What is Obstructive Sleep Apnea (OSA)?
Obstructive sleep apnea is a sleep disorder in which breathing is briefly and repeatedly interrupted during sleep. The “apnea” in sleep apnea refers to a breathing pause that lasts at least ten seconds. Obstructive sleep apnea occurs when the muscles in the back of the throat fail to keep the airway open, despite efforts to breathe.Another form of sleep apnea is central sleep apnea, in which the brain fails to properly control breathing during sleep. Obstructive sleep apnea is far more common than central sleep apnea.
Consequences of OSA?
Obstructive sleep apnea, or simply sleep apnea, can cause fragmented sleep and low blood oxygen levels. For people with sleep apnea, the combination of disturbed sleep and oxygen starvation may lead to the following:
- Heart disease
- Mood and memory problems
- Sleep apnea also increases the risk of drowsy driving.
Symptoms of OSA?
Chronic snoring is a strong indicator of sleep apnea and should be evaluated by a health professional. Since people with sleep apnea tend to be sleep deprived, they may suffer from sleeplessness and a wide range of other symptoms such as
- Difficulty concentrating
- Depression, irritability
- Sexual dysfunction
- Learning and memory difficulties
- Falling asleep while at work, on the phone, or driving.
- Left untreated, symptoms of sleep apnea can include disturbed sleep, excessive sleepiness during the day, high blood pressure, heart attack, congestive heart failure, cardiac arrhythmia, stroke or depression.
Diagnosis of OSA?
One of the most common methods used to diagnose sleep apnea is a sleep study , which may require an overnight stay at a sleep center. The sleep study monitors a variety of functions during sleep including sleep state, eye movement, muscle activity, heart rate, respiratory effort, airflow, and blood oxygen levels. This test is used both to diagnose sleep apnea and to determine its severity. Sometimes, treatment can be started during the first night in the sleep center.
Treatment of OSA?
The treatment of choice for obstructive sleep apnea is continuous positive airway pressure device (CPAP). CPAP is a mask that fits over the nose and/or mouth, and gently blows air into the airway to help keep it open during sleep. This method of treatment is highly effective. Using the CPAP as recommended by your doctor is very important. A big key to success is keeping your supplies replaced every mouth. If supplies are not replaced monthly, the cushion will begin to break down and the seal integrity is loss. Patients compensate from this lose buy tightening the head gear which is uncomfortable and can affects sleep.
Other methods of treating sleep apnea include: dental appliances which reposition the lower jaw and tongue; upper airway surgery to remove tissue in the airway; nasal expiratory positive airway pressure where a disposable valve covers the nostrils; and treatment using hypoglossal nerve stimulation where a stimulator is implanted in the patient’s chest with leads connected to the hypoglossal nerve that controls tongue movement as well as to a breathing sensor. The sensor monitors breathing patterns during sleep and stimulates the hypoglossal nerve to move the tongue to maintain an open airway.
Lifestyle changes are effective ways of mitigating symptoms of sleep apnea. Here are some tips that may help reduce apnea severity:
Lose weight. If you are overweight, this is the most important action you can take to cure your sleep apnea (CPAP only treats it; weight loss can cure it in the overweight person).
Avoid alcohol. It causes frequent nighttime awakenings, and makes the upper airway breathing muscles relax.
Quit smoking. Cigarette smoking worsens swelling in the upper airway, making apnea (and snoring) worse.
Some patients with mild sleep apnea or heavy snoring have fewer breathing problems when they are lying on their sides instead of their backs.
The most important part of treatment for people with OSA is using the CPAP whenever they sleep. The health benefits of this therapy can be enormous, but only if used correctly. If you are having problems adjusting your CPAP or you’re experiencing side effects of wearing the appliance, contact me with questions.
Getting adequate sleep is essential to maintaining health in OSA patients. If you have OSA symptoms or difficulty falling asleep, staying asleep, or waking up un-refreshed, I would be happy to discuss treatment options.