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What is Sleep Apnoea?

Snoring and sleep apnoea are common sleep-disordered breathing (SDB) problems
that can affect your sleep, health and quality of life.

Sleep Apnoea (meaning absence of breath), is caused by the closing of the soft tissue in the upper airway.
It occurs when breathing stops during sleep for at least 10 seconds at least five times an hour.
This can either be weight related, physiological (i.e. simply a narrow airway or pronounced under-bite) or a physical obstruction (i.e. tonsils).
Mild sleep apnoea causes few symptoms, but the condition may lead to low oxygen levels, which can lower life expectancy by up to 15 years.

There are three types of sleep apnoea: obstructive, central, and mixed:

  • Obstructive Sleep Apnoea (OSA)
    The most common type of sleep apnoea. It occurs when your upper airway closes but your efforts to breathe continue. The primary causes of upper airway obstruction are lack of muscle tone during sleep, excess tissue in the upper airway, and anatomical abnormalities in the upper airway and jaw.
  • Central Sleep Apnoea (CSA)
    This affects only 5-10% of the sleep apnoea population. It occurs when your breathing stops but your airway is open. This cessation of breathing results from the body's failure to breathe automatically. It's as if a short circuit prevented the brain from keeping the respiratory system functioning properly.
  • Mixed Apnoea
    A mixture of both OSA and CSA.

Snoring and sleep apnoea often occur together, caused by changes in your upper airway while you sleep.
Your airway may narrow, limiting airflow as you breathe; it may vibrate, commonly heard as snoring;
or it may collapse, so you stop breathing.

This third type of change is called Obstructive Sleep Apnoea (OSA), and may last for ten seconds or more.
Your airway may even move through all three stages:

Healthy upper airway


Obstructed upper airway


When tissues obstruct the upper airway completely, they prevent breathing. They actually work to suffocate the sleeper. The sleeper wakes up enough to regain control of the upper airway, breathe again, and then fall back to sleep. This happens from dozens to hundreds of times per night for people with OSA, but they usually don't remember waking up.

Partially obstructed upper airway


Each obstruction deprives the body of oxygen and forces it to retain carbon dioxide that it would normally exhale. As a result, the body's blood gases get out of balance, and the body is subjected to a 'toxic' environment. When the body sets off 'alarms' that it needs more oxygen, the brain wakes the sleeper, breathing resumes, and the individual falls back to sleep until the next obstruction occurs.

These obstructions increase heart rate, raise blood pressure, and eventually blunt the body's automatic response system, resulting in increasingly more severe apnoeas and hypopnoeas.
The brief wake-ups that people with OSA experience also diminish their quality of sleep, resulting in sleep deprivation.

The common symptoms of sleep deprivation may be what bring most people with OSA to see their physician, these may include:

  • Excessive daytime sleepiness
  • Poor concentration
  • Poor memory
  • Depression
  • Restless sleep
  • Headache in the morning
  • Loud snoring
  • Change in personality
  • Frequent urination during the night