Mr Michael Oko FRCS(Ed) FRCS(ORL-HNS)
Consultant ENT Surgeon and Sleep Apnoea Specialist, Lincolnshire
Major health benefits can be lost without something we often take for granted: sleep, the best medicine.
The best thing you can do in preparation for your COVID-19 vaccine is to get a good night’s sleep. Flu studies show that your immune system is twice as likely to respond well to the vaccine if you sleep well. Sleep is vital to keep your immune system at its best. As Lincolnshire ENT surgeon and sleep specialist Mr Michael Oko says: “Before you get that all-important jab, make sure you sleep well”. This is often easier said than done.
COVID-19, work worries, money concerns, home/family-life are common issues that affect sleep. Mr Oko says: “When you have anxieties, it is not surprising that you can’t fall asleep easily.” However, you could be suffering from a form of obstructive sleep apnoea (OSA).
What is sleep apnoea
OSA is usually when your airways become partially blocked while you sleep, which you may not be aware of. Other symptoms include snoring, self-waking, multiple trips to the loo at night and loss of libido. During the day, you may find concentrating difficult or feel tired, which can be associated with depression, cause mood swings and then escalate to further difficulties in sleeping.
Seeking a diagnosis or treatment for sleep apnoea often comes from family members concerned about their relative’s interrupted breathing. Mr Oko advises taking the sleep apnoea ‘STOPBANG’ questionnaire and comments “A score of three or more is concerning as this condition – often dismissed as ‘just’ snoring – is, in fact, potentially fatal if not treated.”.
Mr Oko explains: “In severe cases, its effect on the body is akin to strangulation, which prompts a stress response from the body. Too much of this puts a strain on the heart.” He says that one in three people with severe sleep apnoea will have a heart attack or stroke and around 15% will die if left untreated; crucially, with treatment, risk numbers revert to a normal level.
OSA is twice as common in men versus women. Women going through menopause are also more likely to develop OSA yet tend to attribute their tiredness, headaches and general feeling directly to menopausal symptoms.
Making sure that mobile phones or similar devices are not used for 90 minutes before sleeping may be enough to reset your body.
Signs of sleep apnoea in children
Three per cent of children have sleep apnoea. The signs can include restless sleep, night-terrors, bed-wetting and difficulty concentrating during the day. It is often confused with ADHD causing unnecessary consequences from the misdiagnosis.
Lifestyle changes can help towards a better night’s sleep. Taking a gentle evening walk, practising yoga, a hot bath, listening to an audiobook on a timer and not going to bed too late are all important elements in sleep hygiene.
Eating well and lighter evening meals, giving up smoking and drinking less alcohol, as well as making sure that mobile phones or similar devices are not used for 90 minutes before sleeping may be enough to reset your body. Studies show that the ‘blue light’ from the mobile device screens enormously reduce the ability for quality sleep.
Apps are also available that focus on cognitive techniques to help reset sleeping patterns naturally.
If treatment is required, it will start by visiting your GP who will be able to refer you to a sleep specialist. Referrals continue during the pandemic; the consultation can take place via video call and the equipment to perform a sleep study can be sent to your home.
For adults, treatment may involve a breathing device called a CPAP (Continuous Positive Airway Pressure). This machine gently provides air into a mask you wear over your nose and mouth throughout the night while you sleep. For children, surgery in the form of removing tonsils is sometimes recommended.
Diagnosis and treatment make a massive difference to whole families, says Mr Oko. “People describe it as “transformative”: everyone enjoys a higher quality of life and better relationships. Once everybody sleeps well, everybody benefits.”