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Sleep Apnoea Syndromes

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Sleep Apnoea Syndromes

Definition

Sleep Apnoea Syndromes are a group of disorders in which breathing stops more than 30 times during sleep for approximately 10 second periods or more. Blockage of the upper airway, failure of the respiratory drive or a combination of both factors may result in Sleep Apnoea which causes low levels of oxygen in the blood, daytime sleepiness and can be fatal in some cases.

Description

Sleep Apnoea Syndromes can cause the heart to beat abnormally, excessive sleepiness during the day, a headache in the morning and/or slow mental functioning. Studies have also indicated a link between Sleep Apnoea Syndromes and high blood pressure (hypertension), mental confusion, memory loss and angina. The causes of Sleep Apnoea can be divided into three groups which include; obstructive, central or mixed.

OBSTRUCTIVE

This is the most common type of Sleep Apnoea Syndrome and usually occurs in moderately or severely obese people who sleep in a supine position (on the back). It is reputed to affect 4% of middle-aged men and 2% of middle aged women. Some patients suffering from the problem may experience morning headaches, personality changes, behavioural disorders and mental confusion. The patient may also suffer from impotence.

Breathing depends on the action of certain muscles in the upper airways, which during sleep tend to narrow and sometimes collapse in people with Sleep Apnoea Syndrome. People who are diagnosed with Sleep Apnoea will often have a long history of loud snoring.

When the airway becomes obstructed, snoring stops because airflow has also ceased. During this time the body is not getting enough oxygen and will eventually cause the person to awaken briefly with a loud snore to resume breathing. This loud snore usually wakes the person up with a start accompanied by snorting and gasping. After a few deep breaths, the person will usually fall back to sleep only to have the cycle repeated many times during the night and in some cases up to 400 times a night. If the airflow at the nose or mouth is absent for 10 seconds this constitutes an Apnoea. In many patients the airflow interruptions may last for 20 to 30 seconds and even longer in some cases up to 3 minutes. The key feature is the carbon dioxide level during sleep falls below the critical level required to stimulate breathing. Naturally, anyone disturbed in such a way does not wake in the morning feeling refreshed.

CENTRAL

This includes a number of conditions which are not well understood and much less commonly responsible for Sleep Apnoea. Central Sleep Apnoea does not result in an obstruction of the airway. It is believed to occur as a result of a failure of the respiratory drive. This can be caused by such ailments as brain tumours, poliomyelitis or failure of the central breathing control in the brain which occurs for an unknown reason.

MIXED

Mixed Sleep Apnoea starts as unobstructed Sleep Apnoea which is quickly followed by obstruction of the airway. Mixed Sleep Apnoea Syndrome occurs more frequently than central but less often than obstructive Sleep Apnoea.

Treatment Options

As with all conditions, your Doctor should be consulted. Your Doctor will diagnose and treat this ailment. Ask your Doctor about the latest advice on this condition. In some cases, surgery may be advised. Obstructive Sleep Apnoea has a strong association with hypertension. Systemic blood pressure does not decrease during sleep in sleep apnoea as it would in other patients. The blood pressure rises at the end of each apnoea.

Children with Sleep Apnoea and snoring have a higher incidence of behavioural problems than other children. Children with breathing problems during sleep are more likely to show a higher prevalence of problems, including mood swings, hyperactivity, aggressive behaviour and social problems. Considering these findings it is important to seek medical treatment for a child with Sleep Apnoea and related disorders.

Pharmacist’s Advice

Ask your Wizard Pharmacist for advice;

  • A person suffering from Sleep Apnoea should avoid drinking alcohol. After drinking alcohol, snoring may develop more easily into obstruction of the airway. It has been shown that alcohol has a depressant effect on the upper airway muscles and on the arousal mechanisms for breathing.
  • It is suggested that obese people should lose weight particularly those people who have large fatty necks. Ask your Pharmacist for advice about healthy ways to lose weight.
  • Continuous Positive Airway Pressure (CPAP) is a common treatment for Sleep Apnoea Syndromes. CPAP involves a nose mask being worn by the patient while sleeping which supports the upper airway and prevents its collapse. Ask your Pharmacist to demonstrate how a CPAP mask should be used.
  • Ask your Pharmacist about adhesive strips that can be applied to the nose while sleeping to help keep the airway open.
  • Try to avoid sleeping on the back. Patients who are prone to Sleep Apnoea Syndrome may find the incidence decreases when sleeping face down or on one side. Tilting the head of the bed upwards may also help to prevent attacks.
  • Before sleeping it is advisable to avoid taking antihistamines and/or sleeping pills if possible to decrease the risk of Sleep Apnoea.
  • Patients suffering from the problem should not drive a car or operate machinery at work due to fatigue.
  • Avoid smoking because smokers experience narrowing of the pharynx due to the mucosal oedema and inflammation associated with smoke. Studies show that smoking increases the risk of developing Obstructive Sleep Apnoea.
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