefly. The per­son then settles back to sleep and the cy­cle starts again. We all have oc­ca­sional episodes of ap­noea but if these episodes are oc­cur­ring more than five times an hour, then OSA is the likely di­ag­no­sis. Many peo­ple who suf­fer from OSA are un­aware that they are not sleep­ing well. They don’t re­call the fre­quent noc­tur­nal wak­ing but their part­ners are acutely aware of the prob­lem.

Those with se­vere OSA may fall asleep dur­ing daily ac­tiv­i­ties such as driv­ing or op­er­at­ing ma­chin­ery; the risk of car crash is in­creased by 7pc to 12pc. Other symp­toms in­clude poor con­cen­tra­tion or ir­ri­tabil­ity, morn­ing headaches, un­re­fresh­ing sleep and de­pres­sion.

The re­cur­rent episodes of low oxy­gen cause in­creased re­lease of stress hor­mones. This ul­ti­mately puts a strain on the heart lead­ing to an in­creased risk of high blood pres­sure, stroke, heart at­tack, and heart fail­ure. There is also a link be­tween OSA and di­a­betes.

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