Obstructive Sleep Apnoea, or OSA, is a condition in which there is an obstruction of the airways. This can be caused by a number of different things, for example a weakening or relaxation of the muscles in the throat during sleep. This narrows the airways, reducing airflow and making it harder to breathe. This can cause irregular breathing and snoring, particularly in those with large adenoids or tonsils. This can temporarily wake the sufferer while they try to resume a normal breathing pattern, leading to disrupted, poor quality sleep.
There are various causes for OSA in both adults and children. Children with enlarged tonsils and adenoids are at risk of OSA as this will block part of their airway. This is the most common cause of obstructive breathing and/or OSA in children. Other causes include childhood obesity, Down’s syndrome and sickle cell disease.
In adults, the causes are much broader and in general more complex to evaluate as there is rarely one problem that is causing the symptoms, unlike in children where the problems are usually more straightforward. These include nasal problems (nasal blockage due to a deviated nasal septum, sinusitis, allergy or nasal polyps), throat related problems (tonsillitis, large tonsils, an elongated uvula), voice issues (eg. laryngeal swelling due to acid reflux), and issues with neck size or swellings in the neck (eg. increased neck size due to obesity, thyroid problems, enlarged lymph nodes).
Snoring is often the first symptom of OSA. Parents of children with OSA may notice their child is sleeping in unusual positions in order to help them to breathe. Frequent but brief arousal from sleep is also common among sufferers, along with increased sweatiness or restlessness. This is the brain alerting the body to the struggle with breathing. Being extra tired during the daytime will be a repercussion of this. Some children may be aggressive or hyperactive during the day due to feeling over-tired. Struggling to focus or concentrate is another side effect. In extreme cases, the sufferer may lose their appetite and growth as well as school- work could suffer.
Difficulties with breathing while sleeping can be linked to several medical conditions, so it is important the right tests are carried out to determine a diagnosis. An over-night sleep study performed by a technologist or physiologist is the best method. Breathing, heart rate and oxygen levels will be recorded. This can often be performed as a home sleep study so you do not necessarily have to stay overnight in hospital.
Treatment will vary from patient to patient. If the tonsils or adenoids are the primary cause, then an operation to remove those may be arranged. Other possible treatment options include positive airway pressure therapy (CPAP OR BiPAP), nasopharyngeal airway treatment (NPA), nasal steroids and mandibular advancement (moving the jaw forward).