The symptoms of obstructive sleep apnoea (OSA) are in many ways very distinctive and easy to spot.
The implications – both for quality of life and in terms of potential co-morbidities such as heart disease, depression, stroke and diabetes – are significant enough to warrant serious attention. And management, with treatments such as Continuous Positive Airway Pressure (CPAP) machines, is relatively straightforward and can have an absolutely transformative impact on the lives of those affected.
It is therefore a source of great frustration and concern that up to 80 per cent of people with OSA remain undiagnosed and untreated – a worrying situation that could, with better recognition of symptoms by GPs and the general public, be much improved.
OSA occurs when muscles in the throat relax and cause an obstruction in the airway during sleep, resulting in a pause in the individual’s breathing (or ‘apnoea’) that can last upwards of 40 seconds at a time. This can lead to dips in blood oxygen levels, and can wake the affected person up throughout the night, often without them being aware of it. In severe cases, more than 30 apnoeas happen each hour.
The symptoms of OSA, such as loud snoring, stopping breathing or struggling to breathe when asleep, as well as daytime sleepiness, are all things that should make an affected person’s GP, friends and family stop and take note.
However, with the standard stereotype of someone with OSA being an overweight middle-aged man, it is feared that many people who do not fit the mould are also slipping through the net. While this group might be at greater risk than much of the rest of the population, the truth is that men and women of all ages, shapes and sizes, and even around 3% of children, are affected by OSA.
With the condition in many other cases too often misdiagnosed as depression, ‘tiredness’ or even diabetes, the result is that hundreds of thousands of people in the UK are living unnecessarily with this potentially dangerous condition.
If untreated, OSA can have severe consequences, and may increase the risk of hypertension, stroke and cardiac arrest. It is also associated with Type 2 diabetes and depression. Quite apart from the serious consequences to an affected person’s health, extreme daytime sleepiness can also have a major impact on their social and professional lives. Operating heavy machinery or driving for long periods when sleepy can be extremely dangerous; it is thought that 20 per cent of serious road traffic accidents are caused by sleepy drivers.
The British Lung Foundation has made efforts to address the impact OSA has on the health of the nation by providing helpline support, running awareness campaigns, and publishing guides and information both for the public and specifically for GPs and other primary care staff.
But this alone is not enough. OSA is a serious health concern and needs to be treated as such. All GPs need to receive adequate training in order to recognise symptoms. And there needs to be a concerted effort from government and NHS bodies to improve public awareness, and ensure that all OSA patients have access to sleep services and appropriate treatment, wherever they are in the UK.
Obstructive sleep apnoea needn’t cause the problems it all too often does at the moment. If we can improve all round awareness of OSA’s symptoms, and breakdown some of the stereotypes that are often attached to the condition, then we can do much to help improve the situation in the UK.