What is obstructive sleep apnoea (OSA)?
What does OSA stand for?
Obstructive: the upper airway is blocked or narrow
Sleep: it happens when you're asleep
Apnoea: your breathing stops for a short time (ap-nee-a)
Obstructive sleep apnoea (OSA) is a condition affecting your breathing when you sleep. It happens when the wall of your throat narrows or closes.
OSA is the most common type of sleep apnoea, affecting about 1 in 20 people.
Both adults and children can have OSA, but you're more likely to have OSA when you're an older adult.
OSA is an ongoing condition, but there are treatments to manage the symptoms, and lifestyle changes can make a big difference too.
How does OSA affect your breathing?
When you have OSA your breathing stops, and starts again, while you sleep.
Your throat narrows or closes while you sleep and the muscles of your upper airway relax.
You do not breathe enough, or your breathing stops for a short time. This wakes you up, or brings you out of a deep sleep, to start breathing again.
You can stop and start breathing like this hundreds of times. It’s more likely to happen in deep sleep (rapid eye movement or REM sleep) which is more in the second half of your sleep.
OSA makes it hard to get a good sleep and can leave you feeling very sleepy when you’re awake.
Signs and symptoms of OSA
If you share a bedroom with someone, they might be more aware of your snoring and pauses in your breathing when you’re asleep than you are. There are other signs and symptoms to look out for when you’re awake too.
Your doctor is more likely to think you have OSA if you have two or more of these symptoms:
Symptoms when you're asleep:
- snoring
- pauses in breathing (apnoeas)
- unable to sleep or broken sleep
- choking during sleep
Symptoms when you're awake:
- waking up tired and feeling unrefreshed
- waking up with a headache
- feeling extremely tired and sleepy during the day. You can use the Epworth Sleepiness Scale to check how sleepy you are during the day.
- finding it harder to concentrate or remember things.
Children with sleep apnoea may also:
- be irritable
- be hyperactive
- not do so well academically at school.
See your GP if:
- your breathing stops and starts while you sleep
- you snore or make gasping, snorting or choking noises while you sleep
- you always feel very tired when you're awake.
What causes OSA?
You're more likely to get OSA if you:
- are very overweight (obese)
- are older (this usually means you're over 60)
- are male
- have a large neck (greater than 40.6cm)
- have a narrow airway
- have a set-back lower jaw or chin
- have large tonsils or adenoids. This is the most common cause of OSA in children
- have other family members with sleep apnoea
- smoke or drink alcohol
- sleep on your back
- are in the later stages of pregnancy
- have another lung condition, like COPD or asthma
- have other conditions, including Down's syndrome.
What are the risks from OSA?
It's important to get treatment for OSA
OSA can be serious if it's not diagnosed and treated. It can affect your general health, wellbeing and quality of life.
It's important to get treatment for OSA to lower your risk of other health problems.
Treatment can also lower your risk of accidents from being tired and drowsy during the day.
Without treatment, OSA can affect your health and cause, or worsen:
- high blood pressure
- heart disease
- type 2 diabetes
- stroke
- depression or mood changes.
OSA may affect other areas of your life too. For example, you may:
- find it hard to focus at work or at school
- have mood changes which could affect your work, family or social life
- have difficulties in your relationship with your partner if you have one
- have a higher risk of having an accident caused by tiredness, including when driving.
Driving and OSA
There are rules about driving if you have sleep apnoea because it increases your risk of having an accident while driving.
If you have a driving licence, you must:
- tell the DVLA if you have OSA and excessive sleepiness, or your doctor suspects you have. You can do this online or by downloading a form. You can be fined it you do not tell the DVLA about your condition.
- follow all necessary treatment for your OSA
- not drive until your doctor confirms your symptoms are under control.
Once your sleepiness is under control, you can check with the DVLA if you're now able to drive again.
OSA and your lung condition
Managing OSA and your lung condition
People with lung conditions have a higher chance of getting OSA.
If you have a lung condition, it’s important to treat your OSA too. Untreated OSA is linked to worse lung condition symptoms, flare-ups and asthma attacks.
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Making lifestyle changes can lower the risk of OSA making your lung condition worse
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Treatments can improve sleep and quality of life for people with OSA and lung conditions.
Find out more about treatments for your lung condition.
You're more likely to get OSA if you have asthma, especially if you're overweight or have asthma that's difficult to control.
OSA can make your asthma symptoms worse and increase your risk of an asthma attack, so it’s important to get it diagnosed and treated. If your asthma is not well controlled, ask your GP to check for OSA.
With the right diagnosis and treatment, you can improve both your asthma and sleep symptoms.
- Speak to your GP or nurse - it's important to diagnose OSA as soon as possible.
- When you have your asthma review, remind your GP or nurse that you also have OSA.
- Ask your GP or nurse to include OSA in your asthma action plan.
- Always ask for an urgent GP appointment or call 111 as soon as you notice asthma symptoms getting worse or keeping you awake at night.
Having OSA alongside your COPD increases your risk of sleep problems and COPD flare ups.
Managing any other conditions as well as possible helps to lower your risk of worse COPD symptoms. Find out more about treating COPD.
- Speak to your GP or nurse - it's important to diagnosed OSA as soon as possible.
- When you have your COPD review, remind your GP or nurse that you also have OSA.
- Ask your GP or nurse to include OSA in your COPD self-management plan.
- Ask for an urgent GP appointment or call 111 as soon as you notice COPD symptoms getting worse, or keeping you awake at night.
- Go for regular reviews for your COPD, including looking at COPD symptoms that could also keep you awake at night, like coughing and wheezing.
- Speak to your GP about medicines you're taking for COPD, for example theophylline, which can affect the quality of your sleep.
Studies suggest you're more likely to have OSA if you have an interstitial lung disease (ILD), especially a type of ILD called idiopathic pulmonary fibrosis (IPF).
If you have IPF and any problems with your sleep, ask your GP to check your risk of OSA.
OSA treatments have been found to make a difference to OSA symptoms for people with IPF, and also lower the risk of IPF flare ups.
Studies also suggest that CPAP treatment for OSA can improve quality of life and life expectancy for people with OSA and IPF.
- Speak to your doctor or specialist - it's important to diagnose OSA as soon as possible.
- When you have your lung review for your IPF, remind your doctor or specialist that you also have OSA.
- Ask your doctor or specialist to include OSA in your IPF self-management plan.
- Ask for an urgent GP appointment or call 111 as soon as you notice your lung symptoms getting worse, or keeping you awake at night.
