Sleep Apnoea
Breathing and Sleeping…
… What could be simpler? For many people, the relaxed airway during sleep doesn’t just vibrate and make a noise (snoring), it also sucks shut causing them to choke in their sleep over and over throughout the night.
When snoring includes choking, or pauses, it is highly likely that it has progressed to some degree of obstructive sleep anpea (OSA).
What’s the difference between snoring and sleep apnoea?
When a person goes to sleep, the muscles in the body relax, including the muscles that hold the airway open when awake. In some people, the airway is narrow enough that the suction from just normal breathing causes the relaxed muscles of the airway to vibrate and make noise during sleep. This noise is what we call snoring.
Some people snore so badly the relaxed airway partially or completely sucks shut. Each event of airway collapse is called an "apnoea", which means "without breath". American spelling is “apnea” and British spelling is “apnoea”.
This can happen many times a night, and if it happens often enough it causes other complications such as tiredness or full bladder during the night, it can be diagnosed as Obstructive Sleep Apnoea Syndrome.
What? Will I choke to death?
No! The main problem is NOT that you will choke to death.
During an apnoea, the person continues to sleep even though they are struggling to breathe, until the need to take that next breath overcomes the ability to stay in deep sleep (which it will ALWAYS do at some point), and they then come out of deep sleep into lighter sleep, which allows the airway to pop back open again. So the airway always opens up, but at the cost of disrupted deep sleep. If deep sleep is being constantly disrupted, it is more likely the person will feel more sleepy at inappropriate times during the day than they would otherwise.
Most of the time they won't wake right up, so as soon as the airway is open they dive back down into deep sleep again and the process repeats itself over and over throughout the night. As the person changes from deep sleep to light sleep the muscle tone comes back and the airway pops open often with a loud gasp.
Even before the apnoea happens, airway nerves responding to the vibration of the muscles during snoring can send a signal to the brain that the snoring is actually the beginning of choking. The sleeping brain goes on alert and produces stress hormones which accelerate the heart rate and increase blood pressure. So even without apnoea itself, just the snoring alone can result in poorer sleep quality and daytime tiredness.
A closer look inside
This video shows how sleep apnoea works from the inside, demonstrates some of the common symptoms and complications, and also shows how some of the common treatments physically work.
Video showing how obstructive sleep apnoea occurs within the airway
So is disturbed sleep the only problem?
Apnoea and Health
When actual apnoea occurs, pressure changes in the airway and chest act on the heart and blood pressure system to cause the heart to beat faster and blood pressure to rise. Because this can happen over and over throughout the night, night after night, people who have sleep apnoea have a higher risk of developing high blood pressure and/or diabetes over time.
Weight gain
Chronic fatigue arising from the disturbed sleep associated with snoring can stimulate appetite which leads to weight gain which in turn can make the snoring and/or sleep apnoea more problematic.
Treatment of the snoring can break the cycle and assist sustainable weight loss through reduced appetite and increased energy for exercise.
Full bladder
Sleep disturbance throughout the night can prevent a person from producing the hormone that normally slows down urine production. People with problematic snoring and/or sleep apnoea are therefore more likely to need to go to the toilet during the night or first thing in the morning.
Treatment of problematic snoring and/or sleep apnoea allows the hormone to be produced normally during uninterrupted deep sleep, so the bladder slows down for the night as it should.
How can you help me?
The doctors and health professionals at the SLEEP WELL CLINIC provide comprehensive home sleep testing and treatment services for anyone suffering problematic snoring, or possible sleep apnoea.
Consulting doctors are available by appointment throughout Aotearoa New Zealand.
We also offer testing and treatment services to patients in other centres using portable monitors and extensive phone or telemedicine support for consultations.
Wherever you are, our therapy support team ar available throughout the week by telephone to help you with your treatment once you get started.
Sleep Test
A simple home Sleep Test measuring oxygen levels and heart rate is a helpful first step because sleep apnoea is so common and you can't tell easily if someone is just snoring or if they have sleep apnoea.
The sleep test will assess cardiometabolic risk, and it will also rule in and rule out different treatment options, so you aren’t left guessing.
You should always perform a sleep test to check for apnoea before treating snoring.
Pros: The test will be followed up with a consultation with one of our doctors and you will know what the right treatment is for you.
Also: If a repeat test or even a higher level home test is required, we will provide at no extra cost.
Mandibular Splint
Mandibular Advancement Splints (MAS) are mouthguard-like devices that are adjusted to pull the bottom jaw forward during sleep so that the airway becomes more open. There are several designs available, but not all are the same.
Pros: Small and portable and can help with snoring and mild sleep apnoea.
Cons: Lower success than CPAP and not recommended for moderate sleep apnoea. Because of this, we might suggest a trial splint that can be used to work out the correct settings and ensure the MAS is right for you before committing to a specialist model.
CPAP Therapy
CPAP stands for Continuous Positive Airway Pressure. Originally developed for more severe sleep apnoea, modern CPAP therapy has increasingly been used to manage mild sleep apnoea and more recently, even social snoring. CPAP uses a small increase in airway pressure through a mask to stop snoring and sleep apnoea. The Sleep Well Clinic has a clinical support team who help people try CPAP for a few weeks before making a long-term decision.
Pros: 100% guaranteed elimination of snoring and/or any severity of sleep apnoea.Cons: Less portable than MAS or surgery.