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Anyone who has been kept awake at night by their partner’s snoring may have strong views about the need to find better solutions for this common problem.
This is when the airways become blocked, making the person wake up many times a night. This raises blood pressure and the risk of heart attacks and strokes, not to mention making sufferers dangerously tired in the day time.
So, what causes this sleep disorder and what are the prospects for a cure?
If the airway narrows a little it can make the tissues vibrate as the air passes through, leading to the unwelcome chainsaw-like noises of snoring.
Partners of those affected often say it sounds like the person is choking or gasping for breath in the night.
If they happen more than 30 times an hour, this is classed as severe apnoea, giving an alarming one in three chance of a stroke or heart attack in the next decade. This may be because whenever breathing pauses, the low oxygen causes a rise in blood pressure and heart rate as the person responds by waking up, causing stress to the heart over time.
A CPAP machine doesn’t suit everyone (Photo: Getty)
How is sleep apnoea currently treated?
The current mainstay of treatment for bad sleep apnoea is to go to sleep every night using a CPAP machine with a mask that blows air into the lungs. This helps keep the airway open.
That shouldn’t stop people getting investigated, though, as there are other options, which may help with both sleep apnoea and snoring.
If diagnosed with sleep apnoea, people are advised on lifestyle changes like trying to lose weight, as fat tissue in the neck and throat can compress the airways.
Another strategy is “positional therapy”, which means using various methods for helping someone to avoid sleeping on their back, as side sleeping helps to keep the airways open.
“In one way or another, you need to make sure you or your bed partner turns from the back to their side,” he said.
“Every snoring and sleep apnoea patient is unique,” said Cheong. “Some patients, they narrow at the level of the palate, some it’s the back of the throat. Depending on how they narrow and collapse, we can customise operations to reshape their palate, or back of the throat, so that it minimises the snoring.”
The patient turns it on every night using either a phone app or a remote control.
How could medicines help?
Surgeries and implants might seem extreme measures, so a new pill treatment for sleep apnoea has caused great interest.
In a large trial, people taking the medicine had half the number of pauses in their breathing as people taking placebo tablets. And a fifth of the people taking the drug had fewer than five pauses per hour, meaning their apnoea was classed as under control.
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Manufacturer Apnimed has not yet released the full details of the study, including which people responded best. The medicine is unlikely to help everyone with sleep apnoea, but these results seem promising on the face of it, said Cheong.
The new weight-loss injections, Wegovy and Mounjaro, are also helping people’s efforts to solve their sleep problems by losing weight – which was previously more difficult. “Weight loss is always a good thing in sleep apnoea,” said Professor Dijk.
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