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Sleep apnea

OtolaryngologyRespiratory Medicine

Sleep apnea is a condition in which the patient's breathing stops briefly during sleep, resulting in a lack of oxygen to the body and a loss of sleep quality. According to the Asthma Society of Hong Kong, sleep apnea is becoming more common in Hong Kong, with about 4% of males and 2% of females suffering from the disease [1].

Sleep apnea is mainly classified into obstructive sleep apnea, central sleep apnea and mixed sleep apnea, with the majority of patients suffering from obstructive sleep apnea.

Symptoms

People with sleep apnea may experience the following symptoms:

Excessive snoring during sleep
Intermittent or short pauses in breathing during sleep.
Symptoms of sleep apnea can also affect daily activities.
Daytime sleepiness and lack of energy
Decreased daytime concentration
Headaches upon waking
Unstable mood swings

Causes and Risk Factors

Obstructive sleep apnea is the most common form of sleep apnea. When the head and neck muscles of the patient relax after falling asleep, the surrounding tissues compress the airway and prevent the patient from breathing.

Central Sleep Apnea is caused by a disorder of the central system of the brain, and is most common in patients who have suffered a stroke or heart disease. Some patients may also suffer from Central Sleep Apnea under the influence of certain medications.

Mixed Sleep Apnea is a condition in which the patient suffers from both Central Sleep Apnea and Obstructive Sleep Apnea. As the oxygen level in the blood decreases during apnoea, the patient will struggle to wake up after apnoea, and the interrupted sleep will make the patient feel unusually tired in the morning.

High risk individuals

The following people are at higher risk of developing sleep apnea:

People over 50 years old
Men are more likely to suffer from sleep apnea than women
Obese
Neck circumference over 40cm
Physical inactivity
Smokers and alcoholics
Enlarged tonsils
Physiological abnormalities (e.g. short chin, long bell, narrow windpipe, enlarged tongue, curved septum, displaced nasal bones)
Nasal polyps
Family history
Endocrine problems

Diagnosis

Polysomnography collects the following data to fully analyze the patient's physical condition:

Brain waves
Eye movement
Blood oxygen level
Snoring

Treatment

Lifestyle Changes	Obese people who lose 5 to 10% of their body weight will experience improvement in sleep apnoea symptoms. Smoking cessation Reduce alcohol intake
Continuous Positive Airway Pressure (CPAP)	Continuous Positive Airway Pressure (CPAP) is used nightly to prevent narrowing of the airway during sleep and to minimise short pauses in breathing, which helps to improve sleep quality and fatigue.
Dental appliances such as mandibular advancement device (commonly known as anti-snoring braces)	Supporting the airway, the soft palate and the throat wall to keep the upper airway open.
Surgery	For patients with overgrown soft palate and palatal angle, enlarged tonsils or adenoids, displaced nasal bones or nasal polyps, the doctor may consider arranging surgical removal or treatment.

Impact

Sleep apnea may cause or increase the risk of the following diseases:

Stroke
High blood pressure
Heart disease
Atrial fibrillation
Metabolic syndrome

High-risk work, transport and mechanical work may lead to serious accidents if the patient's mental state is poor at work.

Preventive screening

If you are at high risk, pay attention to your sleep quality. If you are worried about sleep apnea, talk to your doctor.

Frequently Asked Questions

Sleep apnoea is not uncommon in children. The most common cause of sleep apnoea is enlarged glands or tonsils that block the airway, so it is advisable to consult a specialist.

It is recommended to avoid drinking alcohol before bedtime as it can worsen the symptoms of sleep apnea by affecting breathing. In addition, excessive intake of alcohol may cause drowsiness and relaxation of the airway muscles, worsening the symptoms of sleep apnea.