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The Link Between Air Pollution and Sleep Apnoea

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Those who suffer from obstructive sleep apnea (OSA) are likely already aware that this condition can be dramatically improved with the use of a continuous positive airway pressure (CPAP) machine as well as by making some basic lifestyle adjustments.

Eating a healthy diet, exercising and losing a bit of weight can all produce dramatic effects. However, what if the symptoms associated with your OSA have not significantly improved? Are there any other factors that may be at play?

Many professionals will cite that the pollutants found within your home and sleeping area can impact your OSA as well as the associated symptoms. Let us take a more in-depth look at this concept so that the appropriate changes can be made in a proactive manner if you suspect that a problem may exist.

More Than Allergies Alone

Allergies (known within the medical community as "allergic rhinitis") can be annoying and they will often have an impact upon our daily lives. While these may occur any time of the year, their symptoms tend to be similar. Common signals that you could be suffering from allergies will often include:

  • Watery eyes
  • A runny nose
  • Nasal and/or chest congestion
  • A sore or "scratchy" throat

To be clear, there is no direct evidence to suggest that allergies can lead to OSA (or vice-versa). The main takeaway point here is that those who suffer from allergies are more likely to experience an uptick in the severity of symptoms associated with OSA.

What Types of Allergens Could Negatively Impact the Symptoms of OSA?

One of the issues with modern homes is that the majority contain some type of allergen. This is particularly the case during the colder months of the year when air circulation is at a minimum or if certain types of upholstery (such as shag carpets) are present.

Some of the most common allergens which the majority of us are exposed to include:

  • Pet hair
  • Pollen
  • Indoor mould
  • Dust mites
  • Seasonal spores such as ragweed

However, there is a lesser-known category of allergens that might have an even more dramatic impact upon the severity of your OSA. These particles are referred to by the rather scientific-sounding names of PM2.5 and nitrogen dioxide.

The main issue here is that the size of these particles is extremely small; approximately 2.5 micrometers in diameter. When this is compared to the 10-micrometer size of common pollutants, the overall effect becomes clear.

Smaller airborne particles are more difficult to remove from the air and they tend to remain suspended within an atmosphere for longer periods of time, increasing the chances that they will be inhaled during the overnight hours.

It is therefore no great surprise that those who live within regions known for higher concentrations of these two particles have stated that they have more difficulty sleeping. They are also more likely to have been diagnosed with OSA in the past.

How Might Air Pollution Exacerbate the Symptoms of OSA?

We need to highlight the fact that pollutants are physical irritants to the respiratory system. Common examples include tearing eyes when approaching a smoky campfire and coughing if you happen to be hiking during hay fever or ragweed season.

These tiny pollutants will cause a certain amount of airway irritation (varying between individuals). If such irritation causes minor damage to the mucous membranes of the throat and nose, it makes perfect sense that the severity of OSA will likewise increase.

This once again arises from the physical causes of OSA. If your airways begin to inadvertently collapse during the overnight hours, you are more likely to experience issues such as lapses in breathing and severe snoring.

In other words, the diameter of your airways is directly correlated to the symptoms associated with OSA. When we now take into account the fact that pollutants can cause further irritation, it is logical to assume that the onset of this condition will be quicker, more frequent and (potentially) more severe.

What About Seasonal Concerns?

There are obviously certain times of the year when you are more likely to suffer from allergies. These coincide with specific plants and organisms which produce airborne spores. Furthermore, let's keep in mind that the windows of your home will remain open for longer periods in order to increase air circulation.

While this may be a great way to reduce interior levels of humidity, we should also point out that open windows and doors will allow pollutants and other particulate materials to enter. If you happen to live within a major urban area associated with high pollution levels, you could very well be creating more of a problem than a solution.

The scenarios mentioned above are thought to be why those who have been diagnosed with OSA tend to experience more severe symptoms during the spring, summer and early autumn.

If you happen fall into this category, you are likely eager to learn if there are any steps which can be taken in order to mitigate the potential impacts of air pollution. Let us now outline some professional suggestions.

Minimising the Effects of Pollution on Obstructive Sleep Apnea

Being aware of the existence of any potential pollutants within your home is arguably one of the most important steps to take. There are a host of air quality test kits which can be purchased. These are easy to use and they will alert you to the presence of airborne particulate matter.

Assuming that these substances have been detected, it might be wise to take a handful of steps including:

  • Replacing old or worn-out carpets.
  • Use a dehumidifier when needed.
  • Clean up pet hair and dander on a regular basis
  • Avoid smoking indoor
  • Regularly check for the presence of mould
  • Use an extractor fan when cooking in the kitchen

Of course, these steps will do little to improve outdoor conditions, If you currently reside in an area associated with high levels of pollution, it is wise to sleep in air conditioning whenever possible. The filters contained within modern units will help to eliminate much of this particulate matter before it enters into your home.

The Proper Use of a CPAP Machine

It should finally be mentioned that regularly using a CPAP machine while sleeping is one of the best ways to minimise the impact of indoor pollution. Not only will the increased pressure help to keep your airways open, but the majority of units contain built-in filters which can be quite effective at reducing the amount of particulate matter you would otherwise be exposed to on a nightly basis.

Ongoing studies are now highlighting the relationship between obstructive sleep apnea and pollution. This is why such scenarios need to be taken very seriously if you have been finding it difficult to obtain a sound night of sleep.

For additional advice or to determine if OSA might be present, do not hesitate to speak with your doctor or a qualified sleep specialist.

Author: Jenny Hall

About author: Jenny Hall is a clinical manager at Baywater Healthcare. She has extensive specialist clinical experience from Regional Nurse Adviser through to Senior Nurse Adviser, Service Lead and Contract Manager. She has provided leadership for the Regional Nurse Advisers ensuring best practice, implementation of National Guidance and Clinical Governance. Ms. Hall has worked with Baywater Healthcare since 2013, with leadership responsibility in delivering Home Oxygen and Long-Term Conditions services. Her clinical team focuses on delivering services closer to home which offer the NHS value with optimum clinical outcomes. Previously, Ms. Hall provided leadership to Regional Nurse Advisors with Air Products, a company providing home oxygen services to Wales, East Midlands and North London. She has served as a Senior COPD National Trainer and Nurse Adviser COPD Response with Innovex, ensuring highest competencies were maintained and best practices delivered. Ms. Hall has a Ba Honours Degree as a Registered General Nurse from Oxford Brookes University and MSc Health Studies from Staffordshire University. She completed Respiratory Education and Training Courses and the Edinburgh Sleep Course. Jenny Hall’s LinkedIn profile: https://www.linkedin.com/in/jenny-hall-34331b60/

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