When Sleep Doesn’t Leave You Rested
You can spend eight hours in bed and still wake up unrefreshed. Daytime sleepiness, morning headaches, poor concentration and persistent fatigue are often blamed on stress or a busy schedule. But sometimes the cause lies in how you breathe while asleep.
In obstructive sleep apnoea, the upper airway repeatedly narrows or becomes blocked. Breathing is disrupted, oxygen levels may fall, and sleep becomes fragmented. The person may remember none of this – often a partner first notices loud snoring and pauses in breathing.
“Sleep apnoea is not only about sleep quality. Repeated breathing disturbances and drops in oxygen place additional strain on the cardiovascular system. This is why snoring accompanied by daytime sleepiness, high blood pressure or heart rhythm disturbances is a reason to assess breathing during sleep.”
Iusup Omarov, Deputy Chief Medical Officer at Kandinsky Clinic, Cardiologist, PhD, member of the American Heart Association and European Society of Cardiology.
How can you tell there may be a problem?
Regular loud snoring is a noticeable sign, particularly when accompanied by pauses in breathing. Excessive daytime sleepiness, waking unrefreshed, morning headaches, high blood pressure and episodes of arrhythmia should also raise concern. Risk is higher in people with excess weight, metabolic syndrome, diabetes and certain cardiovascular conditions.
Screening questionnaires can assess initial risk. When indicated, a doctor may recommend a home sleep apnoea test (HSAT). The patient sleeps in their own bed while a compact device records the parameters needed to assess breathing during sleep. Home testing is not suitable for everyone, and a negative result does not always rule out sleep apnoea.
Why isn’t there one solution for everyone?
Causes and severity vary, so treatment is tailored to the individual. It may include positive airway pressure (PAP) therapy (air delivered through a mask to help keep the airway open during sleep), lifestyle changes and weight loss, oral appliances or, for certain anatomical problems, ENT treatment.
“If breathing problems are related to anatomical narrowing of the upper airway, it is important to identify where the obstruction occurs. In selected cases, after a thorough assessment, surgical correction may be considered – for example, for certain conditions affecting the nose or throat. Surgery, however, is not a universal treatment for sleep apnoea and should only be performed when clearly indicated.”
Gulnaz Toxanbayeva, ENT at Kandinsky Clinic
For some patients, custom-made oral appliances can hold the lower jaw forward during sleep, helping to keep the airway open.
“An oral appliance for sleep apnoea is not a standard protective mouthguard. It is a custom-made medical device that changes the position of the lower jaw during sleep. This method is not suitable for every patient, so the decision is made after a sleep assessment and evaluation of the patient’s dental status.”
Roman Shulga, Prosthodontist at Kandinsky Clinic, member of the American Academy of Dental Sleep Medicine
Sleep apnoea can be easy to miss because the main events happen while you are asleep. But its effects can be felt throughout the day. Persistent snoring, pauses in breathing during sleep and ongoing daytime fatigue are not simply quirks of sleep, but symptoms worth discussing with a doctor.
