SHARES
Allan is perplexed. No matter how many hours of sleep he clocked, he would be extremely sleepy – falling asleep while driving and at class lectures. He could not understand the reason that he is tired all the time. He also experienced frequent nightmares of being choked or drowning. Soon, he discovered that people started to complain about his annoying loud snores.
Most of us have encountered roommates that snore, and this noise disturbs our sleep. However, snoring is more than an annoyance, it may be an indicator for a dangerous sleep condition – obstructive sleep apnoea (OSA).
What is OSA?
In a person with OSA, shallow or stopped breathing can be observed briefly during sleep.
Abnormal breathing occurs when the throat muscles relax erratically during sleep, causing the airway to narrow or close. This leads to inadequate or no breathing for 10 to 20 seconds, which results in reduced oxygen level and increased carbon dioxide in blood. As the brain registers the difference in blood chemistry, the brain signals for sudden awakening of the person to allow reopening of the airway. Breathing usually resumes with loud snoring. This pattern can repeat itself throughout the night. Nevertheless, it is likely that the person is unaware about the sleep interruption.
Someone with OSA usually snore at night, usually first complained by their roommates. He or she might also wake up with sudden choking or gasping. Due to disturbed sleep at night, the person might feel sleepy or fatigue during the day, which can cause trouble concentrating, depression or irritability. Some young children may experience these symptoms too, unaware that they are caused by OSA.
How is OSA diagnosed?
Not everyone that snores has OSA. Hence, physical examinations and additional tests are usually required to confirm the diagnosis for OSA. During the test, sensors are placed on various parts of the body to measure body functions. There are two common tests to detect OSA:
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Polysomnography (PSG)
The gold standard for the diagnosis of OSA is through overnight sleep study with PSG. This test is performed by having at least seven sensors attached to the patient. The sensors would then measure brain waves, heart rate, eye and leg movements, breathing, blood oxygen level and snoring throughout the night. These measured parameters can provide information for accurate diagnosis for OSA.
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Peripheral Arterial Tone (PAT) test
This test is suitable for patients with suspected clinical history of OSA, but are unable to tolerate a full PSG. The test uses three sensors to measure sleep, blood oxygen level and stress level. After measuring these parameters, the test result will be analysed by a professional to provide a diagnosis.
What are the dangers of OSA?
Having OSA may pose the patient to many more health risks if left unmanaged. Some dangers of OSA includes:
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Increased risk of heart and brain complications
Having episodes of stopped breathing place the heart under tremendous stress. Hence, people with OSA are at a higher risk of experiencing high blood pressure, heart failure, heart attack and irregular heartbeat. Having heart problems also potentially increases the risk of getting a stroke.
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Increased risk of diabetes
Low blood oxygen and sleep interruptions due to OSA can lead to the upset of glucose metabolism. Therefore, this may cause the blood sugar level to be higher than normal. If you do not control OSA and blood sugar level properly, the blood sugar level may continue to increase, which can result in diabetes.
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Reduced concentration and brain function
According to a study, the speed of information processing, attention and working memory, and executive functions, was found to be impaired among subjects with OSA. In fact, another study concluded that drivers with OSA are three times more prone to motor vehicle accidents.
What’s next?
Consult a doctor if you or your roommate snores, or experiences signs and symptoms of fatigue and and sleepiness. With appropriate diagnosis, OSA is a condition that can be corrected through treatment or lifestyle changes.
Acknowledgement:
Dr. Gan Eng Cern, ENT Surgeon at A Specialist Clinic for Sinus, Snoring & ENT, who has contributed to this article.
References
- Somers VK, White DP, Amin R, Abraham WT, Costa F, et al. Sleep apnea and cardiovascular disease. Circulation. 2008; 118 (10): 1080-1111.
- Pamidi S, Tasali E. Obstructive sleep apnea and type 2 diabetes: Is there a link? Front Neurol. 2012; 3: 126.
- Ellen RL, Marshall SC, Palayew M, Molnar FJ, Wilson KG, Man-Son-Hing M. Systematic review of motor vehicle crash risk in persons with sleep apnea. J Clin Sleep Med. 2006 Apr 15;2(2): 193-200.
- Lim WJ, Bardwell WA, Loredo JS, Kim EJ, Ancoli-Israel S, et al. Neuropsychological effects of 2-week continuous positive airway pressure treatment and supplemental oxygen in patients with obstructive sleep apnea: A randomized placebo-controlled study. J Clin Sleep Med. 2007 Jun 15; 3(4): 380–386.
- Pamidi S, Tasali E. Obstructive sleep apnea and type 2 diabetes: Is there a link? Front Neurol. 2012; 3: 126.
- How is obstructive sleep apnea (OSA) diagnosed? [Internet] [cited 2018 July 5] Available from: http://www.dentalsleepsolutions.com/index.php/about-sleep-apnea/obstructive-sleep-apnea-diagnosis-psg-vs-hst
- Obstructive sleep apnea. [Internet] [cited 2018 July 5] Available from: https://www.mayoclinic.org/diseases-conditions/obstructive-sleep-apnea/symptoms-causes/syc-20352090
- Obstructive sleep apnea syndrome. [Internet] [cited 2018 July 5] Available from: https://www.webmd.com/sleep-disorders/guide/understanding-obstructive-sleep-apnea-syndrome#2
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by Joanne Lee
Multipotentialite. Loves creating and seeing ideas come alive. View all articles by Joanne Lee.
