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Other names: Prinivil

OBSTRUCTIVE SLEEP APNOEA (OSA): SYMPTOMS, SLEEPINESS
Symptoms
Many of the features of OSA are not a direct result of snoring per se but are a consequence of obstructive events during sleep which cause blood oxygen levels to drop to dangerously low levels. The absolute priority given to the body’s need for oxygen can be put into perspective when we consider that a healthy human can survive without food for several weeks, survive without water for days, but will die within minutes of oxygen deprivation. Not surprisingly, snoring is the most prevalent symptom of OSA, occurring in about 95% of patients with the syndrome. A cluster of other symptoms is also very common and will be found to a greater or lesser extent depending on the number of apnoeas experienced in a night and the severity of oxygen deprivation.
Sleepiness
The patient with OSA is classically prone to daytime sleepiness, often found slumped in front of a television or at the table during a dinner party. Most alarming are those patients who seek help after falling asleep behind the wheel of a car or while operating dangerous machinery. The tendency to fall asleep during the day is attributed to poor quality sleep at night caused by arousals associated with each obstructive event. Anyone who has observed a patient with OSA will be aware of the repetitive nature of airway obstruction and the resulting sleep fragmentation. Airway collapse is followed by increasing respiratory efforts to overcome the obstruction and to relieve intolerably low blood oxygen levels (hypoxaemia). The degree of sleep disturbance probably relates to the severity of the apnoeic period; some patients experiencing a mild arousal from REM to NREM states, while others will be fully awakened by such an episode. Sufferers of advanced OSA are caught in a cruel cycle. The relentless process of obstruction and arousal many times a night leaves the sufferer sleep deprived, lethargic and irritable. He cannot help trying to make up for lost sleep at every opportunity yet it is sleep which sets in motion events such as loss of upper airway tone which in turn result in obstruction and arousal.
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