Obstructive Sleep Apnea

What is obstructive sleep apnea?

Apnea means “without breath.” Sleep apnea is a sleep disorder that results in interrupted sleep that is characterized by snoring and pauses in breathing for at least 10 seconds or longer during sleep. These pauses occur many times throughout the night interrupting sleep which may cause daytime sleepiness. Sleep apnea is very common, as common as adult diabetes, and affects more than 12 million Americans.
Long-term, this disorder can cause high blood pressure, cardiovascular disease, memory problems, weight gain, impotency and headaches. Short-term effects include poor job performance and accidents due to fatigue and sleepiness.

What are the causes of obstructive sleep apnea?

Blocked or narrowed airways in your nose, mouth, or throat can cause sleep apnea. Your airway can become blocked when your throat muscles and tongue relax during sleep.

Sleep apnea can also occur if you have large tonsils or adenoids or a large uvula. During the day, when you are awake and standing up, these may not cause problems. But when you lie down at night, they can press down on your airway, narrowing it and causing sleep apnea. Sleep apnea can also occur if you have a problem with your jawbone.

In children, the main cause of sleep apnea is large tonsils or adenoids.

Sleep apnea is more likely to occur if you are overweight, use certain medicines or alcohol before bed, or sleep on your back.

What are the symptoms of obstructive sleep apnea?

The main symptoms of sleep apnea that you may notice are:

• Being so sleepy during the day that you fall asleep while working or driving.
• Feeling tired in the morning.
• Waking up with a headache.

Your bed partner may notice that while you sleep:

• You stop breathing.
• You often snore loudly.
• You gasp or choke.
• You toss and turn.

Children who have sleep apnea:

• Nearly always snore.
• May have a hard time breathing during sleep.
• May be restless during sleep and wake up often.

But children may not seem very sleepy during the day (a key symptom in adults). The only symptom of sleep apnea in some children may be that they do not grow as quickly as most children their age.

How is obstructive sleep apnea diagnosed?

There are many types of sleep disorders that have the same signs and symptoms. A polysomnogram (sleep study) can determine if a patient has sleep apnea.

How is obstructive sleep apnea treated?

The most common treatment of sleep apnea is continuous positive airway pressure (CPAP). CPAP treats obstructive sleep apnea by providing a gentle flow of positive-pressure air through a mask to splint the airway open during sleep. The result is that breathing becomes regular, snoring stops, restful sleep is restored, and quality of life is improved.

Other less common treatments include surgery and oral appliances, which may be effective in certain individuals. A surgical procedure can be done to increase the size of the airway by removing any obstruction such as enlarged tonsils, polyps or growths that may be blocking it. An unusually formed jaw may be causing the problem and can be corrected with surgery.

Some patients may benefit from an oral appliance that repositions the tongue or jaw so that airflow is not restricted.

You may be able to treat mild sleep apnea by making changes in how you live and the way you sleep. For example:

• Lose weight if you are overweight.
• Sleep on your side and not your back.
• Avoid alcohol and medicines such as sedatives before bed.