What is obstructive sleep apnoea?
Obstructive sleep apnoea is cessation of airflow at the mouth and nose for more than ten seconds, occurring more than 30 times in a seven hour sleep, caused by airway obstruction. Some surveys suggest that one in four people with diabetes mellitus may have OSA, others that 4 out 5 obese people with diabetes may be affected. There is uncertainty about the rate of OSA in the general population; perhaps 1 in 25 is affected, perhaps more. Obstructive sleep apnoea can be a factor in causing raised blood pressure and in those who suffer one of the severe consequences of high blood pressure, stroke, in whom as many as 75% give a history of having had sleep apnoea.
What causes obstructive sleep apnoea?
Factors linked to OSA include structural abnormalities of the upper airway, being overweight and obese and having a family history of OSA. Scientific studies have shown that in OSA the airway is narrowed and that there is more fat next to the airway in those who are overweight and obese. The muscles supporting the airway may be less good at holding the airway open allowing it to collapse and obstruct.
Does obstructive sleep apnoea matter?
OSA causes snoring interrupted by pauses in breathing, choking and gasping during sleep, restless sleep and excessive daytime sleepiness and perhaps falling asleep at work or while driving a motor vehicle. Quality of life may be seriously impaired by general fatigue, poor concentration, irritability, forgetfulness, morning headaches, depression and sexual dysfunction.
Driving and sleep apnoea
Falling asleep while driving may result in serious injury or death to the driver and passengers as well as those in other vehicles involved in the accident.
A driver whether professional or not who is overweight or obese and believes that he or she is affected by sleep apnoea should consult his or her medical practitioner and consult the regulations at the DVLA. Employers of professional drivers have a duty of care to their employees and their passengers and should work with occupational physicians to detect and treat OSA.
Treatment of Obstructive Sleep Apnoea?
Anyone who believes they may have obstructive sleep apnoea should consult their general medical practitioner (GP) in the first instance.
There are a number of useful sites providing information including that of the Sleep Apnoea Trust at http://www.sleep-apnoea-trust.org/ . See also: http://www.bbc.co.uk/health/conditions/sleepapnoea1.shtml#treatment_and_recovery_
Weight Reduction and Obstructive Sleep Apnoea
Those who are overweight and obese and who have symptoms of sleep apnoea are advised in the first instance to consult their medical practitioner. For more information see:http://www.webmd.com/sleep-disorders/sleep-apnea/news/20090928/weight-loss-helps-sleep-apnea and http://www.sciencedaily.com/releases/2009/09/090928172344.htm
Anthony R Leeds
Medical Director, Cambridge Weight Plan
November 30th 2009
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