Sleep apnoea

A disorder in which there are episodes of temporary cessation of breathing (lasting 10 seconds or longer) during sleep. People with sleep apnoea may not be aware of any problem during the night, but they may be sleepy during the day, with poor memory and concentration. Severe sleep apnoea is potentially serious and may lead to hypertension, heart failure, myocardial infarction, or stroke. Obstructive sleep apnoea is the most common type and may affect anyone, but more often middle-aged men, especially those who are overweight. The most common cause is over-relaxation of the muscles of the soft palate in the pharynx, which obstructs the passage of air. Obstruction may also be caused by enlarged tonsils or adenoids. The obstruction causes snoring. If complete blockage occurs, breathing stops. This triggers the brain to restart breathing, and the person may gasp and wake briefly. In central sleep apnoea, breathing stops because the chest and diaphragm muscles temporarily cease to work, probably due to a disturbance in the brain’s control of breathing. Causes include paralysis of the diaphragm and disorders of the brainstem. Snoring is not a main feature. People who are overweight may find losing weight helps. Alcohol and sleeping drugs aggravate sleep apnoea. In one treatment, air from a compressor is forced into the airway via a mask worn over the nose. Night-time artificial ventilation may be needed. Tonsillectomy, adenoidectomy, or surgery to shorten or stiffen the soft palate may be performed.


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