Obstructive Sleep Apnea

What is Obstructive Sleep Apnea?

Obstructive sleep apnea (OSA) is a common condition affecting up to 2% of the adult population. It can occur at any age and in both sexes.

A "sleep apnea" is an period during which you stop breathing for several seconds while asleep. In the obstructive type of sleep apnea, you continue to make efforts to breathe, but are unable to do so due to a temporary closure of your upper airway.

Symptoms

Each episode of apnea during sleep leads to a brief period of suffocation, which causes the levels of oxygen in your blood to fall. When this happens, your body forces your breathing muscles to work harder to open your airway, and the period of apnea ends with a loud snort. At this time, you will either partially or completely awaken. Most people with apnea, however, are not aware of these episodes.

Your partner may complain about your loud snoring, and may notice periods during your sleep where you stop breathing. You might experience choking sensations at night, frequent awakenings, unrefreshing sleep, or excessive sleepiness during the day. OSA can result in memory problems, poor performance at work, and a loss of sexual interest. The excessive sleepiness resulting from OSA can lead to car accidents. When severe, obstructive sleep apnea can lead to serious complications such as high blood pressure, heart rhythm disturbances, and heart failure.

Contributing Factors

OSA is more commonly seen in people who are overweight, or who smoke or drink alcohol regularly. It is more common in the elderly, and in women it is more common after menopause. Sleeping pills or alcohol can aggravate sleep apnea.

These "risk factors" for sleep apnea contribute to breathing problems either by narrowing the upper airway, or by causing the muscles that normally keep the airway open during sleep to become too relaxed. In some instances, large tonsils or an abnormally small lower jaw can contribute to obstruction of the upper airway.

Rarely, obstructive sleep apnea can be caused by a medical condition, such as an underactive thyroid gland.

Diagnosis

To be evaluated for sleep apnea, you should meet with a doctor specially trained in sleep disorders medicine. Be prepared to give a good description of your sleep, including (if possible) a description of your sleep by your partner. You should also make careful note of any daytime symptoms, such as headaches in the morning or sleepiness through the day. Once you have met with a physician, you may be booked for an overnight sleep study to confirm the diagnosis of sleep apnea, and to determine its severity.

A sleep study involves spending a night in the hospital, during which your sleep and breathing are measured. The procedure is painless, and a technologist is available through the night to supervise you.

Treatment

The treatment of OSA depends on your symptoms, the severity of your apneas, and the results of your sleep study. Some basic treatments, such as losing weight, avoiding alcohol and sedatives, and treating nasal congestion with decongestants, might in some cases be enough. However, many people need other forms of treatment, such as nasal CPAP (continuous positive airway pressure), corrective upper airway surgery, or special devices worn in your mouth during sleep. Your doctor can tell you more about these forms of treatment.

Once you have started treatment, you may need to do another sleep study to ensure that the treatment is working.