DIABETES NEW ZEALAND

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The big snore

Sleep apnoea affects more than 24,000 New Zealanders. Rose Miller explains this common condition that can have major implications for health.

Snoring may be the butt of many a joke, but for a lot of New Zealanders it’s no laughing matter. And it’s not just a problem for those who have to listen to the noise – snoring can have serious implications for the snorer’s wellbeing, too.

Snoring is a key symptom of obstructive sleep apnoea (OSA), a chronic and progressive sleep disorder with potentially serious health consequences.

During deep sleep the muscles in our throats relax. For someone with OSA, the muscles become so relaxed that part of the airway is closed off and the person stops breathing. The level of oxygen in the blood drops, and the sleeper will choke and gasp then wake up for a moment and begin to breathe again, quickly falling back to sleep and rarely remembering waking. This can happen hundreds of times a night, and the moments without oxygen might last up to or over one minute.

A person with OSA may often have no idea they have a problem – a family member or bed partner might be the first to notice signs of sleep apnoea. They may still feel sleepy when they wake, and have a headache and dry throat. Daytime sleepiness is one of the most common symptoms and sufferers may often need to take daytime naps.

Someone with OSA may also experience problems with their memory, may feel grumpy and irritable, have mood changes, morning headaches, and have difficulty concentrating. They could have chronic exhaustion and lose interest in sex. Some of these symptoms can be put down to other causes, such as stress, which is why OSA can often be missed.

OSA affects about 9% of men, 4% of women, and 3% of children between 2 and 12 years of age in the general population. OSA is most common in men over 50.

It is more common if a person is overweight.Excess weight on the outside of the throat increases pressure on the inside of the throat, which narrows the airway. That being said, while being overweight is commonly associated with OSA, up to 20% or more who have been diagnosed with OSA are not overweight. Other risk factors include alcohol, and taking tranquillisers or sleeping tablets.

Left untreated, sleep apnoea has been linked to high blood pressure, heart disease, stroke, memory loss, obesity, and insulin resistance, a precursor to type 2 diabetes. The good news is that successful treatment (see panel) may reduce the risks of these ailments.

What is less well known is the possible association between OSA and type 1 diabetes. OSA is prevalent in those with type 1, but more studies are necessary to understand the link.

Treatment

If you think you might have symptoms of sleep apnoea, see your GP.

**This article first appeared in the Winter 2017 issue of Diabetes Wellness magazine. Subscribe to Diabetes NZ today to receive your copy.