When sleep goes wrong, it can pose serious risks for our health and wellbeing. Sleep-disordered breathing (SDB) is the umbrella term for a variety of different nocturnal breathing disorders, including central sleep apnoea (CSA), obstructive sleep apnoea (OSA), and Cheyne-Stokes Respiration (CSR). Here’s a quick primer on the types, the risks, and the treatment.
What are the different types of SDB ?
Let’s start with some vocabulary. An apnoea is an event where breathing stops completely for ten seconds or more. A hypopnoea is similar, but breathing is reduced not stopped. An arousal occurs when the brain notices the lack of oxygen and kick-starts the breathing process. This mini-awakening is responsible for the disturbed nights and poor-quality sleep associated with SDB. The Apnoea-Hypopnoea Index (AHI) indicates the number of events that occur per hour of sleep. People with severe sleep apnoea can experience over 30 arousals (mini wake-ups) per hour – it’s no surprise they feel exhausted during the day!
Obstructive sleep apnoea (OSA) occurs when the muscles of the throat relax and obstruct the upper airway during sleep. OSA is often accompanied by loud snoring or snorting, especially during arousals. Central sleep apnoea (CSA) is much rarer, and occurs when the brain stops sending signals to the breathing muscles during sleep. The airways remain open, but breathing stops. With Cheyne-Stokes Respiration (CSR), there is a period of shallow breathing followed by deep breathing, with intermittent central apnoeas.
What are the risks of SDB?
It’s common knowledge that a bad night’s sleep can leave us feeling grumpy, forgetful and depressed the next day. Untreated SDB is more than ‘a bad night’s sleep’: it can have very serious consequences. It diminishes quality of life and is associated with cardiovascular and metabolic disorders. For example, if you have untreated OSA, you have almost twice the risk of developing diabetes and cardiovascular disease1, three times the risk of dying from cardiovascular issues2, and more than six times the risk of having a traffic accident3. And that’s before we talk about the impact of loud snoring on your long-suffering bed partner and your relationship.
What are the treatments for SDB?
It is estimated that up to 80% of people with SDB are not diagnosed. That’s a real shame, because effective treatments are available.
For many people, nothing beats continuous positive airway pressure (CPAP). This treatment delivers mild air pressure that keeps the airways open. Advanced devices are able to identify and respond to OSA, CSA and CSR, and there is a female-friendly version to meet the specific needs of women with OSA.
Other solutions are also available. For example, customised dental devices can help to restore normal night-time breathing and improve sleep quality. Changing your lifestyle can also help: for some people – but not all – OSA can be caused or worsened by obesity, alcohol and smoking, or the use of sedatives.
If you think you might suffer from SDB, make an appointment with your doctor and get yourself checked out. And if you have questions about SDB, why not ask one of our specialist sleep clinicians on 0800 917 7071 or email them at mySleep@resmed.com?
- Greenberg et al. Gender differences in morbidity and health care utilization among adult obstructive sleep apnea patients, Sleep 2007. In this study the increased risk of diabetes and cardiovascular diseases is calculated specifically amongst women with sleep apnoea.
- Campos-Rodriguez et al., Cardiovascular Mortality in Women With Obstructive Sleep Apnoea With or Without Continuous Positive Airway Pressure Treatment: A Cohort Study, Annals of internal Medicine, 2012. In this study the increased risk of cardiovascular death is calculated specifically amongst women with sleep apnoea.
- Teran-Santos et al. The association between sleep apnea and the risk of traffic accidents, New England Journal of Medicine 1999. In this study the increased risk of traffic accidents is calculated in the general sleep apnoea population (men and women).