Obstructive sleep apnoea otherwise known as OSA is a disorder in which your breathing is repetitively interrupted during sleep. Apnoea means an absence of breathing. It is due to a collapse of the upper airway and the incidence is dramatically increased in patients who are overweight or suffering from obesity.
An apnoea episode is defined as complete cessation of breathing lasting 10 seconds or greater. The patient typically complains of sleepiness during the day, and awakening with gasping or a choking sensation. There is loud snoring and frequent pauses in breathing during sleep as reported by the partner. There is fatigue and a lack of energy due to the simple lack of sleep and the patient complains of an interrupted sleep pattern.
OSA causes hypertension that is resistant to standard treatment and it predisposes to coronary artery disease, stroke and increases premature death.
Individuals with OSA are rarely aware of any difficulty with their breathing even when they wake up. It is much more of a problem and is recognised by people close to them. Symptoms may have been present for years or even decades without anybody realising what is actually happening. During this time, the individual tends to become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance. Of course, individuals who generally sleep alone are often unaware of the condition.
The muscle tone of the body relaxes during sleep and then the airway in the throat, being composed of soft tissue, is prone to collapse in individuals suffering from OSA. Many people experience episodes of OSA for short periods only and this is often associated with an upper respiratory infection that causes symptoms such as nasal congestion or tonsillitis, producing a temporary enlargement of the tonsils.
OSA is associated with obesity mainly through the mechanical manifestation of the increased mass of soft tissues in the neck secondary to excessive storage of adipose tissue that goes with being overweight or suffering from obesity.
The treatment of OSA needs to be centred upon identifying the risk factors and if these themselves can be treated, or reversed. Then the condition usually resolves successfully. Clearly if the individual presents with being overweight or suffering from obesity then it goes without saying that this needs to be addressed as a priority.