Apnoea – something to lose sleep over

The Star

2 days ago

PETALING JAYA: Microsleep refers to brief, involuntary episodes of sleep lasting just a few seconds during a person's waking hours.
This naturally makes it frightening if it happens to a driver, as a vehicle can travel quite a distance in just seconds.
The danger of microsleep is real. Based on the last statistics provided by the police, 1,305 fatali­ties were attributed to ­drivers falling asleep due to fatigue between 2011 and 2021.
There are many causes of unsatisfactory or inadequate sleep that contributes to micro­sleep, and one area that continues to draw research is sleep breathing disorders, including sleep apnoea.
'During sleep, the brain and body goes through various stages of rest and recovery. As sleep deepens, our airway muscles progressively relax and narrow the air passage. Soft tissues of the airway also progressively lose their strength and responsiveness with age, inflammation and ­disease, thus restricting air flow,' said Assoc Prof Dr Yap Yoke Yeow, an Ear, Nose, and Throat (ENT) specialist with the KPJ Johor Specialist Hospital. Dr Yap Yoke Yeow
'This can happen many times during sleep and even cut off the supply of oxygen to our lungs periodically. To ensure we are able to continue breathing, our brain would then interrupt the sleep cycle and 'wake' us so that airflow is restored.
'As such, our sleep isn't as restful as it should be, and people who suffer from this ailment could wake up feeling tired.
'Apnoea is defined as the absence of airflow through the nose or mouth for more than 10 seconds at a time. When one experiences more than 30 episodes of apnoea in seven hours of sleep, that is classified as severe obstructive sleep apnoea (OSA),' he said.
In view of the importance of a good night's rest, Dr Yap added that medical attention should be sought if one suffers from excessive daytime sleepiness or micro­sleeps.
Management of sleep breathing disorders range from lifestyle changes to myofunctional therapy, where a therapist helps the patient retrain orofacial muscles (controlling the tongue, lip and cheek areas) to improve functions like breathing – especially in addressing mouth breathing, swallowing and speech.
Other than surgery, interventions for difficult cases of OSA include using Continuous Positive Airway Pressure (through a machine that delivers a constant stream of air through a mask or nasal prongs while the patient sleeps), as well as wearing a mandibular advancement device (MAD) to sleep.
MAD is a custom-made device that gently pulls the lower jaw (mandible) forward, which in turn nudges the tongue forward so that the airway can be opened to reducing breathing obstructions.
'Parents should also monitor the jaw and facial development of their young child as it impacts various aspects of a child's life, including the ability to breathe properly, among others. Proper development can prevent issues down the line that includes difficulty breathing, including sleep apnoea,' he said.
Experts say people should also look at improving sleep hygiene, which refers to practices that promote quality sleep.
These include sleeping and waking according to a consistent schedule, avoiding stimulants like caffeine or nicotine and heavy meals close to bedtime, reduce mobile device screen time at least an hour before sleep, while exercising regularly, and avoiding intense workouts close to bedtime.