Wearing a mask at night can help people with sleep apnoea
Publication Date:28/03/2008
Do you find yourself nodding off when you don't mean to? In the middle of a meeting, during a meal or when you're driving? If there's no obvious reason for your drowsiness you may have a condition called sleep apnoea.
New guidance for doctors about this condition says that people who are seriously affected should be treated with a mask which they wear at night. This can help them sleep better and feel more awake during the day.
What do we know already?
Sometimes there's a good reason why you might feel very drowsy during the day. You may have just had a baby and have very disturbed sleep at night. Or you might be worried about something which is keeping you awake. But if there's no obvious reason why you feel drowsy during the day and you've had this problem for some time you could have a condition called sleep apnoea.
If you have sleep apnoea you stop breathing for periods of 10 seconds or more when you're asleep. This happens because the muscles in your throat block the flow of air to your lungs. Your brain recognises what's happening and makes your body start breathing again. You might gasp or choke slightly when you start breathing again, but you probably won't wake up or remember what's happened. This can happen many times a night. It means you miss out on the important deep part of a night's sleep and can feel very tired the next day. If you sleep with a partner, their sleep might also be disturbed.
The full name for sleep apnoea is Obstructive Sleep Apnoea/Hypopnoea Syndrome (OSAHS). In order to be diagnosed properly, people usually need to be observed in a sleep laboratory overnight. This helps doctors grade how bad the sleep apnoea is.
- If your breathing is affected between 5 and 20 times an hour, you have mild sleep apnoea
- If your breathing is affected between 20 and 35 times an hour, you have moderate sleep apnoea
- If your breathing is affected more than 35 times an hour, you have severe sleep apnoea.
What does the new guidance say?
The new guidance says that if you have suspected sleep apnoea your GP should refer you to a doctor specialising in sleep problems. If you are diagnosed with moderate or severe sleep apnoea then you should be offered a treatment called continuous positive airways pressure (CPAP). You have this treatment by wearing a mask at night. The mask fits over your nose (or nose and mouth). It is attached to an air pump which blows air into your throat to keep your airway open.
If your sleep apnoea is mild, then you also might be given treatment with CPAP, but only if:
- You life is affected because you feel drowsy during the day
- You've tried changing your lifestyle and other treatments, but these haven't helped.
Doctors often advise people with sleep apnoea to lose weight if they're overweight, to cut down on alcohol and to stop smoking. Other treatments for sleep apnoea include a mouthpiece that you wear at night.
Tell me more about how well the mask works
Lots of research has found that people with sleep apnoea who wear the mask at night are less sleepy during the day. The biggest improvement is in people with moderate or severe sleep apnoea. Some studies also show that people have more energy and feel mentally and physically healthier after using CPAP. They also have more energy to socialise.
There's some evidence that the mask can reduce blood pressure in people with the most severe sleep apnoea. And one study has found that CPAP improves people's driving on a computerised simulated driving programme. Researchers have estimated that CPAP can reduce the risk of having a road traffic accident by 83 percent.
Where does the guidance come from?
The guidance comes from the National Institute for Health and Clinical Excellence (NICE), which decides what treatments should be available on the NHS.
What does this mean for me?
If you think you or someone you live with might have sleep apnoea then this guidance is important for you. The guidance says that people with suspected sleep apnoea should be properly assessed to see if they have the condition. It also says who is entitled to treatment with CPAP.
What should I do now?
If you think you might have sleep apnoea, or someone you live with might have it, you should see your doctor. Sleep apnoea is a serious condition. It can affect how much you enjoy life and your relationships with other people. You might not be able to concentrate at work and be too tired and moody to do things in your spare time. Sleep apnoea might also increase blood pressure and the risk of heart disease, although there's not enough evidence to prove this.
If you have sleep apnoea, CPAP can help in many ways. Most of all it can give you the energy and vitality for life that you have been missing because of poor sleep. But it's important to bear in mind that the mask can be uncomfortable at first. Some people using it have complained of headaches, a blocked nose, dry eyes and chest discomfort. But still, most people who have this treatment stick with it, probably because of the benefits it brings.
From:
National Institute for Health and Clinical Excellence (NICE). Continuous positive airway pressure for the treatment for obstructive sleep apnoea/hypopnoea syndrome. NICE technology appraisal 139. March 2008. (Available at www.nice.org.uk)
To find out more, see our information on sleep apnoea.
News Archive
© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
