EFFECTS OF SLEEP APNEA ON HEALTH

Obstructive sleep apnoea (OSA) occurs when the upper airway repeatedly narrows or closes during sleep, causing reduced airflow or breathing pauses. Sleep becomes fragmented and blood oxygen may fall. Not everyone with OSA experiences pronounced daytime sleepiness.

What symptoms suggest OSA?

• Loud snoring and breathing pauses observed by a partner.
• Gasping, choking sensations or frequent awakenings.
• Daytime sleepiness, fatigue or reduced concentration.
• Morning headaches, dry mouth or sleep that is not refreshing.

Snoring alone does not establish OSA, and some people with OSA do not snore loudly.

Who is at increased risk?

Obesity, increasing age, family history and certain jaw or pharyngeal anatomical features raise the likelihood of OSA. Large tonsils may contribute. A deviated nasal septum can impair nasal breathing, but is not usually the sole cause of OSA.

How can OSA affect health?

OSA is associated with increased risk of hypertension, cardiovascular disease, metabolic problems and concentration difficulties. Excessive sleepiness can increase the risk of accidents, particularly when driving. Individual risk depends on severity, other medical conditions and additional factors.

How is it diagnosed?

Assessment combines a clinical history, examination of the upper airway and an appropriate sleep study, either a home sleep-apnoea test in selected uncomplicated adults or in-laboratory polysomnography. Testing establishes severity and guides treatment. An ENT examination can identify anatomical contributors but does not replace a sleep study.

What are the treatment options?

• CPAP/APAP: positive airway pressure is highly effective and commonly a first-line treatment, particularly for moderate to severe OSA.
• Custom-made mandibular advancement device (MAD): may suit selected patients, including those who cannot tolerate CPAP, following assessment by an appropriately trained dentist.
• Weight management, sleep position and alcohol reduction: helpful supportive measures, but not always substitutes for specific therapy.
• Selected surgical treatments: tonsillectomy, pharyngeal procedures and other operations may be considered after thorough evaluation, particularly if CPAP is not accepted or tolerated. Drug-induced sleep endoscopy (DISE) can help plan treatment.

Septoplasty can improve nasal breathing or CPAP tolerance, but is not, on its own, a reliable cure for obstructive sleep apnoea.

When should you seek assessment?

Persistent snoring with breathing pauses, excessive sleepiness or unrefreshing sleep warrants assessment by a sleep-medicine clinician, often alongside ENT evaluation.