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Dublin Live
Dublin Live
National
Kim O'Leary

Dublin sleep expert explains sleep apnoea and other conditions ahead of clocks change

The spring months are rolling in with the clocks to spring forward by one hour later this month meaning

We get more sunlight, but it can affect the sleep schedule with the changing times. When we don’t get enough quality shut eye at night, it can cause us to suffer from low mood, poor concentration and can even affect our long-term physical health. And for those with sleep apnoea, it can be a struggle to get a decent sleep.

According to the HSE, sleep apnoea is when the walls of the throat relax and narrow during sleep, which can cause breathing difficulties for some.

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But what exactly sleep apnoea is and what other common sleep disorders should people in Ireland watch out for? Dublin Live spoke to Motty Varghese, a Behavioural Sleep Therapist at the Sleep Therapy Clinic, Dublin, to find out exactly what sleep apnoea is and how to get the best sleep possible as the spring months come in.

What is sleep apnoea?

Mr Varghese said: "Sleep apnoea is a sleep breathing disorder that causes you to stop breathing while asleep. Sleep apnoea is characterized by the repetitive closure or narrowing of the upper airway or pharyngeal space.”

"In some individuals the narrowing of the upper air passage due to relaxed throat muscles can lead to a reduction in the flow of air into the lungs, and the closure of it can result in cessation of the airflow into the lungs." Mr Varghese added that people with sleep apnoea can stop breathing "multiple times" throughout the night.

According to Mr Varghese there are two consequences associated with this; a reduction in oxygen levels, and the prevention of a deeper, more restful sleep. He said: "It has two consequences, one is when there is a reduction or cessation of the air flowing into the lungs there is going to be a drop in the oxygen level and this return to normal levels as soon as the breathing is resumed.”

“The other consequence is that we can also get microarousals or mini awakenings in our brain resulting in sleep fragmentation. The person could be in a light stage of sleep and when you are getting the microarousals it prevents the progression of sleep into deeper, refreshing stages and this can cause excessive sleepiness during the day."

Main symptoms of sleep apnoea

There are several symptoms of sleep apnoea, which may be noticed by the sleeper and their bed partner. Mr Varghese explained symptoms of sleep apnoea include:

  • snoring
  • pauses in breathing
  • multiple awakenings at night
  • tossing and turning
  • Excessive daytime sleepiness

How is sleep apnoea diagnosed and treated?

Sleep apnoea is diagnosed and treated by Respiratory or Sleep physicians, in Ireland. He added that sleep apnoea is diagnosed by a sleep study that is done in a hospital, and there are also treatments available. "One of the treatments is CPAP therapy where the person with sleep apnoea use a device called CPAP (Continuous positive air way pressure) when they are sleeping. This involves wearing a mask that is connected to the CPAP device. There's a lot of misconception about CPAP therapy, that it is not comfortable to use the CPAP mask, but someone with sleep apnoea finds it extremely useful."

Mr Varghese explained how the CPAP device provides normal air at a certain pressure through mask, to keep the airways open allowing easier breathing and satisfactory oxygen levels. He also explained that your position can also affect your sleep, and that some individuals can have positional sleep apnoea where most of the snoring and breathing disruption happens when they are lying on their back.

Mr Varghese said: "Positional devices can be used to stop people from sleeping in these positions but a sleep study is essential to establish the presence of positional sleep apnoea."

Other sleep disorders to watch out for

There are also other common sleep disorders that affect people living in Ireland. Insomnia and restless legs syndrome can also stop people from getting a good night's sleep. Mr Varghese explained: "Insomnia is a condition where people can't get sufficient quantity of sleep despite having an adequate opportunity to sleep. Opportunity to sleep is the time between your lights on and off, and we should be able to sleep at least 80-85% of that time.

"But if a person is taking a long time to fall asleep or return to sleep when they wake up at night or wake up earlier in the morning than they would like to, they wouldn't be getting sufficient quantity of sleep," he said. For those who have insomnia that lasts over three months, it is then classified as chronic insomnia. Cognitive Behavioral Therapy for insomnia or CBT-i is the first line treatment for Insomnia and sleep medications are considered when CBT-i is not available or not successful.

Meanwhile, restless leg syndrome is described by Mr Varghese as a "sleep related movement disorder that involves an irresistible urge to keep the legs moving" which usually happens in the evening or at night time. He said: "People often describe it as a burning or tingling sensation and it can be relieved by just moving the legs and can cause sleep disturbances at night."

When asked the age-old question of how much sleep adults really need at night, Mr Varghese said that everyone has their own unique sleep need. He said: "American Academy of Sleep Medicine recommends over 7 hours of sleep per night and it is not recommended to sleep less than 6 hours."

When asked about what people do most often that can sabotage their sleep, Mr Varghese said that sleeping in at the weekends, bright light exposure in the evenings particularly from handheld smart devices and taking naps longer than 45 mins can all have a negative effect on our sleep. He explained: "The most important thing that we need to be careful about is having a consistent bedtime, unfortunately people do have a tendency to compensate for loss of sleep like trying to catch up and sleep later on the weekends.”

How Daylight Saving's Time affects sleep

Mr Varghese said that the upcoming time change from Daylight Saving's with the clock going forward can impact how we sleep. Mr Varghese said that there have been several studies into Daylight Saving's Time and its effects on peoples' sleep. He said: "There's been number of studies done on that and there are plans to abolish switching the time twice a year in Europe and also in the US.

"With the daylight savings there is some research that proves that there is an increase in the reporting of cardiovascular incidents in the first week after switching to the Daylight Savings. Another study in the United States showed an increase in motor vehicle accidents by 6% and that's something we need to be careful about to make sure people are not sleep deprived soon after the Daylight Saving is introduced."

So, what can we all do before the clocks change on March 26? "It would be useful to advance your bedtime by 15 minutes and wake time by 15 minutes for a few nights leading up to the clock change, to avoid sleep loss," added Mr Varghese.

For more information and advice, visit www.sleeptheraphy.ie

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