'High costs' of sleep disorder

Snoring can be an irritation for partners who experience disturbed nights.

But Dr Keith Prowse, honorary medical adviser for the British Lung Foundation, warns if it is extremely loud, with regular pauses and gasps, it can be a sign of sleep apnoea - a serious condition which can lead people to feel excessively sleepy during the day - which can lead to dangers if someone is driving or using heavy machinery.

In this week's Scrubbing Up, Prof Prowse warns many with the condition are undiagnosed - but says it is easily treatable.

Obstructive sleep apnoea is one of the commonest sleep conditions in Britain today.

It is thought to affect about 4% of men and 2% of women as well as children. Many people are undiagnosed and try to cope with symptoms which could be easily treated.

In obstructive sleep apnoea the sleeping person's airway is blocked or partially blocked when the muscles of the throat relax.

This interferes with breathing, often stopping it altogether for short periods many times a night leading to lack of oxygen, restless sleep and heavy snoring.

The sleep disruption causes excessive sleepiness and tiredness during the day so that people often fall asleep at work, during meals or even standing up.

In drivers or people working with heavy machinery the dangers are clear.

There is good evidence to show that the incidence of road accidents is high in individuals with the condition.

It also means that people become depressed or bad-tempered and lacking in concentration, disrupting their social lives and relationships.

The costs of undiagnosed untreated sleep apnoea to the NHS are high”

Known risk factors include excessive weight or a high neck circumference (eg collar size above 16). Although commoner in men it can affect anyone at any age.

Once a diagnosis is made, treatment is relatively cheap and simple.

It may involve use of a CPAP machine at night (CPAP = Continuous Positive Airways Pressure). This blows air under low pressure through a nasal mask into the air-passages preventing them from closing.

The response is immediate and obvious after only a few hours or one night.

Other treatments may involve a small device which fits into the mouth at night and holds the jaw forward or removal of obstructions such as large tonsils.

Apart from the obvious dangers, the socio-economic effects and the effects on professional and personal life of the continuous mental and physical exhaustion, sleep apnoea also hastens and provoke other serious health problems such as heart disease, high blood pressure, diabetes and stroke.

The costs of undiagnosed untreated sleep apnoea to the NHS are high.

Better awareness and recognition by health professionals is essential in improving early diagnosis and in relieving much of the misery which the condition produces.

Simple tests are available for GPs and others to help distinguish the condition from other causes of excessive tiredness. Another uses a monitor on the finger to record the changes in blood oxygen at night, usually giving a clear indication of the condition.

Greater awareness and early diagnosis of sleep apnoea is very important in tackling this potentially dangerous but treatable condition.