Obstructed Sleep Apnoea (OSA)

Does your airway collapse during sleep?


Obstructive Sleep Apnoea (OSA) is a condition where the airway gets sucked together or collapses as the person inhales. Chest movement indicates that the person is trying to breathe, but is unable to move air in or out of the lungs, and in fact, the more you try to inhale, the tighter the airway sucks together. This collapse of airway causes an apnoea, which is a gap in the breathing that may last as long as 90 seconds, and only stops when the person wakes up sufficiently to clear their airway and drag in a noisy breath before falling asleep again.

The Obstruction

The part of the airway that usually collapses is near where the mouth joins the throat and the obstruction is found in the part of airway that is above this point, or closer to the tip of your nose. This means that your upper airways – the parts that are high up in your skull are narrowed or obstructed, and the part that is in your throat collapses. If your upper airways were not abnormally narrowed or obstructed, then the airway lower down would not collapse.

Why does my airway become obstructed?

It may be that you have a physical narrowing – such as the bridge of your nose being broken and pieces of bone are blocking the airway or you have a sinus infection. If you have had your airways examined and they are functioning fine in a physical sense, then perhaps your primary problem is breathing too much air. When a person breathes too much it is called hyperventilation, and a typical result of hyperventilation is a blocked or running nose.

The Snoring Connection

Snoring can perhaps be thought of as the sound of hyperventilation during sleep and there is a strong link between the two conditions because it is normal for the OSA sufferer to have had chronic snoring for a number of years before the airway begins to collapse and breathing to be disrupted. This long-term snoring habit is the result of a poor breathing pattern that occurs all of the time, while you are both awake and asleep.

As well as an historic connection to OSA, there is also a direct connection because snoring gets louder and more forceful right before the collapse and the apnoea. After the gap in the breathing, there is initially less snoring, but it builds up again before the next apnoea. It is unlikely that you snore all night, and so it is also unlikely that you will have apnoeas all night either, but instead they come in waves.

Stroke, heart disease, diabetes and depression are linked to loud snoring and OSA, and the sufferer is frequently so tired that he or she lacks the desire to take part in every-day activities. This disrupted breathing pattern can also cause a problem for others because bed partners are also likely to be sleep deprived or stressed as they wait during an apnoea for you to take your next breath and a lack of energy affects family, social and work life.

What can I do about it?

Treatments for snoring and OSA include the use of surgery, tongue depressors, mouthguards, or the CPAP machine. Surgery and devices help to widen the airway near where the collapse occurs and the CPAP increases air pressure in the lower airways preventing them from collapsing. While many people find these treatments difficult to tolerate, the mechanical remedies are generally helpful in the short term. But because they enable you to hyperventilate even more easily, though more quietly, they don't cure the problem and so are required for the rest of your life.

If you would like to stop the problem entirely, then changing your automatic breathing pattern while you are awake will also change your breathing pattern while you are asleep. A Buteyko trial showed an average 31% drop in the volume of air a person automatically breathed after using the Buteyko method for 3 months. This resulted in an average 71% drop in symptoms. Admittedly this study was done on asthma, but the same kind of principle can be applied to snoring and sleep apnoea. If you automatically breathed more like a healthy person should do at rest (quietly through the nose) and less like someone running (noisily through the mouth) while you sleep, then you would snore less. If you snored less, you would have less airway narrowing and collapse, which means that you would have less apnoeas.

The Buteyko method restores sound, restful sleep without the need for surgery, devices or machines because it addresses the real problem rather than trying to deal with the symptoms.