"Apnea" means not breathing. If you have Obstructive Sleep Apnea (OSA), you may stop breathing for short periods of time while sleeping. Even when you are trying to breathe, there may be little or no airflow into the lungs. These pauses in airflow (apneas) can occur intermittently during sleep, and cause you to wake up from a sound sleep. Frequent apneas can cause many problems. With time, if not treated, serious health problems may develop.
OSA is more common in men, women after menopause and people who are over the age of 65. OSA can also occur in children. There are several groups of people who are particularly at risk for developing OSA. People who are overweight are more likely to develop sleep apnea. OSA can occur in people who have large tonsils or adenoids. OSA can also run in families of people of normal size and in people with certain types of jaw problems. People with these jaw problems have difficulty keeping the back of their throat open. Some of these conditions are called micrognathia (a small jaw) and retrognathia (a pulled back jaw).
There are many clues that tell your provider that you may have OSA. You may not be aware that you have OSA, but these symptoms may be more obvious to a spouse, other family member, or close friend.
Common symptoms you may have during sleep:
Lack of sleep can cause you to fall asleep while driving and result in car accidents. Periods of stopped breathing can, with time, cause high blood pressure (hypertension), heart disease, stroke and early death.
An overnight polysomnogram or sleep center-based sleep study is a test commonly ordered to diagnose OSA. This requires a patient to sleep in a testing center overnight with many sensors attached and with a technologist directly monitoring sleep patterns all night. This type of testing is recommended in some circumstances, especially when your physician needs more detailed information.
With new technology, the diagnosis of OSA can now be made using a small device that monitors your sleep breathing patterns in the comfort of your own home. This test is less expensive and often preferred by patients. The American Academy of Sleep Medicine has endorsed this test as both accurate and reliable in the right circumstance. A board certified sleep specialist reads all home sleep tests.
Sleep apnea can be effectively treated, and there are a number of ways to do so. The type of treatment recommended will depend on the reason for and severity of the sleep apnea. If your OSA is from being overweight, weight loss may cause the apnea to go away completely. You can avoid alcohol for at least 4 hours before going to bed. If you sleep on your back, you can use a pillow or some other strategy to force yourself to sleep on your side. Some people sew a tennis ball into their pajama bottoms to remind them not to turn on their back.
Continuous Positive Airway Pressure (CPAP) is a common device ordered to treat most conditions of OSA. CPAP is delivered by a compressor that blows air (with or without oxygen) into a mask that is worn snugly over the nose and or mouth during sleep. The flow of air acts like a splint to keep the upper airway from collapsing. This helps prevent obstruction and the apnea from occurring. The air pressure is adjusted to a setting that best controls the apnea. Often a person will also notice much less snoring when wearing CPAP.
Dental devices are another option for treatment of OSA. These devices are custom fit by a trained dentist and work by moving the lower jaw forward to open up the airway.They work best in mild and moderate sleep apnea but are also used in patients with severe sleep apnea who cannot tolerate CPAP. Patients often use dental devices as a temporary solution in place of CPAP for travel or camping as well. Minor bite changes and temporomandibular joint discomfort can occasionally occur and follow up with your dentist is important.
Surgery may be recommended in some cases. When the tonsils or adenoids are causing the throat to be blocked, a tonsillectomy may be recommended. Surgery may also be helpful for patients with jaw problems. Other surgeries for OSA either clear out the tissue from the back of the throat or reposition the tongue forward. These surgeries are not, however, as effective as CPAP to control your OSA and are usually reserved for patients who fail CPAP.