What is Sleep Apnea?
More than 18 million Americans suffer from Obstructive Sleep Apnea (OSA) or sleep apnea. It affects all age groups and both sexes; but is most common in middle aged men. It is also more commonly seen in the elderly however is potentially less concerning in this population. There are a number of risk factors which can increase the chance of suffering from OSA. Some risk factors include having a small upper airway, having abnormally large throat structures, being overweight, having a recessed small chin, small jaw, large overbite, or large neck size. Smoking and alcohol use can increase the risk. OSA tends to run in families which may indicate a genetic component.
OSA is a condition in which you stop breathing briefly and repeatedly while sleeping at night. OSA has a host of possible signs and symptoms. Listed below are a few of the most common.
Sleep Apnea Symptoms
- Frequent awakenings during the night. The cessations in breathing can lead the body to recognize a lack of oxygen and will trigger you to awaken.
- Wake up gasping for air
- Chronic issue with snoring
- Feeling tired after a full night’s sleep
- Finding it hard to stay awake at work, while driving, or on the phone
- During the day sufferers may experience:
- headaches (especially in the morning)
- excessive sleepiness
- memory and concentration issues
- short temperament
- Long term symptoms can include:
- high blood pressure
- heart attack
- heart failure
- cardiac arrhythmia
- sexual dysfunction
Children with OSA may snore loudly, have pauses in breath, gasp, and snort during sleep. They may be restless during sleep or sleep with their head in an abnormal position. During the day they may complain of frequent headaches especially in the morning. They may also exhibit a nasal speaking voice and breathe regularly through the mouth.
There are several possible causes for sleep apnea; all causes result in blockage of the sufferer’s airway path. Sometimes this blockage occurs in the mouth/throat. This might be due to abnormally large throat structures (i.e. tongue, tonsils, and uvula). Or the throat muscles that normally hold these structures (i.e. soft palate, uvula, tonsils, and back of the tongue) in place relax too much during sleep and allow the structures to shift in such a way to block the airway. A receding small jaw may cause the tongue to sit too far back in the throat which can lead to blockage of the airway. Sometimes the blockage is in the structures of the nose. The nose septum divides the left and right sides of the nose. The turbinites are ridges located in the nasal passages. The septum may be deviated (crooked) or the turbinites may be swollen both of which might block the air passageways.
How is it Diagnosed?
A detailed history can be instrumental in diagnosing OSA. Before coming to your appointment take a moment to reflect on your sleep patterns:
- Time to rise
- Length of sleep
- Frequent awakenings
- Overall sleeping environment
- Regular routine before you go to bed
- History of snoring
- Note any current medications, previous and current medical conditions, and any recent weight gain
- Ask a bed partner if they have noticed any of the following during your sleep; heavy snoring, choking, gasping for air, or cessation in breathing.
A physical exam of the throat nose and mouth should be conducted by a trained physician to detect any structural causes of OSA. We currently have two methods to diagnose your sleeping related problems:
Home Sleep Study
Simple and affordable testing done in the convenience of your home.
In Lab Sleep testing
Tests take place at the State-of-the-Art Sleep Center in Delafield WI.
While history and physical is important, a sleep study is often needed to definitively diagnose OSA. This test will also provide pertinent information on the severity of the case. During a sleep study certain physiological processes will be monitored to detect abnormalities. Some of these processes include heart rate, oxygen levels, muscle activity, respiratory effort, eye movement, sleep state, and airflow. The raw data from a sleep study will be evaluated by the sleep physician and the results and subsequent plan of care will be explained to you.
Obstructive Sleep Apnea Treatment
Sleep apnea is treated most commonly by Continuous Positive Airway Pressure (CPAP). The CPAP is a pump which will gently blow air into the patient’s airway to help keep it open. The CPAP has a mask which will fit over the patient’s nose/mouth. It is a highly effective treatment when it is used in the correct manner. The CPAP should be used all night and every night in order to be an effective treatment. It may take time to become accustomed to using a CPAP.
Another possible treatment is the use of dental appliances, such as an oral mandibular device. The device will move the lower jaw forward in order to help open up the airway. Throat surgery may be done to remove excess tissue which is blocking the airway. Surgery in the nose and jaw may also be considered as possible options. Generally these methods of treatment are most effective in cases of mild OSA and heavy snoring.
Lifestyle changes are also highly effective in alleviating the symptoms of sleep apnea. Following are some of the most common things a patient can do:
- Lose weight. If you are overweight this can increase the risk and severity of your OSA case. An overweight patient may even cure their OSA by slimming down. A CPAP while effective treatment is not a cure.
- Avoid alcohol. Alcohol can cause frequent awakenings and can cause the upper airway muscles to relax.
- Avoid certain medications. Such as sedatives, sleeping pills, and some antihistamines; all which may relax the throat muscles and increases the severity of OSA.
- Quit smoking. Smokers suffer a higher severity of throat swelling which will make apnea and snoring worse.
- Sleep on your side. Some patients find that the symptoms of sleep apnea are less severe if they sleep on their side.
- Treat allergies or sinus issues which may hinder your ability to breathe.