Good sleep good health brochure
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Some sleep problems require professional help, but trying the Tips for Good Sleep could help.
Obstructive Sleep Apnoea (OSA) is a characterised by repeated collapse of the pharynx during sleep causing upper airway obstruction leading to recurrent oxygen desaturation and hypoxemia, hypercapnia, arousals from sleep and sleep fragmentation. These contribute to the adverse consequences of OSA, including cardio-metabolic and neurocognitive effects.
Significant (moderate-to-severe) obstructive sleep apnoea affects 50% of adult men and 25% of adult women (see Heinzer R, Vat S, Marques-Vidal P, et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. The Lancet Respiratory medicine. 2015;3(4):310-318. doi:10.1016/S2213-2600(15)00043-0).
People with obstructive sleep apnoea report:
Other common symptoms are:
Daytime symptoms can include irritability and mood changes.
Although obesity is a common risk factor, many people with OSA are not obese. Other physiological factors that influence OSA risk in individuals include:
Fluid retention and fluid shifts overnight may also play a role. Craniofacial anatomy can be important in some people.
Consequences of OSA include excessive daytime sleepiness and fatigue, and reduced quality of life, particularly in younger and middle-age individuals. A large body of evidence has shown OSA leads to hypertension. These problems have been shown in randomised clinical trials to improve with treatment. OSA has also been linked in a large number of studies to increased:
Referral for investigation should be considered in any person with any symptoms (see above). There are a number of treatment options for OSA. All people with OSA can benefit from weight loss, and in mild OSA this may be all that is needed. For others, commonly used treatments include Continuous Positive Airflow Pressure (CPAP) or oral devices (mandibular advancement device). Studies show adherence to CPAP is 60–70%, much the same as adherence to asthma inhalers, oral anticonvulsants and maintenance of good glycemic control in diabetes. Newer therapies include hypoglossal nerve stimulation.
Fitness to drive is an important consideration in assessing people with OSA. Guidelines require practitioners to consider excessive daytime sleepiness, drowsiness while driving, history of accidents as well as adherence to treatment when making an assessment of fitness to drive. Commercial licence standards are more stringent.
This information has been developed by SA Health and The University of Adelaide