What is sleep apnoea?
Sleep apnoea is a relatively common condition where the walls of the throat relax and narrow during sleep, interrupting normal breathing. This may lead to regularly interrupted sleep, which can have a big impact on quality of life. Doctors now know that it also increases the risk of developing certain heart conditions, with sleep apnoea a risk factor for cardiovascular disease such as hypertension and irregular heart rhythms such as atrial fibrillation (AF).
There are two types of breathing interruption:
Apnoea – where the muscles and soft tissues in the throat relax and collapse sufficiently to cause a total blockage of the airway; it’s called an apnoea when the airflow is blocked for 10 seconds or more.
Hypopnoea – a partial blockage of the airway that results in an airflow reduction of greater than 50% for 10 seconds or more.
Some signs and symptoms of apnoea include: snoring loudly, your partner tells you that you stop breathing and startle awake when you sleep. You can recall sometimes awaking abruptly with shortness of breath, choking or gasping. You may wake up often to use the bathroom. There may be a sleepiness, lack of attention, concentration or focus whilst awake. You may have risk factors for sleep apnoea such as being overweight, smoking or alcohol.
Why is it important to diagnose sleep apnoea?
Treatments can be very effective, but can only be given if a diagnosis is made first! Diagnosing sleep apnoea properly is now given increasing importance by doctors due to the impact on general health and functioning, not to mention the specific effects on the cardiovascular system if left untreated. Often, simple lifestyle modifications such as reduction in alcohol and weight loss can make a big difference, but other specific treatments such as mandibular advancement devices which prop your jaw forwards to keep your airway open at night, or continuous positive airway pressure ventilation (CPAP), which pumps additional air in via a mask to prevent your airways from collapsing whilst you sleep, can be extremely beneficial in reducing and treating symptoms.
What is the relationship between sleep apnoea and atrial fibrillation (AF)?
In repeated cycles of apnoea as the individual’s breathing stops and starts repeatedly throughout the night, the body unsurprisingly goes through extreme stress which activates the autonomic nervous system – specifically the flight or fright response – many many times each night. This means that you experience high levels of stress and associated stress hormones throughout the night without even being aware of it. Over time, this consistent “stress” creates the perfect environment for AF to develop – which in turn can lead to blackouts and heart failure if left untreated. Often, the usual treatments for AF such as drugs or electrical ablation, where the faulty electrical connections in the heart leading to AF are burned away, don’t work unless the original trigger of sleep apnoea is also dealt with.
What is the easiest way to confirm a diagnosis?
Getting a diagnosis of sleep apnoea in the past used to be a bit of a production involving patients being taped up with tubes and pipes all night. Luckily science has moved on now. Using a WatchPAT device is a simple way to effectively diagnose sleep apnoea. This is a simple overnight test, worn on the fist with a finger cuff, and can effectively help your doctor make a rapid diagnosis.
How can I get tested?
Dr Boon Lim is one of London’s leading cardiologists and electrophysiologists, voted Top Doctor of the year in the UK by his peers in 2017 and 2018. He specialises in heart rhythm disturbances, sleep apnoea, cardiac pacing and syncope/fainting. Working in both private medicine and in respected NHS teaching institutions, he is passionate advocate in using state of the art technology to ensure patients with heart problems receive the most cutting edge treatments available.
WatchPAT devices are available at several centres in the UK. If you’d like to see Dr Boon Lim to assess your cardiovascular health and check for sleep apnoea, please contact him for a consultation here.
To book an appointment with a sleep specialist, simply Log in to your account and search our Consultant Directory or raise a Concierge case.
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