Sleep Apnoea treatment in Manchester

Sleep apnoea is when your breathing stops (apnoea) and starts while you sleep.  

This interruption in breathing can lead to poor-quality sleep, leaving you extremely tired during the day, even after a full night’s rest. The most common type, known as obstructive sleep apnoea, occurs when your throat muscles relax and block your airway. Symptoms often include loud snoring, gasping for air during sleep, morning headaches, and difficulty concentrating.  

If left untreated, sleep apnoea can increase your risk of high blood pressure, heart disease, type 2 diabetes, and stroke, significantly impacting your overall health and quality of life.

There are several types of the condition. These include: 

Obstructive sleep apnoea 

This happens when the muscles in the back of your throat that support your soft palate, relax.  

When the muscles relax, your airway narrows or closes as you breathe in. You can't get enough air, which lowers the oxygen level in your blood. Your brain senses that you can't breathe, and briefly wakes you up, often without you being aware of it, so that you can reopen your airway.  

You might snort, choke or gasp. This pattern can repeat itself five to 30 times or more each hour, all night. This makes it hard to reach the deep, restful phases of sleep. 
Risk factors for obstructive sleep apnoea include: 

• Obesity 
• High blood pressure 
• Family history of sleep apnoea 
• Certain medical conditions 
• Age (more common in older adults) 
• Gender (men are more likely to be affected than women, but women's risk increases after menopause)  
• Large neck circumference Narrowed airway (for example enlarged tonsils) 
  
   

Central sleep apnoea 

This is a less common form of sleep apnoea. It occurs when your brain fails to send signals to your breathing muscles. This means that you make no effort to breathe for a short period, leading to the fall in body oxygen levels. You might awaken with shortness of breath or have a difficult time getting to sleep or staying asleep. 

Risk factors for central sleep apnoea include: 

• Being older 
• Being male 
• Having congestive heart failure increases the risk 
• Using narcotic pain medicines. Opioid medicines, especially long-acting ones such as methadone, increase the risk of central sleep apnoea 
• Having had a stroke increases the risk of central sleep apnoea 
  
  

 Complex sleep apnoea syndrome 

This type is a combination of both obstructive and central sleep apnoea.  

It may initially appear as OSA and then show signs of central apnoea, especially after starting treatment like CPAP. CPAP, or continuous positive airway pressure, is a treatment commonly used for obstructive sleep apnoea (OSA). It involves a machine that delivers a constant, gentle stream of air through a mask worn over your nose and mouth during sleep.  

This steady airflow helps keep the upper airway open, preventing it from collapsing and causing breathing pauses. 

Treating sleep apnoea is essential. If left untreated, the condition can lead to more complex problems. These include: 

• Daytime fatigue and sleepiness 
• High blood pressure or heart problems. Sudden drops in blood oxygen levels that occur during OSA increase blood pressure and strain the cardiovascular system. Having OSA increases your risk of high blood pressure, also known as hypertension. 
• OSA might also increase your risk of heart attacks, stroke and irregular heartbeats, such as atrial fibrillation. If you have heart disease, multiple episodes of low blood oxygen can lead to sudden death from an irregular heartbeat. 
• Development of type 2 diabetes, high blood cholesterol levels  
  
  

Treatment options are dependent on the cause of your sleep apnoea.

They include:  

• Lifestyle changes, including improving sleep processes, weight loss, reducing alcohol intake especially at night and reduction in sleep modifying medication may help when the sleep analysis has demonstrated mild sleep apnoea. 
• Individuals may benefit from surgical intervention if there are anatomical issues impacting adversely on flow through the upper airways. 
• Mandibular advancement devices which patients can wear at night which reduces upper airway obstructions can help in some cases. 
• The mainstay currently for sleep apnoea is a CPAP (continuous positive airway pressure) machine, as explained above. 

At The Alexandra, we have three specialists who can help diagnose your sleep apnoea and build a treatment plan tailored to your sleep needs. 

• Dr Aashish Vyas - Consultant Respiratory Physician
• Mr Jay Goswamy- Consultant Ear, Nose and Throat Surgeon
• Mr Yakubu Karagama- Consultant Ear, Nose and Throat Surgeon

You will have an initial consultation with your medical consultant, to assess potential for sleep apnoea, its causes and complications. 

Your initial consultation will look at the potential cause of your symptoms.  Individuals with likelihood of sleep apnoea will then be provided with an overnight sleep monitor and instructions on how to use it.  The sleep assessment occurs at your home and the machine is returned the next day to the Alexandra hospital for analysis of your sleep.  The test reviews sleep parameters including heart rate, blood oxygen saturations and whether sleep disturbance is related to obstruction or centrally driven.   

 A follow up appointment with your consultant goes through analysis of the sleep study, individuals are informed if there is any evidence of sleep apnoea whether it is related to obstruction of the upper airway during sleep or if it is driven centrally by the brains breathing centre.  Treatment options will be discussed. Options can include; mandibular advancement devices which look like mouth guards and are worn at night to keep the upper airway open, sleep apnoea machines, surgical intervention for obstructive or enlarged tissue (for example tonsils) in the upper airway, reduction / alteration in sedative medication.  The aim is to support high quality sleep with reduction daytime tiredness and complications related to sleep apnoea.  Sometimes it is important to repeat the sleep study once treatment has been established to ensure optimum outcome of the treatment process.