Sleep apnoea is a common sleep disorder characterised by pauses in breathing or insufficient breathing during sleep. These breathing pauses can last for tens of seconds and occur at least five to dozens of times per hour, depending on severity. This condition leads to a reduced quality of sleep, as it shifts the individual from deep sleep into light sleep in order to alert the body into taking a breath, disrupting the natural sleep cycle and leading to chronic sleep deprivation and daytime sleepiness.
The most common form of sleep apnoea is Obstructive Sleep Apnoea, where throat muscles relax and physically block the airway during sleep. Sleeping pills can worsen apnoeic events by further relaxing muscles.
People with ADHD have higher rates of sleep disorders, with some evidence showing this also relates to higher rates of sleep apnoea in both children and adults. I'm sure you can imagine how chronic sleep deprivation could increase ADHD symptoms as well as decrease a person's ability to manage their symptoms effectively, and why treatment of sleep apnoea in people with ADHD is therefore important.
Sleep Apnoea and Health
Untreated sleep apnoea can have serious health consequences, particularly for the cardiovascular system. The frequent pauses in breathing during sleep cause repeated drops in oxygen levels, which place strain on the heart and blood vessels. This increases the risk of high blood pressure (hypertension), heart disease, strokes, and even heart failure.
In addition to heart-related issues, untreated sleep apnoea can also contribute to metabolic and mental health problems. The condition is linked to insulin resistance, which can increase the likelihood of developing type 2 diabetes. Sleep deprivation and poor-quality sleep also contribute to cognitive impairment, difficulty concentrating, and memory problems. Mental health conditions such as depression and anxiety are often exacerbated by chronic sleep disturbances, further impacting an individual's overall well-being.
Daytime fatigue is another major consequence of untreated sleep apnoea, with excessive tiredness affecting daily life and increasing the risk of accidents, particularly on the road. People with sleep apnoea may also experience a higher risk of developing liver problems, such as nonalcoholic fatty liver disease. Altogether, untreated sleep apnoea can significantly reduce quality of life, making early diagnosis and treatment crucial for preventing long-term health complications.
I personally developed sleep apnoea at the end of both of my pregnancies, and was able to get a CPAP machine for treatment the second time (the pros of having a husband that works for a sleep clinic). CPAP treatment significantly improved both my sleep and alterness in the daytime, as well as eliminating the snoring and gasping for air that had developed. I used it for several weeks post-partum until my muscles firmed up with normalising hormone levels and the apnoea went away. I'm a firm believer in diagnosing and treating sleep apnoea and do screen for if some symptoms, such as those below, come up when I'm talking to a client.
Symptoms
Common symptoms include snoring, episodes of breathing cessation during sleep, abrupt awakenings with shortness of breath, morning headache, difficulty staying asleep, excessive daytime sleepiness, attention problems, irritability, and frequent night urination.
Several factors can increase the risk of developing sleep apnoea. One of the most significant is being overweight or obese, as excess fat around the neck can narrow the airway and obstruct breathing during sleep. Age is also a factor, with sleep apnoea becoming more common as people get older. Men are at a higher risk than women, although the risk for women increases at peri-menopause. Other risk factors include having a family history of sleep apnoea, smoking, and alcohol consumption, which can relax the muscles in the throat, worsening the condition. Medical conditions such as nasal congestion, high blood pressure, and type II diabetes can also contribute to the development of sleep apnoea.
Treatment
Effective treatments for sleep apnoea are:
Continuous Positive Airway Pressure (CPAP): This is the most common and effective treatment for moderate to severe sleep apnoea. A CPAP machine delivers pressurised air through a mask, keeping the airway open during sleep.
Lifestyle changes: Weight loss, regular exercise, and avoiding alcohol or sedatives can help reduce the severity of sleep apnoea, particularly in mild cases.
Oral appliances: These custom-made devices are worn in the mouth to adjust the position of the jaw or tongue to keep the airway open during sleep.
Positional therapy: For people who have sleep apnoea that occurs mainly when sleeping on their back, positional therapy involves using devices or techniques to prevent back sleeping, such as tennis balls sewn into the back of a t-shirt.
In conclusion, while sleep apnoea is a distinct condition, its intersection with ADHD warrants attention. Here in New Zealand, a person can talk to their GP in the first instance, or approach one of the private sleep clinics that are easily found with an internet search. Most sleep apnoea assessments are performed in a person's own bed with portable devices, like a blood oximeter, to measure oxygen levels in the blood which show dips when apnoeas are occuring. Some pharmacies will even be able to arrange an assessment with these devices.
Clinical psychologist Dr Roberto Olivardia, who has ADHD, talks about being assessed and treated for sleep apnoea and how it has improved his life in this ADDitude article
This article from the Mayo Clinic gives more detail on sleep apnoea in its different forms
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