Obstructive Sleep Apnoea (OSA)
Snoring and Obstructive Sleep
Apnoea (OSA) belong to a spectrum of breathing problems that can affect your sleep, health and quality of life.
Approximately 45% of normal adults snore at least occasionally, and 25% are habitual snorers. Sometimes the snoring can be bad and the throat blocks while sleeping. This is called OSA.
OSA is common amongst males and overweight people. It also becomes worse as people age.
What causes snoring and OSA?
Changes in your upper airway (soft palate, tongue and walls of your throat) take place when you sleep. These passages are usually kept open when we are awake but tend to collapse in deep sleep, causing narrowing (see Figure 1). As the passage collapse, airflow is reduced, causing soft tissue in these air passages to vibrate. This is snoring.
With complete collapse, you temporarily stop breathing. If this period lasts more than 10 seconds, it is known as apnoea.
Normal people should not have more than 5 episodes of apnoea in an hour during sleep.
If someone has more than 5 episodes of apnoea in an hour, he has OSA. Patients with severe OSA have more than 30 episodes of apnoea per hour.
You need an overnight sleep study to determine the severity of sleep disordered breathing.
What is the effect of apnoea on our body?
Every time you have apnoea, there is a release of stress hormones in our body. Many episodes of apnoea can happen each night, placing stress on our heart and brain. Our sleep is also disrupted because apnoeas are accompanied by miniarousals.
Figure 1
What are the effects of OSA on our health?
1. Sleep deprivation
When we have insufficient sleep, we feel tired the next day. This affects our work, concentration, memory and relationships with other people. There is a 7-fold increase in risk of having a motor accident.
2. High blood pressure
The risk of high blood pressure in OSA patients is 2 times higher than normal people.
3. Ischemic heart disease
4. Stroke
How is snoring treated?
Adults who suffer from snoring can try the following self-help remedies:
1. Reduce weight with a healthy diet and regular exercise
2. Avoid tranquilizers, sleeping pills and antihistamines before bedtime
3. Avoid alcohol for at least 4 hours before bedtime and heavy meals or snacks for 3 hours before sleeping
4. Establish regular sleeping patterns
5. Sleep on your side rather than on your back
6. Tilt the head of your bed upwards by 4 inches
How is OSA treated? OSA is treated medically or surgically.
1. Medical Treatment
a. Weight Loss & Exercise Programmes
b. Nasal Continuous Positive Airway Pressure
The patient wears a face mask to sleep. The mask gently blows air into you all the time, holding the airway open during breathing.
c. Oral Appliances
These appliances are like braces worn to sleep to reposition the tongue and lower jaw forward.
2. Surgical Treatment
There are many different types of surgery available. This is tailored to the site of obstruction. Your doctor will discuss the most appropriate treatment for you.
Yishun Health is a network of medical institutions and health facilities of the National Healthcare Group in the north of Singapore. It comprises Khoo Teck Puat Hospital, Yishun Community Hospital and community extensions such as Admiralty Medical Centre and Wellness Kampung. Khoo Teck Puat Hospital • (65) 6555 8000 • www.ktph.com.sg Yishun Community Hospital • (65) 6807 8800 • www.yishuncommunityhospital.com.sg