What is obstructive sleep apnea?
Obstructive sleep apnea is one of the most common sleep-related breathing disorders. It occurs when the muscles relax during sleep, causing blockage of the upper airway. The most common sign of obstructive sleep apnea is snoring. Most people with OSA typically snore loudly. Sometimes there are notable periods of silence when airflow is blocked. Choking or gasping sounds may be heard when the airway reopens.
What are symptoms of obstructive sleep apnea?
OSA can be found in both children and adults. It most frequently effects older men, but also affects women as well.
OSA can lead to a series of negative side effects, impacting day-to-day life. Individuals with untreated OSA often complain of fatigue and excessive daytime sleepiness. Individuals with untreated obstructive sleep apnea may also exhibit: snoring, leg restlessness, joking or gasping at night, insomnia with frequent awakenings, morning headaches, daytime sleepiness, vivid dreams, lack of concentration, cognitive deficits.
There are three types of obstructive sleep apnea:
- Mild OSA
- Moderate OSA
- Severe OSA
Several groups are at higher risk of developing OSA:
- Middle age and older men
- Postmenopausal women
- Obesity: there is a strong correlation between higher body mass index (BMI)
- Individuals with nasal congestion
- Next size: those with a large neck (men, over 17 inches and women, over 16 inches)
- Upper airway abnormalities: enlarged tonsils, overbite
- Individuals with a family member with OSA
- Individuals with acromegaly or hypothyroidism
Risks associated with untreated obstructive sleep apnea:
- Treatment resistant hypertension
- Impaired concentration
- Mood disorders
- Increased risk of motor vehicle accident
- Impaired glucose tolerance (increased insulin resistance)
- Increased risk of stroke
- Increased risk of arrhythmia (atrial fibrillation)
Diagnosis of OSA:
Sleep apnea should be diagnosed by a certified sleep specialist. Most commonly, a home sleep test (HST) will be used to assess for sleep disorders, including obstructive sleep apnea. In certain cases, and in-lab polysomnogram (PSG) may be necessary to diagnose obstructive sleep apnea or other sleep related disorders. Examples of such cases include: suspected narcolepsy, severe pulmonary disease, polycythemia, suspicion of nocturnal seizures, neuromuscular weakness.
Treatments for OSA include:
CPAP (Continuous positive airway pressure) therapy: CPAP is the standard form of therapy for most individuals diagnosed with OSA. CPAP provides a steady stream of pressurized air to patients through a small mask they can wear while sleeping.
Oral Appliance : these appliances are often referred to as mandibular advancement device (MAD). This device, typically made by a dental specialist, physically repositions the jaw forward to expand the airway. Some are designed specifically for snoring. Others are intended to treat both snoring and sleep apnea. These oral appliances are an effective treatment option for individuals with mild to moderate OSA.
Surgery: Surgery is an option for individuals diagnosed with OSA, when other treatments such as CPAP or oral appliances have been unsuccessful. Surgical options address OSA by reducing or removing tissue from the soft palate, tonsils, uvula, or adenoids. Historically, one of the most common surgical methods was the uvulopalatopharyngoplasty (UPPP). Adenotonsillectomy, the surgical removal of the tonsils and adenoids, is a popular treatment option for children diagnosed with OSA.
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AASM Certified Sleep Specialist
American Academy of Sleep Medicine