Sleep Apnoea and Oxygen Desaturation Causing Sleep Fragmentation and Poor Recovery
Sleep is an essential part of human health, allowing the body to rest, restore, and recover. However, for some people, a good night’s sleep is elusive due to sleep disorders such as sleep apnoea and oxygen desaturation.
Sleep apnoea is a common disorder that affects millions of people worldwide, causing brief pauses in breathing during sleep. These interruptions lead to fragmented sleep and poor sleep quality.
Oxygen desaturation occurs when the blood’s oxygen level drops below normal during sleep, resulting in hypoxemia and potential long-term harm.
Both sleep apnoea and oxygen desaturation have a significant impact on physical, emotional, and mental well-being, causing problems like sleep fragmentation and poor recovery.
This article aims to provide insights into sleep apnoea and oxygen desaturation, their connection, and how they affect sleep quality.
What is Sleep Apnoea?
Obstructive Sleep Apnoea (OSA) is a type of sleep apnoea that occurs when the muscles at the back of the throat fail to keep the airway open during sleep. This leads to frequent or periodic airflow restriction and interruptions in breathing rhythm.
As a result, individuals with sleep apnoea experience gasping or choking sensations between regular breaths at night, impacting their ability to obtain sufficient deep-stage NREM (non-rapid eye movement) sleep. Deep-stage sleep is crucial for natural body restoration, leaving individuals feeling refreshed upon waking.
Causes of Sleep Apnoea
Overweight individuals may experience reduced muscle tone in their upper airway, which can lead to more frequent airflow blockage when lying flat on their backs or during relaxed sleep. Alcohol consumption also increases the risk of breathing interruptions during sleep by relaxing the muscles involved in airflow. Smoking tobacco worsens breathing characteristics and can cause slight narrowing in the lung’s airways, making it challenging to take efficient breaths.
Oxygen Desaturation and Its Impact
Oxygen desaturation occurs when the oxygen levels in the blood drop below normal for an extended period. This can lead to hypoxemia, a reduction in the oxygen-carrying capacity of red blood cells. Hypoxemia can cause symptoms like shortness of breath, confusion, rapid heart rate, and even death in severe cases.
During sleep, oxygen desaturation can occur when a person experiences episodes of sleep apnoea, resulting in lower oxygen levels in the blood. This can have long-term consequences on one’s health.
The Link Between Sleep Apnoea, Oxygen Desaturation, and Sleep Fragmentation
Sleep Fragmentation Explained
Sleep fragmentation refers to the interruption of sleep during the night and can manifest in various forms, such as insomnia, arousal disorders, or apnoeic events seen in sleep apnoea. These interruptions negatively affect restorative sleep states, which are essential for optimal health.
How Sleep Apnoea Leads to Sleep Fragmentation
Sleep apnoea significantly contributes to sleep fragmentation due to the frequent interruptions in breathing it causes throughout the night. Continuous awakenings prevent individuals with sleep apnoea from maintaining normal sleep patterns, resulting in poor quality restorative sleep, fatigue, and daytime drowsiness.
Deep slow-wave phases of NREM sleep, crucial for cognitive consolidation and memory formation, also become limited, impacting energy levels and concentration during waking hours.
The Role of Oxygen Desaturation in Sleep Fragmentation
Oxygen desaturation also plays a significant role in sleep fragmentation. Reduced oxygen levels due to airflow limitations frequently trigger arousals, interrupting peaceful sleep and causing fatigue and drowsiness. Over time, this can lead to cognitive decline, affecting both physical and psychological well-being.
Effects of Sleep Fragmentation and Poor Recovery
Daytime Sleepiness and Fatigue
The most common symptoms associated with poor recovery due to fragmented sleep include excessive daytime sleepiness, drowsiness while driving or operating machinery, difficulties concentrating at work, and irritability. These issues can have an impact on mental and emotional health as well.
Cognitive Impairment
Memory retention, focus, and other cognitive functions gradually decline in people experiencing sleep fragmentation. A study published in Sleep Medicine Reviews shows a significant reduction in the speed of cognitive processing following a single night of disrupted sleep.
Impact on Physical Health
Poor recovery can contribute to obesity and other secondary conditions. Fragmented sleep hinders hormone regulation, promoting insulin resistance, and increasing the risk of pre-diabetic states, early heart disease, and type II diabetes. Additionally, fragmented sleep patterns have been linked to an increased risk of hypertension, stroke, and depression.
Diagnosis and Treatment Options
Diagnosing Sleep Apnoea and Oxygen Desaturation
Sleep apnoea and oxygen desaturation can be diagnosed through a sleep study or polysomnography. This test involves monitoring an individual’s physiological activity during sleep using electrodes placed on the scalp, face, legs, chest, and airway area to generate a long record of data like Electroencephalogram (EEG) and Electromyogram (EMG).
Mandibular advancement splints, also known as oral appliances or dental devices, are a common treatment option for managing oxygen desaturation levels in individuals with sleep-disordered breathing, including sleep apnoea. These devices are custom-made and worn in the mouth during sleep to help alleviate breathing difficulties and improve oxygen flow.
The splint works by repositioning the lower jaw (mandible) slightly forward, which helps open up the airway and prevent it from collapsing during sleep. By advancing the mandible, the soft tissues at the back of the throat are also pulled forward, reducing the risk of obstruction and improving the airflow.
By maintaining a more open airway, mandibular advancement splints can effectively reduce the frequency and severity of oxygen desaturation episodes. This means that oxygen levels in the blood are better maintained throughout the night, minimizing the detrimental effects of hypoxemia.
Continuous Positive Airway Pressure (CPAP) Therapy
For individuals with moderate to severe sleep apnoea, Continuous Positive Airway Pressure (CPAP) therapy is often recommended. This therapy involves using a small portable device that delivers constant positive air pressure through a mask, opening up the nasal passages and improving airflow during sleep. This leads to better-rested nights with reduced sleep fragmentation.
Myofunctional therapy is a specialised treatment approach that focuses on correcting improper muscle function in the oral and facial area. It aims to address the underlying causes of sleep apnoea by targeting the muscles involved in breathing, swallowing, and tongue posture. During myofunctional therapy, patients undergo exercises and techniques that help strengthen and retrain these muscles to function properly. This therapy can help improve tongue positioning, increase muscle tone in the airway, and promote better breathing patterns during sleep. By addressing the muscular issues contributing to sleep apnoea, myofunctional therapy offers a non-invasive and drug-free approach to treating the condition, potentially reducing the severity of symptoms and improving overall sleep quality.
Lifestyle Changes and Other Treatments
Lifestyle changes such as weight loss and exercise management can improve sleep disorders related to obesity, which can cause intermittent airway reductions and hinder the restoration process during sleep. Behavioural modifications like positional therapy and avoiding alcohol or tobacco usage have also shown significant results in improving obstructive sleep apnoea conditions.
Tips for Better Sleep and Recovery
To promote better sleep and recovery, consider the following tips:
- Create a comfortable sleeping environment: Ensure your bedroom is dark, quiet, and cool, and use comfortable bedsheets that help you relax.
- Create a consistent sleep routine: Set consistent sleeping and waking times, even on weekends, to establish a regular internal clock routine and promote restful sleep.
- Reduce exposure to stimulants: Avoid consuming alcohol, nicotine, or caffeine products at least four hours before bed, as they can hinder natural relaxation and make it difficult to fall asleep.
- Regular exercise: Engage in regular exercise to stimulate hormone production, improve physical health, and enhance cognitive function, reducing anxiety and promoting uninterrupted sleep.
- Limit electronic device exposure before bedtime: Blue light emitted by screens disrupts natural melatonin regulation, affecting circadian rhythms and sleep quality. Switch off devices or use blue light filtering glasses to minimise electronic usage before bedtime, promoting relaxation.
Conclusion
Sleep apnoea and oxygen desaturation significantly impact an individual’s well-being, leading to sleep fragmentation and poor recovery. Effective diagnosis requires consultation with a sleep specialist who can recommend therapies like Mandibular advancement splints, Continuous Positive Airway Pressure (CPAP), professional therapy options such as myofunctional therapy and weight management to improve sleep habits. Avoiding triggers such as alcohol and nicotine close to bedtime is also advised.
Lifestyle changes like regular exercise and minimising electronic device exposure before sleep contribute to overall health improvements. Implementing these changes can significantly enhance quality of life and promote optimal health benefits in the long run.
