With Dr Adrian Chazan
It’s National Sleep Awareness Week in August this year, so it’s an appropriate time to mention that 39.8% of Australians suffer from inadequate sleep. This snowballing figure is due no doubt to upswings in obesity, depression and anxiety, and the 24-hour round-the-clock world we live in today.
It’s estimated that the effects of poor sleep or sleep deprivation cost the Australian economy (factoring in wellbeing, health expenses and lost productivity) $66.3 billion in 2016-17—not to mention it leads to mental illness, physical health problems, and road and work-related accidents on an individual level.
One well-known (but often misunderstood) sleep disorder is Obstructive Sleep Apnoea (OSA). “OSA is a breathing-related sleep disorder caused by repetitive or partial blockage of the upper airway during sleep,” says Dr Adrian Chazan, Respiratory and Sleep Physician at The Centre for Sleep and Pulmonary Medicine in Melbourne. Approximately 8% of the general population suffer from severe OSA, with the number ballooning for milder cases.
Signs and symptoms
The most obvious sign of OSA is excessive daytime sleepiness—waking up unrefreshed, struggling to concentrate throughout the day, and performing poorly at work or school.
“The problem is that many OSA sufferers have been living with poor sleep (and its side effects) for years—so they might not think anything of it,” Dr Chazan warns. Night-time signs of OSA include loud snoring and disturbed breathing (pauses, choking sounds).
There are two common misconceptions about OSA—and they’re likely responsible for a lot of missed diagnoses. Firstly, OSA has a strong association with obesity. And while obesity is indeed a risk factor and significant cause of OSA (obstructing airways due to an increase in soft tissue in the mouth and throat), there’s also a subsection of patients whose suffering is anatomical, and not weight-related. “If you have a family history of OSA, it’s more likely you’ll develop it too,” says Dr Chazan.
Secondly, OSA generally affects older people—but it can affect sleepers of all ages, including children. Healthy sleep is crucial to a child’s development; left untreated, OSA can contribute to learning disorders among children.
Diagnosis and treatment
OSA is diagnosed through a combination of clinical assessment (going through sleep-related symptoms and examining the upper airways) and sleep testing. Patients can be sleep-tested at home or in a sleep lab. The process involves sleeping overnight while wearing monitoring equipment to measure breathing, oxygen saturation in the blood and brainwaves, and body positioning.
There are three options for treating OSA, typically depending on the severity of the condition:
1. Positional devices: devices that keep patients from lying flat on their back, enabling better night-time breathing.
2. Dental devices: mouthguard-type devices made by dentists who specialise in sleep. Dental devices tend to work best in mild to moderate OSA.
3. CPAP machine: an air pump and mask that administer gentle air pressure to a person’s upper airways as they sleep. Patients with severe OSA will require CPAPs as treatment.
“People are often apprehensive about the CPAP machine being noisy or inconvenient, but the technology is advancing all the time, and masks are getting smaller.” Plus, Dr Chazan adds, once they experience their first uninterrupted night’s sleep in years, the CPAP becomes a patient’s best friend.
Where sleep apnoea appears to be the result of obesity, weight loss is usually part of a long-term treatment plan. “Weight loss can make a huge difference to OSA, and some people can even be cured by it,” explains Dr Adrian.
The risks of not treating OSA
Not sleeping well affects every aspect of our lives: work, relationships, and overall productivity. But that’s not the only risk of leaving OSA untreated.
“Blocked airways during sleep doesn’t just result in poor sleep quality—the repeated drops in blood oxygen levels (often hundreds of times in a night) cause repetitive stress responses inside the body, triggering the release of stress hormones that spike blood pressure, inflating blood sugar levels, and placing extra pressure on heart and blood vessels,” explains Dr Adrian. Compounded over the years, this puts sufferers at a roughly 7-fold higher risk of death and cardiovascular disease, as well as diabetes and mental health issues. OSA patients are also 4-9 times more likely to be victims of motor vehicle accidents, and are at a higher risk of being involved in industrial accidents.
Thus—the side effects of poor sleep aside—seeking treatment for OSA is crucial.
Most importantly, Dr Chazan advises Australians not to put up with lousy sleep. “There are many types of sleep problems, and people often put up with symptoms for years, not realising that it could be a very treatable medical disorder.”
Dr Adrian Chazan and The Centre for Sleep and Pulmonary Medicine
The sleep study unit at St Vincent’s Private Hospital Werribee is the only private overnight sleep laboratory in Melbourne’s Western suburbs. The lab features large, comfortable rooms, a quiet environment for sleeping, and expert, friendly staff around the clock.
A Respiratory and Sleep Physician as well as a General Physician, Dr Adrian Chazan takes a holistic approach in his treatment of all kinds of sleep disorders, including restless leg syndrome, insomnia, and narcolepsy.
Dr Chazan consults at:
The Centre for Sleep and Pulmonary Medicine
St Vincent’s Private Hospital Werribee Consulting Suites
240 Hoppers Lane Werribee 3030
Phone: (03) 9191 4043