More than half a million people in the UK are thought to have sleep apnoea but less than one in four are aware of it.
"Sleep apnoea is a major cause of disability due to the daytime sleepiness it causes," says Professor John Gibson, a sleep apnoea expert at the British Thoracic Society (BTS).
"This can seriously affect social functioning, work performance and the ability to drive safely.
"Hundreds of thousands of sufferers are still undiagnosed in the UK, usually because the condition has not been considered by individuals or their doctors."
Sleep apnoea is a respiratory condition in which the throat narrows or closes during sleep and repeatedly interrupts a person's breathing.
This results in recurrent falls in the oxygen level in the blood and the frustrated breathing efforts cause the brain to wake the person up.
This can occur hundreds of times a night without the sufferer realising, leading to poor sleep quality and severe sleepiness during the day.
The good news is that if you are diagnosed with sleep apnoea, something can be done. You will probably be prescribed Continuous Positive Airways Pressure (CPAP) where a machine raises and regulates the pressure of air breathed in and prevents the airway from collapsing during sleep (see picture above).
Symptoms include heavy snoring, daytime sleepiness, morning headaches, poor concentration and an increased need to pass urine at night.
Overweight men between 30 and 65 are most commonly affected. The incidence of sleep apnoea in women is lower, which may be partly explained by a lack of awareness of the condition.
Sleep apnoea also affects children, particularly those with enlarged tonsils or adenoids.
Health risks
If left untreated, the condition can increase the risks of high blood pressure, coronary heart disease, stroke and diabetes.
People with sleep apnoea are seven to 12 times more likely to have a road accident than those without the disorder, according to the BTS.
Tests show that people driving with sleepiness due to sleep apnoea perform worse than drivers with blood alcohol levels over the legal drink drive limit.
You are unlikely to be aware that you have problems breathing while you are asleep unless your partner or a family member notices the episodes of stopping breathing.
However, if your sleep is continually disrupted you may become aware of the problem and you will begin to experience symptoms of sleep apnoea during the day.
The most common symptoms are:
- Snoring
- Witnessed episodes of stopping breathing during sleep
- Restless/unrefreshing sleep
- Frequent trips to the loo every night
- Morning headaches
- Excessive daytime sleepiness
- Irritability
- Impaired concentration
- Decreased libido
Diagnosis
Most patients can be diagnosed by doing a home recording. Recorders are available for people to wear overnight in bed.
These register either the blood oxygen level alone or oxygen plus snoring, heart rate and breathing efforts using sensors on the finger and around the body.
If you have been diagnosed with sleep apnoea you will probably be prescribed CPAP to reduce your symptoms.
The patient wears a mask over their nose and mouth, and a machine raises and regulates the pressure of the air breathed in, preventing the airway from collapsing during sleep.
CPAP has good results; by controlling the apnoea it improves the quality of sleep and the person awakes feeling much more refreshed and remains alert throughout the day.
CPAP also suppresses the snoring, meaning the person's partner can also sleep better.
A minority of patients find CPAP treatment very uncomfortable to use. They may be helped by a mouth splint (also called a mandibular advancement device) made by a specialised dentist, but the benefit is less predictable than that of CPAP.
Surgery is rarely used in treating sleep apnoea, apart from removing the tonsils when these are very large.
