Obstructive Sleep Apnoea in Adults

What is Obstructive Sleep Apnoea?

Obstructive sleep apnoea (OSA) is a condition where a patient can’t breathe in enough air while asleep. Most people with OSA have the problem every night and may wake in the morning feeling unrefreshed. OSA is a potentially serious medical condition which requires treatment.

How common is OSA?

OSA is very common. Current estimates are that 4% of males and 2% of females suffer from OSA.

What is an apnoea?

An apnoea is where a patient doesn’t breathe for longer than 10 seconds while asleep. If you suspect your partner has OSA, watch them sleeping. If they stop breathing for longer than 10 seconds, they likely have some degree of OSA. Taking a video recording of them sleeping can be very helpful to bring to your consultation.

What are the symptoms of OSA?

Obvious symptoms include:

• Restless sleep and snoring
• Sleepiness during the day
• Waking unrefreshed
• Bed wetting

Less obvious symptoms and associated conditions include:

• Morning headache
• Poor concentration
• Mood changes
• High blood pressure

Is OSA a serious condition?

OSA is a very serious condition. It needs to be treated because it can lead to problems with blood pressure and heart disease, and can significantly impair daytime alertness — including when driving.

What causes OSA?

OSA is multifactorial in almost all cases. Contributing risk factors include obesity (BMI > 25), male sex, blocked nose, large tonsils, redundant soft palate, large tongue, sedative medication, alcohol, and smoking.

What investigations do I need?

To accurately diagnose OSA, a sleep study is recommended. This helps quantify the degree of OSA and guides treatment planning, including whether a CPAP machine may be appropriate.

How is OSA measured?

OSA is measured using the Apnoea Hypopnoea Index (AHI) — the number of apnoeas and hypopnoeas per hour of sleep:

• Mild — AHI 5–15
• Moderate — AHI 15–30
• Severe — AHI > 30

What can be done medically for OSA?

Medical treatment for OSA involves a CPAP machine. Dr Dan Robinson and Dr Sam Dowthwaite typically start patients on combination intranasal steroids and saline nasal washes for 6 weeks to assess improvement. Other medical options include weight loss, reducing alcohol, and reducing sleeping tablets.

What are the surgical options for OSA?

If you have a blocked nose, addressing this is the first surgical step. The procedure is either a rhinoplasty or a septoplasty and turbinoplasty depending on the cause of your nasal obstruction. Improving nasal breathing has a high success rate in improving sleep quality, and also helps many patients tolerate CPAP better.

If further intervention is needed, a modified uvulopalatopharyngoplasty (UPPP) may be considered. Dr Dan Robinson has been trained in a modified UPPP technique by one of the leading sleep surgeons in Australia. Dr Sam Dowthwaite has also had international experience in transoral robotic surgery on the base of tongue for snoring.

What to do from here?

If you would like to see Dr Dan Robinson or Dr Sam Dowthwaite about your OSA, make an appointment. It is helpful to know the names of any nasal sprays you have trialled and to bring along any sleep study results. We look forward to helping improve your sleep.