Sleep disorders vary regionally – and so does support and diagnosis

Recent research carried out by the British Lung Foundation, in conjunction with both Guys and St Thomas’ Hospital in London, has highlighted that the provision of services to diagnose obstructive sleep apnoea, or OSA, varies a great deal across the UK, and it doesn’t match the worst areas for the problem.

OSA is linked to serious ill health, and the figures for the problem have continued to rise steeply across the last few years. This is partly due to the higher numbers of the population reaching middle age, at which time OSA becomes much more prevalent, and also because of certain lifestyle factors. Increased weight is a major contributory factor in the problem, due to our vastly changed pattern of eating and drinking across the last decade.

The population’s average age and girth has increased, both of which are risk factors for obstructive sleep apnoea. These increases are forecast to continue.

Sleep Apnoea infographic

Disturbed unsatisfactory sleep

OSA is a condition that disrupts breathing during sleep, usually as a result of the muscles and soft tissues in the throat relaxing and collapsing to block the airway. This usually lasts for 10 or more seconds. It affects people of all ages, including up to 4% of middle-aged men, 2% of middle-aged women and 20% of those aged over 70. However, it is estimated that around 80% of cases remain undiagnosed. In real terms we estimate about four million people in the UK to be sufferers.

Although it’s relatively easy to treat OSA, when it is left undiagnosed and untreated, it has been closely linked with a range of serious health concerns including stroke, heart disease, depression, diabetes, and high blood pressure. More recently, Alzheimer’s disease, glaucoma, and certain forms of cancer have also been related to it. OSA can also significantly affect one’s quality of life and ability to work, as well as increasing the chances of road accidents due to fatigue.

Regional differences

Wales, large parts of East Anglia, East Yorkshire, Lincolnshire and the North-East were found to be areas with the highest predicted rates of OSA. Larger urban areas in England and Scotland and the counties to the west of London were amongst the areas with the lowest predicted prevalence.

This pattern contrasted considerably with the availability of local sleep services for diagnosing and treating the condition, with large urban areas being better served despite the lower risk of OSA, and parts of mid-Wales, the North-West and East Anglia having much lower numbers of identified sleep centres, of which there are 289 in total, each one being required to serve an average of 1.25 million people.

Diagnosis of OSA

Professor Adrian Williams, Medical Advisor at the British Lung Foundation, Professor of Sleep Medicine at Guys and St Thomas’ Hospital, and co-author of the study says in a press statement: “Too often, a lack of awareness leads to the symptoms of OSA being not recognised or dismissed simply as an irritation for anyone who shares a room with someone affected. However, OSA can have a severe impact on quality of life and is associated with a range of serious health problems including heart disease, stroke, diabetes and depression.

“In most cases, OSA is easily treatable in a way that can successfully minimise the associated risks.

Self-diagnosis is therefore often a key requirement for OSA, and fortunately, by using easily accessible NHS approved products, such as an oral appliance, or mouthpiece which keeps open the airway whilst sleeping, the majority of serious cases can be prevented and better health attained.

By John Redfern