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OBSTRUCTIVE SLEEP APNEA

What Is It?

Sleep apnea is a serious potentially life threatening condition.

  • OSA is common (4% men / 2% women), about the same incidence as asthma.
  • Characterized by repeated episodes of upper airway obstruction during sleep.
  • Almost always associated with snoring, although not everyone who snores has OSA.
  • Patients may experience choking. Bed partner may notice pauses in breathing (apneas).
  • Frequent interruptions of sleep lead to excessive daytime sleepiness.
  • Early recognition and treatment are important as OSA is associated with heart attacks, hypertension, and stroke.

Who Gets It?

  • More common in men
  • Increased incidence with age
  • People who snore
  • People who are overweight
  • Higher incidence in people with high blood pressure

How Is It Diagnosed?

  • First need to suspect it; sleeping partners/spouses notice snoring with spells of choking and pauses in breathing during sleep.
  • Test called a Polysomnogram that records a variety of body functions during sleep, such as:
    • Electrical activity of the brain
    • Eye movements
    • Muscle activity
    • Heart rate
    • Respiratory effort
    • Blood oxygen levels
  • Used to diagnose OSA and determine it’s severity, frequently can initiate therapy during the test

How Is It Treated?

  • Tailored to individual
  • Behavioral - weight loss, avoid sedatives and alcohol, practice good sleep hygiene
  • Physical or mechanical - nasal Continuous Positive Airway Pressure (CPAP)
  • Dental appliances, particularly if OSA is mild
  • Surgery:
    • Tonsillectomy and adenoidectomy work well in children
    • Correction of nasal obstruction
    • Procedures to advance the jaw and tongue forward
    • UPPP - often combined with above; only approximately 50% success rate when done alone
    • Somnoplasty
    • Tracheostomy - only for severe life-threatening apnea
  • Research - How OSA affects and interacts with other medical conditions