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Sleep Apnoea in Singapore

Sleep apnoea refers to the repeated pauses in breathing that occur during sleep. These pauses can disrupt normal sleep and reduce oxygen levels in the body. The most common form is obstructive sleep apnoea (OSA), in which the airway becomes temporarily blocked during sleep.

According to the World Health Organization and local health studies, sleep apnoea affects millions worldwide, with OSA being the predominant type. In Singapore, it is increasingly recognised as a condition that can influence long-term health if not properly managed.

What Are the Types of Sleep Apnoea?

Obstructive Sleep Apnoea (OSA)

In OSA, the airway becomes blocked during sleep, preventing airflow to the lungs. This is the most common form of sleep apnoea. The severity of OSA is measured using the Apnea-Hypopnea Index (AHI), which tracks the frequency of breathing interruptions per hour of sleep.

Central Sleep Apnoea (CSA)

CSA occurs when the brain does not send proper signals to the breathing muscles, resulting in pauses in breathing even when the airway remains open.

Mixed (or Complex) Sleep Apnoea

Mixed sleep apnoea is a combination of OSA and CSA, where both airway obstruction and signalling issues are involved.

What Are the Symptoms of Sleep Apnoea?

Symptoms of sleep apnoea often occur both during sleep and throughout the day due to poor sleep quality. While there is a significant overlap in symptoms between obstructive sleep apnoea (OSA) and central sleep apnoea (CSA), some key differences exist.

Common Symptoms

  • Difficulty concentrating

    Reduced oxygen levels and poor sleep quality can make it challenging to focus on daily tasks or recall information.

  • Daytime sleepiness (hypersomnia)

    People may feel exhausted during the day, sometimes dozing off unintentionally at work, while reading, or even driving.

  • Morning headaches

    Waking up with headaches may result from low oxygen and disturbed sleep during the night.

  • Insomnia

    Some individuals struggle to stay asleep due to repeated breathing disruptions, leading to restless nights.

  • Irritability and mood swings

    Poor sleep may affect emotional regulation, contributing to irritability, low mood, or heightened stress.

Symptoms More Specific to Obstructive Sleep Apnoea (OSA)

A common feature, often noticed more by a bed partner than the person themselves.

Breathing may stop during sleep, followed by a sudden snort, choke, or gasp as normal breathing resumes.

Some individuals experience increased perspiration during sleep as the body struggles with disrupted breathing.

Waking up multiple times to urinate is a recognised feature associated with OSA.

Symptoms More Specific to Central Sleep Apnoea (CSA)

Breathing interruptions may cause sudden awakenings accompanied by a feeling of breathlessness.

Some people may notice discomfort or pressure in the chest during the night.

This is a distinct pattern of irregular breathing marked by cycles of shallow breaths, deep breaths, and pauses.

Note: Not everyone with sleep apnoea snores. If symptoms persist, consider medical evaluation.

What Causes Sleep Apnoea and Who is at Risk?

Sleep apnea does not have a single cause. Instead, several factors may increase the likelihood of developing the condition. These vary from person to person and do not always lead to sleep apnoea, but they may play a role in increasing the risk.

Extra tissue around the neck and throat may narrow the airway, making it more likely to collapse during sleep.

Sleep apnoea can affect people of all ages, but is more commonly reported in middle-aged and older adults. It is also seen more often in men, although women may be affected, particularly after menopause.

Having close relatives with sleep apnoea may increase the likelihood of developing the condition, suggesting a genetic component.

These may relax the muscles of the airway or irritate the respiratory passages, which can contribute to breathing disruptions during sleep.

Some people naturally have a smaller airway or larger tonsils and adenoids, which may make airflow more difficult.

Lying on the back may encourage the tongue and soft tissues to fall backwards, potentially obstructing the airway.

How is Sleep Apnoea Diagnosed in Singapore

Diagnosis may involve a clinical review and one or more sleep studies. The approach depends on symptoms and medical history.

The ENT doctor examines the nose, throat, and airway for structural factors such as nasal blockage, enlarged tonsils, or a narrowed airway.

Conducted in a hospital or sleep lab. It records sleep stages, breathing pauses, oxygen levels, heart rate, and related signals through the night.

A sleep study using portable monitoring to record breathing patterns, airflow, and oxygen levels during sleep.

What Complications Can Sleep Apnoea Cause?

Sleep apnoea may be linked with several health conditions. These associations have been observed in clinical studies, though the extent of risk can vary from person to person.

Repeated drops in oxygen during sleep may contribute to elevated blood pressure levels.

Sleep apnoea is associated with an increased strain on the heart, which may affect heart rhythm and circulation.

Breathing interruptions and reduced oxygen may be related to a higher risk of stroke in some individuals.

Research has found connections between disrupted sleep and changes in glucose metabolism.

Poor sleep can affect hormone balance and appetite regulation, which may contribute to weight changes.

Studies have reported links between sleep apnoea and erectile dysfunction.

What Non-Surgical Treatments Are Available for Obstructive Sleep Apnoea (OSA)?

Non-surgical approaches are often considered first when managing sleep apnoea. These methods focus on keeping the airway open and improving breathing during sleep.

A device that delivers a steady flow of air through a mask to prevent airway collapse.

Provides two pressure settings — higher when inhaling and lower when exhaling — which may be more comfortable for some individuals.

A type of device that adjusts airflow automatically during sleep, sometimes used in central or complex sleep apnoea.

Custom-made devices worn in the mouth to help move the lower jaw forward, allowing better airflow.

Encourages sleeping in positions that reduce airway obstruction, often avoiding sleeping on the back.

These options form part of the commonly used OSA treatment in Singapore and may be tailored depending on the severity and type of sleep apnoea.

What Surgical Treatments Are Available for Sleep Apnoea?

When non-surgical methods are not effective, surgery may be considered. Surgical procedures aim to remove or reduce tissue that blocks the airway or to alter airway structure.

Removal of enlarged tonsils or adenoids that may obstruct breathing.

A procedure that reshapes the soft palate and surrounding tissue to widen the airway.

Reduces the size of the turbinates in the nose to improve airflow.

Corrects a deviated nasal septum that may contribute to airway blockage.

Removes or reduces tissue at the base of the tongue to prevent it from blocking the airway during sleep.

Reinforces the palate to lessen collapse and vibration during breathing.

These procedures are part of the range of treatment options for obstructive sleep apnea. In some instances, a sleep apnoea surgeon may recommend surgery if other methods are not sufficient. Each approach is considered on an individual basis as part of broader sleep apnoea treatment in Singapore.

FAQs about Sleep Apnoea in Singapore

Snoring occurs when tissues in the throat vibrate due to partially blocked airflow. Sleep apnoea, on the other hand, involves repeated pauses in breathing that can lower oxygen levels and disturb sleep. Learn more about ENT snoring.

If you or someone close to you notices loud snoring, pauses in breathing during sleep, or excessive daytime tiredness, it may be time to seek a medical assessment. Persistent morning headaches, mood changes, or difficulty concentrating are also signs that should not be ignored.

In some mild cases, weight reduction or lifestyle adjustments may lessen symptoms, but sleep apnoea does not usually resolve without medical attention. A formal diagnosis is often needed to understand the severity and guide treatment.

Yes. Enlarged tonsils or adenoids are common causes in children and can lead to restless sleep, loud snoring, or mouth breathing. A paediatric ENT specialist can assess whether treatment is required.

Blocked nasal passages due to allergies may make breathing harder at night and worsen existing sleep apnoea. Managing allergies, such as a sensitive nose allergy, may help improve airflow during sleep.

Doctors use clinical evaluation and sleep studies to confirm the condition. This may include an overnight polysomnography in a sleep lab or a home sleep test to measure breathing and oxygen levels.

Untreated sleep apnoea may be linked with long-term health issues such as high blood pressure, heart disease, diabetes, and an increased risk of stroke. Early diagnosis and management can help reduce these risks.

Sleep Apnea Doctor / Surgeon in Singapore

If you are experiencing symptoms such as daytime fatigue or pauses in breathing during sleep, consider consulting an ENT specialist for an evaluation. Dr Leslie Koh sees patients at Mount Alvernia Hospital.

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