Condition: Sleep Apnoea

Obstructive Sleep Apnoea can affect everyday life. Common day-time symptoms include excessive daytime sleepiness, impaired concentration, morning headaches, and mood irregularity (‘short fuse’). At night the symptoms include loud (e.g., loud enough to be heard in an adjacent room) snoring or grunting, sensations of choking in sleep, waking up gasping, and jerking movements. The disruptions to sleep caused by OSA has been associated with increased risk of patients developing more serious health conditions including strokes, heart failure, and hypertension.

Some individuals are more prone to developing OSA:

• Men over 50
• Women who are post-menopausal
• People with a BMI of over 28 kg/m² or a neck/collar size of over 17inch (43cm)

Other risk factors include:

• Short stature
• Oronasal conditions
• Sedo-analgesic medications for pain or psychiatric conditions
• Large tongue or tonsils
• Craniofacial variants
• Pre-existing heart rhythm abnormalities
• Certain neurological conditions

There is also significant research that suggests between 30-50% of patients with high blood pressure, especially those requiring more than one drug for treatment, that snore have OSA. Individuals who smoke, or drink regularly also have a higher change of developing OSA.

Furthermore, there is now strong and emerging evidence that OSA is an independent risk factor for coronary heart disease, hypertension and stroke (estimated 2-4x increased risk). There is also evidence that successful treatment of OSA can reduce diastolic blood pressure by up to 5 mmHg in trials. Over time, this might have a profound impact on cardiovascular and cerebrovascular risk.

For patients or partners of patients concerned that they suffer from OSA, OneWelbeck offers a full specialist evaluation through our Sleep Studies. The OneWelbeck OSA pathway will include an at-home sleep study to analyse breathing and sleep behaviour which can decipher whether they are suffering from OSA. The OneWelbeck sleep studies pathway includes:

• Diagnostic blood tests
• Study with SUNRISE device which is an overnight sleep study to be taken in the comfort of your own home for 1 night
• Your results are analysed within 48 hours, and your overnight sleep report together with other investigations are discussed at a detailed medical consultation with a respiratory sleep doctor. A full history and examination (preferably with an accompanying partner) will also be taken
• Please note that further diagnostics may be required, such as a more detailed NOX T3 study within our Lung Health centre or an EEG within our Neurology centre

Following these tests, treatment with a device and/or other management strategies are discussed and arranged. This may involve referral to another specialty.

Alternatively, a patient can book an appointment by calling 020 3653 2006 or emailing lunghealth@onewelbeck.com

Professor Michael Polkey, Consultant in Sleep Medicine gives a short overview on the sunrise device and explains how OneWelbeck can offer this sleep diagnostic service to patients with sleep disturbance.

Upon completing the OneWelbeck Sleep study, if there is a positive diagnostic for OSA there are a variety of treatments that will be advised by the sleep consultant based on the feedback from the diagnostics.

The gold standard treatment for OSA is the continuous positive airway pressure (CPAP) machine. This is a mask, connected to a machine, that will blow air through the nostrils and/or mouth throughout the night, keeping the airways open and the snoring at a minimum.

There is also the option for nasal and throat surgical sleep treatments for OSA. The patient will be notified if they have the option to undergo these once they have been assessed.

Any additional medical issues that are identified in the sleep study tests will be internally referred to the appropriate sub-specialty.

Professor Michael Polkey, Sleep Medicine Consultant at OneWelbeck Lung Health gives an overview of obstructive sleep apnoea and how OSA can affect you.