It is estimated that over 1.2 million (6%) Australians experience sleep disorders. Although insomnia is highly prevalent, Obstructive Sleep Apnea Hypopnea is the most common sleeping disorder, and is thought to affect 4% of the population.
Why do I snore? And should I be worried?
When we’re awake, the muscles in our nose, mouth and throat keep our upper airways open allowing air to flow freely to and from our lungs. However, when we’re asleep, these muscles relax blocking the passageway somewhat. As we breathe in, the tissues surrounding the airway vibrates resulting in the familiar snoring sound.
However, for some people, the obstruction is so extreme that it causes either a complete absence of breathing (apnea), or very slow and shallow breathing (hypopnea). Due to the lack of oxygen, the brain will alert the body to wake up in order to open the airway and breathe again. Depending on how often this cycle occurs, this can severely disrupt your sleep.
If apneas or hypopneas are happening repeatedly throughout the night (where each represents a reduction of breathing for at least 10 seconds in duration), you may have Obstructive Sleep Apnea Hypopnea (OSAH).
What are the symptoms?
At least 15 or more obstructive apneas/hypopneas per hour of sleep, or at least five obstructive apneas/hypopneas per hour of sleep and either of the following sleep symptoms:
- Nighttime snoring, snorting or gasping
- Breathing pauses during sleep
- Daytime sleepiness and fatigue
- Unrefreshing sleep despite sufficient opportunities to sleep
Sleep apnea may also be accompanied by:
- Morning headaches
- Dry mouth
- Insomnia due to frequent awakenings at night
- A need to get up during the night to urinate
- Sexual problems such as erectile dysfunction or low libido
Am I at risk?
Although anyone can have sleep apnea, there are several factors which can increase your risk. These include:
- Being overweight
- Menopause in women
- Older age (40-60yo)
- Family history
- Genetic syndromes that reduce upper airway patency (e.g. Down’s syndrome)
It is important to remember that sleep apnea is a serious sleep disorder, and can contribute to a range of other problems including:
- Heart disease
- High blood pressure
- Work-related injuries
- Non-work related motor vehicle accidents
Because you may not be aware of your snoring, your bed partner is sometimes the best person to ask. If either you or your partner is concerned, your GP can complete a thorough history examination, and refer you to a specialist if needed. Your specialist will help select the right treatment for you – this is generally an oral appliance or machine that keeps your airway open and prevents it from collapsing.
How can a psychologist help me?
A psychologist can help support your medical treatment for sleep apnea in a number of ways, such as helping you to make lifestyle changes, lose weight or by treating any co-existing mental health conditions. Medicare rebates for these services are available under the chronic disease management scheme, which offer rebates for up to five sessions a year.
If you are having sleep difficulties and your doctor rules out sleep apnea and other medical conditions, or if you have been treated for apneas/hypopneas but you continue to experience difficulties with your sleeping or fatigue, seeing a psychologist can help. A psychologist will work to assess whether your difficulties are due to another type of sleep disorder or mental health disorder. Treatment for sleep disorders generally includes identifying and addressing factors in your environment and behavioural habits that may be interfering with your sleep and its quality. Strategies such as sleep-restriction protocols are relatively simple and can help people reset habitually poor sleeping.
For people with mental health disorders, improving sleep quantity and quality can often lead to a considerable improvement in functioning and a reduction in other symptoms.
If you have been experiencing sleep difficulties due to sleep apnea, another sleep disorder or emotional difficulties, then consider making an appointment to see us at M1 Psychology.
Access Economics. (2004). Wake up Australia: The value of healthy sleep. Retrieved from https://www.sleep.org.au/documents/item/69
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. DSM-V.
Hoekema, A., Stegenga, B., Wijkstra, P.J., van der Hoeven, J.H., Meinesz, A.F., & and de Bont, L.G.M. (2008). Obstructive Sleep Apnea Therapy. Journal of Dental Research, 87, 882-887. doi: 10.1177/154405910808700917.