Snoring's hidden threat

Sleep apnoea is very common, but less than one-in-three sufferers know that they have it. Although sleep apnoea can affect all ages, it's most common in middle-aged men, in whom 2-4% are sufferers, according to the British Thoracic Society (BTS).

"Sleep apnoea is a major cause of disability because it causes daytime sleepiness," says Professor John Gibson, a sleep apnoea expert at the (BTS).

"This can seriously affect social behaviour, work performance and the ability to drive safely.

"Hundreds of thousands of sufferers are still undiagnosed in the UK, usually because the condition has not been considered by individuals or their doctors."

Sleep apnoea is a respiratory condition in which the throat narrows or closes during sleep and repeatedly interrupts a person's breathing.

This results in a fall in the blood's oxygen levels. The difficulty in breathing causes the brain to wake the person up.

This can occur hundreds of times a night without the sufferer realising. It leads to poor sleep quality and severe sleepiness during the day.

The good news is that something can be done if you're diagnosed with sleep apnoea. You'll probably be prescribed Continuous Positive Airways Pressure (CPAP). This device raises and regulates the pressure of air that's breathed in, and it prevents the airway from collapsing during sleep.

Symptoms include heavy snoring, daytime sleepiness, morning headaches, poor concentration and needing to pass urine at night more often.

Overweight men between 30 and 65 are most commonly affected. Sleep apnoea is less common in women, possibly due to a lack of awareness of the condition.

Sleep apnoea also affects children, particularly those with enlarged tonsils or adenoids.

Health risks

If left untreated, the condition can increase the risks of high blood pressure, coronary heart disease, stroke and diabetes.

People with sleep apnoea are seven to 12 times more likely to have a road accident than those without the disorder, according to the BTS.

Tests show that drivers who are sleepy due to sleep apnoea perform worse than drivers with blood alcohol levels over the legal drink drive limit.

You're unlikely to be aware that you have problems breathing while asleep unless your partner or a family member notices the episodes when you stop breathing.

However, if your sleep is continually disrupted, you may become aware of the problem and you'll begin to feel symptoms of sleep apnoea during the day.

The most common symptoms are:

• snoring
• witnessed episodes of stopping breathing during sleep
• restless/unrefreshing sleep
• frequent trips to the loo every night
• morning headaches
• excessive daytime sleepiness,?irritability
• impaired concentration
• decreased libido

Diagnosis

Most patients can be diagnosed by doing a home recording. Recorders are available for people to wear overnight in bed.

These register either the blood oxygen level alone, or oxygen plus snoring, heart rate and breathing efforts, using sensors on the finger and around the body.

If you've been diagnosed with sleep apnoea, you'll probably?be prescribed CPAP to reduce your symptoms.

The patient wears a mask over their nose and mouth, and a machine raises and regulates the pressure of the air breathed in. This prevents the airway from collapsing during sleep.

CPAP has good results. By controlling the apnoea, it improves the quality of sleep. The person wakes up feeling much more refreshed, and remains alert throughout the day.

CPAP also suppresses the snoring, meaning that the person's partner can also sleep better.

A minority of patients find CPAP treatment very uncomfortable to use. They may be helped by a mouth splint (also called a mandibular advancement device), which is made by a specialised dentist. However, the benefit is less predictable than that of CPAP.

Surgery is rarely used in treating sleep apnoea, apart from removing the tonsils when these are very large.