Sleep Clinic Galway
Apnoea is a Greek word meaning ‘without breath’. There are three types of apnoea that occur during sleep: central, obstructive, and a third type of mixed apnoea which is a combination of the two.
Central Sleep Apnoea
Central sleep apnoea results from the brain failing to send the signal to breathe. The person stops breathing during sleep and no effort is made by the breathing muscles to resume breathing. Eventually, the brain sends the right signals and breathing resumes. While central sleep apnoea is a rare condition in the general population, some children and adults diagnosed with obstructive sleep apnoea can also have an occurrence of central sleep apnoea.
Obstructive Sleep Apnoea (OSA)
During your school days, you may remember reading about Joe the “fat boy” from the Pickwick Papers written by Charles Dickens in 1837. Joe ate food in great quantities and was liable to fall asleep during any situation. His breathing was heavy, he snored, and he was continuously sleepy.
Originally described as Pickwickian syndrome, this type of breathing was later categorised as obstructive sleep apnoea syndrome by Dr Christian Guilleminault. In the early 1970s, while working at the Stanford University Sleep Disorders Clinic, Dr Guilleminault teamed up with cardiologists to monitor the blood pressure of sleeping patients. The team discovered that when patients stopped breathing during sleep, their blood pressure dramatically increased. When this continued over time, the increase to blood pressure became permanent, occurring both day and night.
Needless to say, obstructive sleep apnoea exerts considerable stress on the body, often resulting in poor health. People with obstructive sleep apnoea experience a decrease to quality of life as well as increased risk of cardiovascular disease. There is growing data that OSA also increases the risk of developing diabetes and possibly cancer.
The prevalence of obstructive sleep apnoea continues to increase, and shows no sign of abating. In a 2009 paper published in the journal Sleep Medicine, Dr Kevin Finkel and colleagues from the Washington University School of Medicine, reported that obstructive sleep apnoea (OSA) affects approximately 20% of US adults, of whom about 90% are undiagnosed.
In a separate telephone poll of 1,506 adults in the USA, results showed that 31% of men and 21% of women indicated a high risk of OSA. For obese people, this figure jumps to as high as 57%.
Obstructive sleep apnoea is the most common type of sleep apnoea in humans, and involves a repetitive pausing of the breath during sleep caused by the collapse of the throat. Breathing may stop for as long as one minute or more, even as the brain continues to send signals to the breathing muscles to breathe.
Upon resumption of breathing, the individual takes a number of large gasps of air into their lungs, snores for a period of time, and then stops breathing again. This cycle of snoring, apnoea, gasping, and snoring continues all night long.
The sleeper are usually not aware that they have stopped breathing, or the large catch up breaths after they resume breathing. It is usually their sleeping partner who lies awake, listening and worrying as opposed to having a good nights sleep. Often, snorers are urged by their partner to visit their family doctor to get the condition checked out. The doctor, in turn, will usually refer the snorer to a sleep clinic, where they may participate in a study on how they breathe during sleep. This study is called a polysomnogram and can be conducted overnight at the sleep clinic or at home. During the sleep study, brain activity, eye movement, heart rate, blood pressure, breathing and blood oxygen saturation are recorded. The most important data during the sleep study is known as the apnoea hypopnoea index (AHI).
To attend our Galway sleep clinic to learn breathing re-education using the Buteyko Method, complete the contact us form.
The apnoea hypopnoea index was developed by Dr Guilleminault and is still used today to characterise the presence and severity of sleep apnoea. The AHI is generally expressed as the amount of apnoeas and hypopnoeas per hour:
- An apnoea describes a complete stopping of the breath during sleep for ten seconds or longer
- A hypopnoea describes a reduction to breathing flow of greater than 30% during sleep, lasting for 10 seconds or more, which causes a decrease to blood oxygen saturation of at least 4%
An AHI of 5 to 15 is classified as mild obstructive sleep apnoea; 15 to 30 is moderate OSA; 30 or more is severe OSA.
People who experience snoring and obstructive sleep apnoea breathe intensely. As part of my work, I am a frequent flyer, and during long haul flights, drowsiness often sets in with some passengers falling asleep. As their sleep deepens, I have a habit of listening intently to their breathing, and sad as it seems- I sometimes count the number of breaths per minute as well as getting a sense of the speed and amplitude of each breath. Time and time again, I witness that people who snore and who stop breathing during sleep demonstrate a fast inspiration as they take a large volume of air into their lungs with each breath. In other words, their breathing is hard, which in turn increases the negative pressure in the upper airways sometimes causing collapse and stopping of breathing. In examining the relationship between breathing and obstructive sleep apnoea, it is important to consider two factors; namely; the speed and volume of breathing as well as the diameter of the upper airways.
Attend our sleep clinic in Galway, to significantly reduce your snoring and obstructive sleep apnoea. Persons attend four sessions over a two weeks. Dates and further information is available from here.