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Few facts about obstructive sleep apnoea and how to reduce symptoms.

Obstructive sleep apnoea is a common respiratory condition characterised by interrupted breathing during sleep. People suffering from this disorder struggle to sleep properly as their upper airways collapse, ceasing their breathing for a brief moment. A person with sleep apnoea will most likely remain asleep but they might be snoring or gasping during the night. The episodes of restricted, or interrupted, breathing are linked to changes in heart rate and drop in blood oxygen levels.^[1]

As reported by the British Lung Foundation, approximately 1.5 million adults living in the UK suffer from sleep apnoea and up to 85% remain undiagnosed.^[2] It’s been reported that men are two to three times more likely to be inflicted with sleep apnoea than women.^[3] Middle-aged men are at the highest risk of developing this condition. ^[4]
Obesity, just as being overweight, increases the risk of sleep apnoea. That is because the fatty tissue around the neck is more likely to block the airways and restrict breathing.

“Estimates vary, but around half of people with OSA[ obstructive sleep apneoa] have excess body weight”^[5]

Unrestricted tobacco use, heavy alcohol consumption and a sedentary lifestyle are also amongst factors linked to this disorder.

What are the symptoms?

The most common symptoms of sleep apnoea are loud snoring, tossing and turning and waking up unrefreshed in the morning. Some people awaken with a sore throat or dry mouth during the night. Due to decreased sleep efficiency, people with sleep apnoea often experience excessive daytime sleepiness, morning headaches and have difficulty concentrating.

Obstructive sleep apnoea can also instigate or worsen other health issues, for instance, it may increase acid reflux in people with digestive disorders. It may also irritate the airways and trigger an asthma attack during the night. Furthermore, people with sleep apnoea often have high levels of bad cholesterol( LDL) and low levels of good cholesterol ( HDL).

“OSA [obstructive sleep apnoea] can affect your quality of life. It can also lead to other health problems, including high blood pressure, heart attack, stroke and diabetes. You’re more likely to have accidents at work and on the road. And your ability to work may be affected.” ^[6]

How to treat sleep apnoea?

The most common treatment for obstructive sleep apnoea is nasal continuous positive airway pressure (nCPAP). A device that is used for this treatment is called a CPAP machine and it allows the flow of oxygen to one’s nose and mouth during sleep. Thanks to this, there are no interruptions in breathing, which allows better sleep. Make sure to consult your doctor first as in some cases, for instance, if you have enlarged tonsils, surgery is needed. Your doctor may also recommend alternative treatment options, like medication or upper airway stimulation.

Regardless of the treatment, you may still want to consider making a few lifestyle changes that could help your problem.

Here is what you should (and should not) do:

1. Exercise regularly.

As you already know, obesity, especially in the upper body, may obstruct the airways and can cause your breathing to be interrupted. Staying physically active may help you lose fat around your upper airways, allowing a better flow of oxygen. Regular exercise also reduces the accumulation of fluid in the neck and lowers the risk of inflammation. It is likely to increase the quality of your sleep too by increasing deep sleep (stage 3 NREM). All of the above factors lessen the intensity of the sleep apnoea and reduce the symptoms; which means better daytime alertness, improved sleep quality and better oxygen absorption

2. Avoid eating late.

Research^[7] indicated that consuming meals late in the evening is linked to bad quality of sleep and escalates the intensity of sleep apnoea. Generally, to prevent digestive issues, you should allow about three hours after your last meal before you go to bed. Additionally, what you eat is as important as the timing of your meals. Around your bedtime, abstain from heavy and spicy foods like curries, chips, crisps etc. and instead opt for light snacks low in sugar, salt and fat. Avoid chocolate and caffeinated drinks (tea, coffee, energy drinks ) at nighttime as well, as high levels of caffeine may disrupt your sleep. Throughout the day, make sure to eat enough protein, which you’ll find in lean meats, poultry, fish and seafood as well as in dairy products.

3. Be careful when using opioids.

Opioids are the type of strong painkillers that are primarily used for chronic pain relief. They work by interacting with opioid receptors, suppressing the perception of pain and increasing feelings of pleasure. These include codeine, morphine, diamorphine etc. Opioids are usually prescribed for pain management after surgery, for pain after a trauma or for cancer patients. They are usually used for a short time. If you need to use opioids be careful, as they might exacerbate your breathing problems caused by sleep apnoea and decrease the oxygen levels in your blood.^[8]

4. Quit smoking.

Smoking irritates the airways, causing swelling in the throat and nose, which then reduces the flow of air and makes breathing more difficult. Smoking may worsen the symptoms of sleep apnoea by damaging the upper airways, increasing mucous production and disrupting circadian rhythm, which results in poor sleep quality. A study^[9] suggested that ceasing smoking reduces airway inflammation and production of mucous therefore may improve oxygenation in the body tissues. This may contribute to better sleep.

5. Try sleeping on your side.

Sleeping on your back or stomach may worsen your sleep apnoea by decreasing the flow of oxygen and inducing snoring. Try sleeping on your side instead.

“It is particularly recommended to sleep on the left side as it allows the best blood flow and creates little or no breathing resistance.”^[10]

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Research references

1. https://www.ncbi.nlm.nih.gov/books/NBK459252/
2. https://www.blf.org.uk/sites/default/files/OSA_Toolkit_2015_BLF_0.pdf
3. https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4549693/
5. https://www.blf.org.uk/sites/default/files/OSA_Toolkit_2015_BLF_0.pdf
6. https://www.blf.org.uk/support-for-you/obstructive-sleep-apnoea-osa/symptoms
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6411188/
8. https://pubmed.ncbi.nlm.nih.gov/26545144/
9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4251622/
10. https://www.okoa.org/articles/the-sleeping-positions-for-sleep-apnea-patients