Obstructive sleep apnoea/hypopnoea syndrome

Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is a breathing disorder characterised by recurrent episodes of complete or partial obstruction of the upper airway during sleep, causing either complete airflow obstruction with temporary cessation of breathing (apnoea) or decreased airflow (dyspnoea). 

Common symptoms include excessive daytime sleepiness due to transient waking from sleep to restore normal airway muscle tone and airflow. The condition is more common in men and has increasing prevalence with age and obesity.

A sleep study is usually required to confirm the diagnosis, and moderate to severe cases often respond well to ongoing continuous positive airway pressure (CPAP) therapy, with evidence pointing towards improvements in daytime sleepiness, fatigue and quality of life. Pharmacy teams can assist patients who are struggling with CPAP. Common issues include ill-fitting masks, pressure intolerance, nasal dryness and throat irritation. 

Individuals with mild OSAHS, or for whom CPAP is not suitable, may benefit from an intra-oral mandibular device, which maintains an open airway and prevents it from collapsing. Occasionally, surgery, such as tonsillectomy, may be required. Risk factors, such as smoking, alcohol intake, back sleeping and being overweight should also be addressed. Guidance from the Sleep Apnoea Trust may help with this.