Untreated sleep apnoea is associated with a significantly increased risk of Alzheimer's and dementia, and partners may be the first to spot the warning signs, according to sleep specialists. Heavy snoring that wakes a partner, along with gasping for breath during the night, could indicate the condition.
Sleep apnoea affects about 1 billion people globally, but for many it remains untreated and is dismissed as just heavy snoring. Left untreated, the condition can increase risks for cardiovascular disease, including coronary artery disease, congestive heart failure and stroke.
Signs Partners Should Watch For
Partners should listen out for pausing of breath, choking episodes and gasping for air during sleep. Experts Dr Ryan Chin Taw Cheong and Dr Alanna Hare explained the risks of untreated sleep apnoea and the importance of sleep health to prevent heart disease and other health problems.
Dr Cheong, consultant ENT and sub-specialist sleep surgeon, said: "In the past, we would look at sleep deprivation as a badge of honour. But the culture has shifted to prioritise sleep as a foundation of health. Snoring used to be dismissed, but now there is more awareness that troublesome snoring can be a sign of serious or deadly conditions."
Understanding the Condition
Sleep apnoea is an obstructive sleep disorder where throat muscles relax in REM sleep, causing the airway to be blocked off and reducing the ability to breathe normally. This reduction in oxygen levels can put a strain on organs such as the heart.
Other symptoms that occur during waking hours include daytime sleepiness, fatigue, brain fog, mood disturbances and difficulty concentrating. Untreated obstructive sleep apnoea also carries risks for road traffic accidents, with affected drivers up to ten times more likely to crash due to excessive daytime sleepiness, and these accidents are likely to be more severe as driver reactions are impaired.
Who Is Affected and Treatment Options
Dr Hare, consultant in sleep and ventilation at Royal Brompton Hospital, London, explained that the condition can present in women as insomnia and fatigue more commonly, especially in peri or post-menopausal women. It is often undiagnosed in women because it does not present in the same way as men and is sometimes diagnosed as depression rather than sleep apnoea.
Sleep apnoea can affect anyone, with a 2 to 1 ratio showing it affects men more than women, and increased prevalence after the age of 69. Obesity, menopause, smoking and alcohol consumption are also factors that place people at higher risk.
Dr Hare recommends speaking to a GP if sleep apnoea is suspected. There are also online questionnaires, such as STOP-BANG, to evaluate sleep. Dr Cheong, who works at Royal National ENT and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, discussed personalised diagnostic options, including medical-grade devices to wear in bed to track oxygen levels or a drug-induced sleep endoscopy.
Treatment options include using a CPAP machine to deliver a steady stream of pressurised air through a mask to keep airways open during sleep, installing dental appliances to hold the jaw differently, or a surgical nerve implant to move the tongue forward to keep the airway open during sleep. Dr Cheong says: "Sleep health is the greatest return of investment you can make on your health. Everything else builds upon good sleep. Good sleep is the foundation of all health."
