Sleep Apnea

Obstructive sleep apnea syndrome is a serious disorder in which breathing is repeatedly obstructed for short periods, lasting from seconds to over a minute in duration.

During an apnea, the muscles in the upper airway relax, obstructing the upper airway, resulting in an interruption of breathing associated with oxygen desaturations.

The event is terminated by an arousal, which is usually brief and associated with a resumption of breathing. Normal individuals often have occasional apneas, but with obstructive sleep apnea syndrome the cycle can be repeated hundreds of times a night, resulting in poor quality sleep.

Often people with sleep apnea are unaware they have it and don’t realize that they are having problems breathing while sleeping. A family member or bed partner may notice the signs of sleep apnea first.

Who Is At Risk?

Sleep apnea is a common disorder, occurring in about 4 percent of men and 2 percent of women. It increases in frequency as we get older and is more likely to occur in those who are overweight. Sometimes anatomical features, such as large tonsils, will place a patient at risk. A family history of sleep apnea increases the chances of developing the disorder. Sleep apnea, however, can occur in people of all weights and ages, and specific risk factors need not be present.

Symptoms

One of the most common symptoms is loud habitual snoring. While sleeping, an individual’s breathing may stop or become very shallow. When normal breathing begins again, it often starts with a loud snort or a choking sound. Patients often complain of dry mouth, morning headaches, and frequent urination at night. The individual may be aware of the awakenings but not the snoring or apneas, leading to the complaint of insomnia. During the daytime patients often experience sleepiness and fatigue. Mood and concentration may be impaired.

Health Risks

Sleep apnea can increase the risk for work-related accidents and driving accidents due to trouble concentrating, forgetfulness or sleepiness. It may also contribute to anxiety or depression.

If left untreated, obstructive sleep apnea may cause hypertension and is a risk factor for heart disease and stroke. It may also aggravate many other health problems including lung disease and kidney problems.

Diagnosis

During an office visit, one of our sleep center physicians will perform a history and physical examination to look for symptoms of obstructive sleep apnea syndrome. The patient will also be evaluated for medical conditions that may cause or exacerbate sleep apnea.

In most cases of suspected obstructive sleep apnea syndrome, a sleep study (all-night polysomnography) will be performed to document the presence of severity of the condition. Treatment options will be discussed during the initial consult and after the results of testing are available.

Treatment

During the initial office visit, general recommendations that often help patients with snoring and obstructive sleep apnea syndrome will be discussed. This may include weight reduction, avoidance of alcohol at bedtime and treatment of nasal congestion.

While the sleep study is being conducted, nasal continuous positive airway pressure (CPAP) may be initiated. After testing, the sleep center physician will individualize treatment to the patient, taking into account the severity of sleep apnea, other medical conditions, and patient preferences.

Recommendations may include the nightly use of nasal CPAP, surgical procedures, oral prostheses or positional therapy. Patients are then carefully followed to ensure that treatment is tolerated and effective.