Obstructive Sleep Apnoea

Obstructive Sleep Apnoea (OSA)

What is obstructive sleep apnea?

Obstructive sleep apnoea, also known as OSA, is a condition characterised by repetitive upper airway obstruction during sleep, resulting in repeated blockage to breathing during sleep. This is because the upper airway collapses repeatedly as you sleep, causing an effect similar to that of being choked throughout the night. When this happens, your sleep is interrupted and there are also recurrent dips in your blood oxygen levels, putting a strain on your heart.

OSA has been known to be linked to:

  • Hypertension
  • Heart attack
  • Ischaemic heart disease
  • Sudden death
  • Stroke
  • Type two diabetes
  • Poor quality of life
  • Poor work productivity

Nearly one-third of Singaporeans experience moderate to severe obstructive sleep apnea.

Bearing in mind that a significant number of OSA cases go underdiagnosed, more people could be suffering from this condition than earlier thought.

What are the symptoms of OSA?

The most common OSA symptoms include:

  • Obstructed breathing episodes
  • Snoring
  • Nocturia
  • Restless night sleep
  • Incidences of choking while sleeping

Daytime OSA symptoms may include:

  • Irritability
  • Lower concentration levels
  • Inadequate sleep
  • Feeling sleepy during the day
  • Morning headache episodes

Who is at risk of developing OSA?

Individuals with the following risk factors have a higher chance of developing OSA:

  • Increasing age
  • Overweight
  • Males
  • Underlying airway obstruction symptoms such as enlarged tonsils and adenoids

What is the rate of OSA in Singapore?

Research shows that about 33% of Singaporeans suffer from moderate to severe obstructive sleep apnea, with many incidences going undiagnosed. Furthermore, the symptoms of night time OSA are usually only observed by your sleep partner, hence, you may not even realise that you are experiencing OSA until daytime symptoms of OSA present themselves.

How is obstructive sleep apnea diagnosed?

Both the examination and diagnosis of OSA are carried out through a planned and monitored sleep evaluation based on the levels of your convenience and comfort. In this respect, there are two types of sleep evaluation methods:

  • In-laboratory polysomnography: also referred to as PSG, this sleep evaluation technique is conducted during in-patient visitations. While this method comes with close monitoring by a medical team, there is higher medical personnel involved, which in turn, results in higher financial expenditures.
  • Home sleep study: this is conducted in the comfort of your home, allowing you to feel comfortable and relaxed during the entire procedure. This technique is more accurate, efficient and is less resource intensive.

How is OSA treated in Singapore?

The treatment options depend on the severity of your OSA, these treatment options include:

  • Continuous Positive Airway Pressure (CPAP): the main treatment for OSA. It delivers a constant airflow to help sustain airway potency. Research has proven that CPAP can substantially minimise the apnoea-hypopnea index, which is a marker of OSA severity. It boosts cognitive ability, and improves sleepiness and blood pressure. It can also be customised to your sleep breathing pattern.
  • Oral appliances: used to aid in the treatment of OSA. Medical devices such as Mandibular Advancement Splints can be used by individuals experiencing mild to moderate OSA symptoms.
  • Surgery: best suited for OSA patients who do not favour nonsurgical treatment options such as dental devices as well as oral devices.

Besides treatment, there are proven lifestyle changes that can help alleviate OSA-related symptoms, including:

  • Reducing weight: Shedding a few excess pounds through both exercise and diet can help minimise the severity of your OSA symptoms.
  • Reducing alcohol consumption: Excessive drinking can exacerbate your OSA symptoms.
  • Taking note of your sleeping pattern: ensure your bedroom is free from distractions such as noise and light, among others. Refrain from drinking caffeinated drinks at night and also don’t sleep during the day.

What health complications are associated with OSA?

It has been proven that OSA patients are at an increased risk of suffering a number of health complications, including:

  • Diabetes: OSA patients are more likely to experience diabetes.
  • Reduced libido: sexual dysfunction issues such as reduced sex libido and erectile dysfunction are common among both male and female OSA patients.
  • Increased mortality: OSA has been linked to various chronic conditions such as high blood pressure, heart attack, stroke, etc., these conditions are linked to increased mortality.
  • Reduced quality of life: individuals with OSA experience increased daytime sleepiness as well as cognitive decline, which can negatively impact their daily lives.
  • Cardiovascular mobility: If left untreated, OSA is likely to develop into cardiovascular issues such as heart attack, hypertension, atrial fibrillation as well as heart failure.
  • Increased risk of accidents: Because it impacts your concentration levels during the daytime, it makes you highly vulnerable to accidents.

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