Obstructive Sleep Apnea (OSA)
What is obstructive sleep apnea (OSA)?
Sleep apnea refers to any disorder in which there are breaks or pauses in our breathing during sleep. In many cases these breaks are caused by a portion of the nose or throat actually blocking our airway during sleep. In this case the disorder is called obstructive sleep apnea.
Why should we be concerned about obstructive sleep apnea?
If the obstructive sleep apnea is severe, it can actually cause the level of oxygen in our bloodstream to drop to dangerously low levels. This can in turn lead to heart problems and other health disorders. Pressure changes in the throat can also be associated with irregularities in the heart beat. Less severe obstructive sleep apnea can interfere with our sleep, causing symptoms such as daytime sleepiness.
How does snoring differ from sleep apnea?
Snoring occurs when some part of the throat flutters when we inhale or exhale during sleep. Most people who have obstructive sleep apnea also snore, but not everybody who snores has sleep apnea. Other than the loud noise, which may disturb bed partners, snoring is not believed to cause any health problems.
How is obstructive sleep apnea diagnosed?
Obstructive sleep apnea is diagnosed by a combination of the clinical history, the physical exam, and one or more diagnostic tests. The most common test is called a sleep study. This test involves close monitoring of a wide variety of important vital signs during sleep, and is most often done at a special sleep study center.
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What is the treatment for sleep apnea?
The first line of treatment for obstructive sleep apnea is treatment of the underlying cause. Obstructive sleep apnea is associated with increased weight and will often improve with weight loss. Nasal obstruction also worsens obstructive sleep apnea, and a combination of medical or surgical treatment can be used to decrease this obstruction. There are several intraoral devices available that may be effective in reducing sleep apnea. These devices work by moving either the tongue or the lower jaw forward. If these measures have not helped, the next step usually recommended is a special type of mask system called CPAP (for Continuous Positive Airway Pressure) to be worn at nighttime. This mask actually pressurizes the inside of the throat, like blowing up a balloon. It is very successful in curing sleep apnea, but some people have difficulty tolerating the mask. If none of the these measures have worked, there are several types of surgery that may help cure obstructive sleep apnea. However, not all individuals with obstructive sleep apnea are good candidates for surgery and some type of apnea are not corrected with surgery. Diagnosis and treatment of obstructive sleep apnea is complex and requires careful evaluation by a skilled physician. If you feel that you have symptoms of obstructive sleep apnea, contact your physician.
How is snoring treated?
Before snoring is treated, it is first important to make sure that the patient does not also have obstructive sleep apnea. Obstructive sleep apnea requires different treatment than snoring, and treatment for snoring may not improve the apnea. Snoring is also associated with increased weight and nasal obstruction, so correcting these two factors may reduce snoring. If snoring persists, there are several operations that can be done to reduce or eliminated snoring. These operations involve removing a portion of the soft palate (the soft part of the roof of the mouth). One of these procedures is called a LAUP ("lay-up," for Laser Assisted Uvulopalatopharyngoplasty) and can be done in the office with a local anesthetic. It is usually done as a series of separate treatments separated by about 6 weeks. Treatment is done until the snoring has stopped or is sufficiently reduced. The other type of surgical treatment is more involved and must be done in the operating room under a general anesthetic. As with obstructive sleep apnea, if you have concerns about snoring you should contact your doctor for a complete evaluation.