Last week, obstructive sleep apnoea sufferer David Cheesmond, from County Durham feared he could die as he could not afford the electricity to power the machine that keeps him breathing. Duncan Leatherdale talks to a Durham doctor about the disease

SLEEPING next to a snorer is a nightly endurance test for thousands of spouses, but the loud snorts and snuffles may be a symptom of something much more sinister.

Those who have obstructive sleep apnoea (OSA) are not usually the ones to notice it.

It is their partners who tolerate persistent snoring and the irregular breathing emanating from their loved ones that first raise the alarm.

The patient may be aware of the disease if they experience excessive tiredness or chronic fatigue, at which point they are urged to turn to people like Dr Mohammad Fayaz for help.

Dr Fayaz has been a consultant respiratory physiologist at University Hospital of North Durham for four years, in which time he has seen hundreds of patients diagnosed with and fully treated for OSA.

It is only in recent years that awareness about the condition has grown.

According to studies in the 1970s and 80s, about four per cent of people had the condition.

Today Dr Fayaz believes up to 20 per cent of people could have it, a sharp rise due in no small part to the increase in obesity.

It is most common in people aged between 30 and 65, and is found in more men than women.

The problem is caused by the muscles at the back of the throat that keep the airway open.

If you have sleep apnoea, they collapse meaning the airway closes and you stop breathing.

This results in less oxygen getting into the blood stream triggering a message to the brain waking the person up, at which point they start breathing normally again.

Dr Fayaz says it can happen hundreds of times during the night and the result is a feeling of excessive tiredness and fatigue as the sleep cycle is permanently disrupted.

The temporary loss of breath also triggers the release of a catecholamine hormone, also known as the fight or flight response, which increases the blood pressure and heart rate in preparation for a perceived battle or need for escape.

These hormones, such as adrenaline, put a great strain on the system and in rare cases, can cause the heart to fail, leading to death.

This is an extreme response, although the regular nature of OSA means sufferers are much more at risk of developing heart conditions or strokes.

“It’s a very serious condition and can severely impact someone’s quality of life,” says Dr Fayaz. “But it is cheap and easy to treat and I have heard many people say ‘why did I not get this seen to sooner’.”

Dr Fayaz moved to allay fears that diagnosis would mean nights in a hospital being watched while you sleep.

“In the most severe cases patients are admitted, but our outpatients system works in the vast majority of cases and involves small monitors, which track heart rates, oxygen levels and blood pressure, being worn during the night in the comfort of people’s own homes.”

There are three levels of the condition, mild, moderate and severe, which can be treated either through lifestyle modification (people lose weight, reduce their body mass index and become fitter), medically (through the use of a Continuous Positive Airway Pressure (Cpap) mask) or surgery.

The latter option is rarer and is usually used if there is a physiological anomaly that is causing the condition, such as an oversized tongue, small chin or swelled tonsils and adenoids.

The most effective cure is simple: lose weight and get fit. While smoking and regularly drinking excessive amounts of alcohol do not cause the condition, they can make it inexorably worse. But even for those who will never be cured, treatment can ensure a much happier and fulfilling lifestyle.

“Like diabetes for example, people may have it for the rest of the lives but if it is diagnosed and controlled then people’s quality of life can be significantly improved,” adds Dr Fayaz.

About 20 per cent of serious car accidents are caused by driver tiredness, and of those many could be caused by driver’s suffering from OSA. But the loss of concentration and risk of dozing off during the day because of OSA is all but wiped out by the condition being treated.

One method of treatment (such as in Mr Cheesmond’s case) is the use of a Cpap mask, worn for between four and six hours every night which blows air through the airways keeping them open and clear during the night.

It may look uncomfortable but sufferers usually find it’s possible to become accustomed to the mask. However, some patients simply can’t tolerate the thought of wearing something over their face to sleep.

“But it is like getting a pair of glasses, at first you do not like them because they are new, but you soon become accustomed and start to wonder how you managed so long without it,” says Dr Fayaz cheerily.

And there’s another benefit of seeking treatment.

As well as a more useful and restful night’s sleep you’re far less likely to suffer a whack on the arm from your snore-frazzled spouse.

Symptoms of obstructive sleep apnoea

• Excessive tiredness or chronic fatigue during the day;
• Difficulty concentrating during the day;
• Persistent snoring and periods of no breathing during the night;
• Regular visits to the lavatory during the night;
• Waking up with a headache.