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If your partner’s snoring is driving you nuts, or you’ve been waking up feeling totally unrefreshed after an eight-hour sleep, it might be time to take a look at what’s going on when the lights go out.
“Lots of people have what we call simple snoring, but if you have snoring with pauses – that is, the person is snoring away, then they stop for a while, and then they start snoring again – that is one of the primary symptoms of sleep apnoea,” shares sleep expert Dr Carmel Harrington.
The main type is obstructive sleep apnoea – which affects around one in four men over the age of 30. This occurs when the walls of your throat close during sleep, blocking your airway and stopping you from breathing. Eventually, your brain notices you’re not breathing and wakes you up.
“You’re not going to remember those wake-ups, though, because they are only momentary,” explains Carmel. “They’re what we call sub-cortical, but they’re enough to open the airway, and then you go straight back to sleep – but it does mean that you can’t really stay in deep sleep or REM sleep.”
These breaks in breathing are called ‘apnoeas’ and can last for 10 seconds or more. It’s a pattern that can repeat hundreds of times in one night, so it’s hardly surprising that people suffering from sleep apnoea rarely feel rested. The two other types are central sleep apnoea, when the brain doesn’t control breathing muscles effectively, and complex sleep apnoea syndrome, which is a combination of central sleep apnoea and obstructive sleep apnoea.
The intermittent snoring pattern is one of the most common sleep apnoea symptoms, says Carmel.
“Sleep apnoea is probably easier to detect if you’ve got a partner, because it tends to be loud and very disruptive to the partner’s sleep.”
But if you live on your own or you don’t have a regular sleeping partner it can be more difficult to detect.
Other tell-tale signs of sleep apnoea are:
“You might also wake up with headaches,” Carmel adds, “and you often have poor memory or feel a bit foggy-headed – all the characteristic signs of sleep deprivation.”
Sleep apnoea symptoms can affect couples, even when only one person has the condition.
“The last thing that is conducive to an intimate relationship is being kept up all night by someone snoring!” says Carmel, who advises couples to sleep in separate rooms until treatment is sought.
Some serious health issues have been linked to sleep apnoea.
“When you have sleep apnoea, you are essentially sleep-deprived; and when you’re sleep deprived, there’s an increased risk of cardiovascular disease,” shares Carmel.
Left untreated, people with moderate to severe sleep apnoea have “an increased risk for stroke, heart attack, obesity, dementia, cognitive decline and depression”. They are also more likely to have high blood pressure, mood disturbances and personality changes and, for men, impotence.
Related: Does sleep deprivation matter?
Having a Body Mass Index (BMI) of more than 30 and/or a neck circumference of more than 42cm are both considered risk factors for obstructive sleep apnoea.
“In overweight individuals, extra fat around the neck and upper airway places more pressure on the airway when they lie back, which makes it more likely to collapse,” Carmel explains. Having enlarged tonsils, alcohol consumption, smoking and use of sleeping tablets are also recognised risk factors.
Interestingly, while men are much more likely to suffer from sleep apnoea than women, this changes around menopause age, Carmel adds. “Women’s incidence actually triples, so post-menopausal women need to be aware that they could develop sleep apnoea even if they’ve never had it before.”
The good news is, help is readily available. Lifestyle changes such as losing weight and cutting down on alcohol, avoiding sleeping tablets, quitting smoking and even using nasal decongestant sprays can all help ease sleep apnoea symptoms. Specially fitted mouthguards can also help in cases of very mild sleep apnoea, says Carmel, and for very severe cases, surgery might be recommended.
But the “gold standard” in obstructive sleep apnoea treatment, she explains, is a CPAP (continuous positive airway pressure) device. With this treatment – as many as 70% of patients can tolerate long-term – a mask fitted over the mouth and/or nose delivers pressurised air while the patient is sleeping to keep the floppy upper airway open. “By keeping the airway open with positive air pressure, it doesn’t collapse,” explains Carmel.
Luckily, some of the cognitive damage done by obstructive sleep apnoea can be turned around. So how long will it take to reverse damage from sleep apnoea? According to the American Academy of Sleep Medicine, “12 months of CPAP therapy… produced significant improvements in nearly all cognitive tests, mood, alertness and quality of life.”
With such a positive prognosis, seeking help if you or a loved one is displaying sleep apnoea symptoms is a worthwhile first step. “Snoring can be an indicator of something with a quite serious outcome,” advises Carmel. “If you think you might have the disorder, talk to your healthcare provider.”
From how to get a better night’s sleep to why you might be still tired after a full night’s rest, head to The Check Up’s dedicated sleep section for more expert tips and advice.
Please note: The tips throughout this article serve as broad information and should not replace any advice you have been given by your medical practitioner.
Dr Carmel Harrington is a sleep scientist who, over the past 25 years, has extensively researched the processes and functions of sleep. Good sleep is a fundamental need that underpins physical and mental health, without it we suffer significant consequences. She believes it is time to wake up to the wonders of sleep.