Diagnosing Sleep Apneoa

Sleep apnoea is an extremely serious condition, which can have detrimental effects on the sufferer’s health and quality of life.  To find out more about what sleep apnoea is and its causes, please visit the ‘Snoring and Sleep Apnoea’ page.

Those with sleep apnoea do not usually spot the signs of the condition themselves.  It is often pointed out to them by a partner, family member, or friend that notices the signs of the condition when they sleep.

 

What are the signs of sleep apnoea?

The three main symptoms of sleep apnoea are:

  • Loud snoring
  • Noisy or laboured breathing during sleep
  • Repeated gasping or snorting during sleep

Some people with sleep apnoea may wake up frequently during the night to urinate.  Those with the condition may have no memory of waking during the night.  This is because the brain often doesn’t wake sufferers fully, but into a much lighter sleep, in order to reopen the airway.  Due to these frequent interruptions to their sleep, sleep apnoea is often detected by the way the sufferer feels the next day.

Signs of sleep apnoea when awake include:

  • Feeling very sleepy during the day
  • Poor memory
  • Poor concentration
  • Headaches (especially in the morning)
  • Not feeling refreshed upon waking
  • Irritability
  • Depression
  • Loss of libido
  • Erectile dysfunction

Diagnosing sleep apnoea

In order to correctly diagnose sleep apnoea, the patient’s sleep must be monitored.  This can be done at either at a sleep clinic, or using a testing device worn at home.  The Sleep Apnoea Trust Association has a list of NHS sleep clinics in the UK.

It is helpful for those that suspect they may have the condition to first fill out the Epworth Sleepiness Scale questionnaire or take the STOPBang test.  These tests can help to determine whether the patient is at high risk of the condition.

In order to eliminate other potential causes of the symptoms (eg. Hypothyroidism), a blood test should be carried out.

Once all other potential causes of the symptoms have been ruled out, the patient should be sent to a sleep centre to be assessed for sleep apnoea.

Once at the sleep centre, the patient’s height, weight and neck circumference should also be measured.  This is because being overweight and having a large neck can increase the risk of developing sleep apnoea.

Sleep specialists should then arrange for the patient’s sleep to be assessed overnight, either by sleeping in the centre itself, or taking some kit home to use while they sleep.

If the patient is going to be assessed at home, the equipment will monitor their breathing, oxygen levels, heart rate, and snoring to highlight any abnormalities. If they are assessed at the sleep centre, a polysomnography will be carried out.  During a polysomnography, electrodes are places on the patient’s skin, and sensors are places on their legs and finger.  A number of different tests are carried out during the assessment, including:

  • electroencephalography (EEG)– to monitor brain waves
  • electromyography (EMG)– to monitor muscle tone
  • recordings of movements in the chest and abdomen
  • recordings of airflow through the mouth and nose
  • pulse oximetry– to measure heart rate and blood oxygen levels
  • electrocardiography (ECG)– to monitor the heart

How serious is sleep apnoea?

The severity of sleep apnoea is measured using the apnoea-hypopnoea index (AHI), which measures how many times per hour the sufferers sleep is affected.

  • Mild – AHI reading of 5 to 14 episodes an hour
  • Moderate – AHI reading of 15-30 episodes an hour
  • Severe – AHI reading of more than 30 episodes an hour

Available treatments for sleep apnoea

Lifestyle changes

Losing weight, cutting down alcohol consumption, stopping smoking, and getting more exercise have all been shown to improve the symptoms of sleep apnoea.

CPAP (Continuous Positive Airway Pressure)

The treatment given on the NHS for sleep apnoea is CPAP.  Sufferers are issued with a CPAP machine and mask.  The mask is worn at night, and it increases the air pressure in the sufferer’s throat; ensuring that the airway stays open and normal breathing continues.  60% of people discontinue using their prescribed CPAP machine, as they find it uncomfortable and inconvenient to use.  However, for people with mild/moderate sleep apnoea, a Mandibular Advancement Device (MAD) can prove just as effective.

Mandibular Advancement Devices (MADs)

If the patient is suffering from mild/moderate sleep apnoea, then a Mandibular Advancement Device such as the Snoreeze Oral Device has been proven to be just as effective as a CPAP machine.  The FDA cleared Snoreeze Oral Device is worn like a gum-shield and can be customised to fit in just a few minutes.  The device works by positioning the jaw to create free space at the back of the throat, ensuring that air can pass through easily.  The neutral position of the device resolves snoring for many people, but the easily-adjustable design means that the jaw can be gently positioned forward to clear the obstructed upper airway. Once the airway is cleared, normal breathing can continue all night and snoring is stopped.