About Sleep Apnoea

• Snoring is very common in the community (60% of men over the age of sixty snore regularly). Snoring is usually a social nuisance, but is often also a marker of a more serious problem called Obstructive Sleep Apnoea (OSA).
• Obstructive Sleep Apnoea (OSA) is the most common sleep disorder in the community after insomnia. An apnoea is the cessation of breathing for ten seconds or more in an adult. The common predisposing conditions are obesity, aging, maleness, and facial shape, but it can also occur in children and women. If untreated, OSA can cause hypertension and makes several other conditions worse including: diabetes, heart failure, abnormal heart rhythms. If severe enough it can cause premature death usually from stroke or heart attack.
• Choking / gagging / gasping in sleep these are symptoms of OSA typically in mild-moderate disease, which paradoxically disappear as the disease gets worse.
• Gastro-oesophageal reflux is commonly a marker of OSA.
• Sleepiness / tiredness are perceived by men and women differently. Women often describe this as a ‘lack of energy’ or ‘poor motivation’ but men describe it as ‘sleepiness’ or ‘tiredness’. It is usually due to inadequate refreshing sleep; either too little sleep time, or poor quality sleep (as is the case in OSA). It reduces performance in most areas of daily life and often is associated with irritability or ‘grumpiness’. It also predisposes people to traffic and industrial accidents.

• Assist in the diagnosis of sleep disorders, including snoring, sleep apnoea, narcolepsy, periodic limb movement disorder and insomnia. Most testing involves sleeping overnight in the Laboratory with various leads attached – refer to ‘About the Sleep Study’ below.
• Determining the correct pressure for those patients undergoing Continuous Positive Airways Pressure (CPAP) for sleep apnoea.
• Checking the effectiveness of dental devices or surgery etc, that have been prescribed for sleep apnoea patients.
• Specific tests, such as Multiple Sleep Latency Test (MSLT). This test includes an overnight sleep study to document sleep quality then a series of 2-5 naps lasting 20 minutes every 2 hours during the next day. This test is a diagnostic tool for people with excessive daytime sleepiness, not due to, or in addition to, sleep apnoea eg: patients with narcolepsy.

An overnight sleep study requires the patient to be fitted in a very systematic way with a number of sensors. Many of the sensors are pasted or taped to the scalp and face with special paste or tape. These sensors help to determine what stage of sleep the patient is in. Other sensors are fitted to the finger (to measure oxygen level), to the chest (to measure heart rhythm and breathing effort) and another to the nose (to measure airflow). There will also be electrodes attached to the chest and base of neck to measure breathing effort and to the leg (to measure any leg movements or jerking). Once the sensors and electrodes are attached they are connected into a computerised system and the equipment is calibrated. The patient’s sleep pattern can now be monitored overnight. Following the study the raw data is analysed by a qualified technician, and then reported on by one of the medical officers. A report is sent to the referring doctor within 5 – 10 working days. Staff are in attendance for the entire procedure.