We need to wake up to the problems of obstructive sleep apnoea

General Practitioners need to be much more alert to the signs of obstructive sleep apnoea (OSA) in their patients, after a UK survey highlighted the high prevalence of symptoms in the population.

British GP talking to senior man in surgery

The survey in question was conducted by by OSA UK, and involved almost 2,000 UK adults aged 25 and over. The survey found that OSA affects one person in five in the UK. However, many of those who suffer from OSA go undiagnosed, as only 12 per cent of men and 6 per cent of women with OSA have ever contacted their GP about it.

The condition is related to obesity, and this proportion is expected to rise in forthcoming years. However, awareness of the condition is currently very low and rates of diagnosis and treatment are lower in the UK than almost all other developed countries.

Leading OSA researcher, Professor John Stradling, from the Sleep Unit at Oxford’s Churchill Hospital, said: ‘The major problem is that patients are often reluctant to talk to a doctor about snoring, or abnormal sleepiness or fatigue, in case they are not taken seriously.’

Berkshire GP, Dr Robert Koefman an ENT specialist, added that more public awareness about OSA was needed and he added that the condition could lead to heart and lung disease amongst other things. ‘At the moment any form of treatment is very much a postcode lottery,’ he said. ‘We need more specialist sleep centres where people can receive appropriate treatment.’

Snoring and OSA are quite deadly and have serious effects. From heart disease to diabetes to impotence, it appears that there is no end to what can be caused.

OSA becomes more likely as people become older, mainly because BMI tends to increase with age. Typically, patients start to present symptoms from 40 onwards and may show a history of gradual progression of these symptoms over the previous five to 10 years.

Common symptoms include unrefreshing sleep, daytime tiredness, the need to sleep, snoring, witnessed breath-holding events and a dry mouth or headache on waking.

As a result of the growing concern for the problem, it was even reviewed this month by Saga in their monthly Newsletter, which highlighted that OSA may be regarded as a nuisance, but it leads to high blood pressure, heart attacks and stroke. It is also linked with a greatly increased risk of accidents at work and on the road caused by tiredness. The main contributory factors to the development of OSA are obesity, a large neck circumference (greater than 16 inches) and a lower mandibular retraction.

However many of us still do nothing to treat it – yet the treatment can be simple and highly effective if caught in good time.

Saga recommend wearing a mandibular advancement device (MAD) which they describe as a special gumshield to hold the lower jaw and tongue forward, creating more space to breathe normally by opening the previously blocked airway.

The most successful of these according to current research by the specialist research team at the leading NHS Hospital for this problem, Papworth, is the SleepPro Custom, a bespoke fitted mouthpiece which they recommend as the first line of treatment for snoring and mild to moderate sleep apnoea.

For those who have been identified with the problem, and referred for treatment, the hospital itself supplies other SleepPro stop snoring mouthpieces direct to patients, along with many other hospitals in the NHS system, which itself recognises SleepPro as an Approved product.

John Redfern