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Obstructive Sleep Apnea
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Obstructive sleep apnea is a serious sleeping disorder that results in a stoppage of breathing during sleep. Obstructive sleep apnea is just one type of sleep apnea but is the most common. It happens when the muscles of the throat relax too much during sleep, closing off the airway and resulting in a blockage of the air passages and a cessation of breathing for a short period of time. This happens multiple times per night. Snoring is the main sign of obstructive sleep apnea in most people. Sleep apnea is most common in older adults but can affect anyone of any age.
Signs and symptoms of this disorder include loud snoring at night, being excessively sleep during the day, having known times of breath cessation during sleep, awakening suddenly with shortness of breath, morning headache, awakening with a sore throat or a dry mouth, getting up to urinate frequently at night, and having insomnia.
Obstructive sleep apnea happens when the muscles of the mouth and throat relax during sleep and block normal breathing patterns. The relaxed muscles narrow the breathing passages for up to 20 seconds or more. You don't get enough oxygen and you wake up briefly to gasp and get some air. You often don't even remember waking up to breathe and go back to sleep again. Awakening is brief enough so that you don't know you've awakened. You can do this up to thirty times in one hour and you won't get solid sleep. This is why you feel tired during the day. You usually are unaware of the problem completely and believe you are sleeping well during the night.
Risk factors for obstructive sleep apnea include being overweight, which increases the amount of tissue in the throat, having a thick neck, more than 17 inches in men and 15 inches in women, having high blood pressure, having chronic congestion in the nose and throat, having a normally narrowed throat, being male, having diabetes, being black or Hispanic, being after menopause, being older, using alcohol, sedatives or tranquilizers or being a smoker.
Complications of obstructive sleep apnea include having chronic heart problems. Heart arrhythmias and high blood pressure can come out of having obstructive sleep apnea and rhythm problems like atrial fibrillation are likely to occur. Daytime fatigue is common with obstructive sleep apnea and it can affect work and school performance. People with obstructive sleep apnea can have problems having general anesthesia or taking certain medications that promote sleep. Having obstructive sleep apnea can mean that your partner cannot sleep because of the loud snoring. Memory difficulties, headaches in the morning and depression or irritability can also be complications of sleep apnea.
Testing for sleep apnea can tell how severe your problem is and what treatment would work the best.
The diagnosis of obstructive sleep apnea includes an overnight sleep test called nocturnal polysomnography. In this test, the doctors and technicians hook you up to machines than monitor your brain activity, breathing patterns, and heart activity. Blood oxygen is determined using oximetry. With oximetry, the oxygen level is measured using a sleeve that fits over your finger. It measures how much oxygen you are getting at any given point in time.
There are home tests to check for sleep apnea that involve measuring airflow, breathing patterns and oximetry while you sleep at home. Doctors will then check your airway using a laryngeal tube that is flexible and lighted in order to determine your anatomy.
Treatment of obstructive sleep apnea depends on the severity of the disease. The doctor may simply have you lose some weight or quit smoking. If these don't work, you may need to sleep under conditions of positive airway pressure. This is known as CPAP and involves a device that is fitted over the mouth and nose and brings a higher than normal pressure to the airway, keeping the airway open. Snoring and breathing problems are reversed. Some people find that CPAP is uncomfortable and they can't get used to it. If this is the case, there is a mouthpiece that is used to keep the airway open. It pushes the jaw forward so that airway remains open.
Surgery can be done to remove part of the soft palate and the uvula. This opens the airway surgically and may mean you do not need positive pressure appliances. The jaw itself can be treated with surgery to open the airway. In severe cases, doctors perform a tracheostomy, which opens the airway at the level of the neck so that air can flow through the neck at all times during sleep.