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What is Sleep Apnea?

Sleep Apnea is a sleep breathing disorder that is characterized by repetitive pauses in breathing during sleep. Pauses occur several times per hour and last for over 10 seconds. As the blood-oxygen levels decrease, the brain awakens the individual which often leads to a loud gasp or snort. Sleep apnea is associated with snoring, witnessed pauses in breathing, and excessive daytime sleepiness.

Generally, sleep apnea goes undiagnosed for a long time. It can't be detected during a routine doctor's appointment, and there's no blood test to diagnose it. In fact, most sufferers don't even know they have it because it occurs during sleep. Often, it is the bed partner or family member who is suspicious. Usually, the person is referred to a sleep doctor.

Obstructive Sleep Apnea is the most common type of Sleep Apnea.

Understand OSA

Obstructive Sleep Apnea is the most common type of Sleep Apnea. The airway either becomes blocked or collapses during sleep, resulting in pauses in breathing, or very shallow breathing. The air that manages to squeeze through the blockage can create loud snoring. This is often seen in people who are overweight or obese.

What is OSA?

Obstructive Sleep Apnea or OSA is a common sleep disorder. If you have OSA, it means that your airway collapses part or all of the way while you are sleeping. The airway can collapse repeatedly during the night. The air going to your lungs is decreased, and your brain wakes your body, so you can start breathing again. The decreased oxygen and frequent nighttime awakenings negatively affect your health.

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Prevalence of OSA

Everyone knows someone with Diabetes or Asthma, but Obstructive Sleep Apnea is as prevalent as these common problems:

  • Roughly 1 out of 5 adults has at least mild OSA
  • Over 18 million people in the United States alone have sleep apnea
  • Millions more snore
  • 90% of OSA sufferers remain undiagnosed and untreated
  • Almost as many traffic accidents are caused by sleep apnea as DUI
  • The risk for sleep apnea is 2 to 3 times greater in men than women
  • The risk to women greatly increases after menopause
  • Pregnancy may be a time of particular risk for women
  • OSA is the most common chronic disease in industrialized societies
  • 27% of all children are affected by habitual snoring, and 2 to 3% of all children have OSA
  • The problem is getting worse due to increasing obesity

What are the symptoms of OSA?

  • Loud or frequent snoring
  • Choking or gasping while you sleep
  • Morning headaches
  • Daytime sleepiness or fatigue
  • Trouble concentrating
  • Irritability

Does snoring means OSA?

About 90 million Americans suffer from snoring; as many as half of those may have the Obstructive Sleep Apnea (OSA). While OSA almost always causes loud and regular snoring, just because you snore doesn’t mean that you have OSA. OSA is a serious condition in which your breathing is obstructed, causing you to wake up in order to start breathing again. Regular snoring doesn’t typically wake you up.

One way to tell the difference between snoring and OSA is to look for the symptoms of sleep apnea:
waking up in the middle of the night gasping for air, continual sleepiness during the day, and always snoozing with your mouth open.

Another way to differentiate between regular snoring and sleep apnea is the type of snoring: Those with sleep apnea tend to snore more regularly and loudly, plus they often gasp for air in their sleep and you can sometimes hear them momentarily stop breathing. People with OSA have more of a choking sound to their snores.

How is OSA diagnosed?

Your doctor will refer you for a sleep evaluation, he may also want to ask people who live with you about your shut-eye habits.You may need to spend a night in a sleep lab or have a sleep study done at your house. You’ll wear monitors to measure things such as:

  • Air flow
  • Blood oxygen levels
  • Breathing patterns
  • Electrical activity of the brain
  • Heart rate
  • Muscle activity

What happens if OSA is untreated?

Untreated OSA may increase the risk of:

  • High blood pressure
  • Heart attack, heart failure, and irregular heartbeats
  • Stroke
  • Obesity
  • Diabetes

OSA can also contribute to memory problems and problems at work and automobile/truck-related accidents due to fatigue. Researchers have also linked sleep apnea to erectile dysfunction.

Who is at risk for OSA?

You are at an increased risk if you are:

  • Overweight
  • Hypertensive
  • Male with a neck size of 17 inches or more
  • Male over the age of 40
  • Female over the age of 50 or after menopause

Not all people with OSA have these risk factors. Children can have OSA as a result of large tonsils or or narrow airways. Young adults, even those who are physically fit, may also have OSA. It's impossible to diagnose OSA just by looking at someone.

OSA and pregnancy

OSA has been noted in pregnancy. According to some researchers, the airway of pregnant women narrows in the last trimester of pregnancy.

It has been found that if a woman has severe snoring or sleep apnea, the health of both the mother and the fetus can suffer. The lack of oxygen caused by the obstructive events in sleep apnea can have adverse health outcomes for both the mother and child. One study is investigating the link between snoring, sleep apnea, and low birth weight.

A recent study found that pregnant women who have sleep-disordered breathing may have an elevated risk of developing diabetes and high blood pressure including eclampsia and pre-eclampsia.

If you or a loved one is pregnant, be sure to watch out for the signs of sleep apnea.

How is OSA treated?

If you have been having symptoms or were recently diagnosed with OSA, you may be wondering what your next step is. There are many different treatment options for OSA. Positive Airway Pressure, or PAP, is the most common treatment for OSA. PAP therapy works by keeping the airway open during the night. These devices provide a stream of air through a mask you wear while you sleep. The air stream prevents your airway from closing, so you don't stop breathing and wake up during the night. PAP therapy helps people with all levels of OSA, from mild to severe. The treatment that is right for you depends on many different factors. You can discuss which treatment is best for you with your health care provider.

For some people, lifestyle changes can help improve or eliminate their OSA. You can try the following in addition to other treatments for OSA. Studies show that a regular exercise program can help improve OSA.

Losing weight

Weight loss can be very helpful for overweight people with OSA. consult your health care provider before trying to lose weight. He or she can make sure that your weight loss program is both safe and effective. The best weight loss programs combine a healthy diet and regular exercise.

Quitting smoking

Smoking irritates your mouth and throat and may make OSA worse. Talk with your health care provider to find a safe and effective way to quit smoking.

People with untreated OSA have an increased risk of car accidents.

Avoiding alcohol and sedatives

Alcohol and sedatives can make OSA worse. Avoid drinking at night or drinking to excess. Talk to your health care provider about any sedatives (such as sleeping pills, anxiety, or pain medications) you are taking.

Sleeping on your side or stomach

Sleeping on your back can make your OSA worse. Try changing your sleep position to your side or stomach. After you try changes to your lifestyle, see your health care provider to check if your OSA has improved.

People with untreated OSA have an increased risk of car accidents.

Oral appliances

Oral appliances are medical devices approved for the treatment of OSA. Oral appliances may work best in people with mild to moderate OSA.

Oral appliances fit over the teeth and are worn during sleep. They can be fixed or adjustable devices. Both types work by moving the jaw forward or preventing the jaw from falling back during sleep to ensure that air can get through. Fixed devices often have to be readjusted by your sleep dentist to make sure they are effective. Adjustable devices can be repositioned without having to be remade.

Dentists who are experienced in the treatment of OSA make oral appliances. These devices are customized using a mold of your teeth to maximize fit and comfort. Oral appliances may not work for you if you have pre-existing jaw pain.

Talk with your health care provider if you would like to learn more about oral appliances.

Surgery

Surgery may be used to help treat OSA. The most common options reduce throat tissue. Some overweight people with OSA get weight loss surgery. These surgeries limit the amount of food someone can eat. If you are considering surgery to treat your OSA, your health care provider should:

  • Let you know the success rate of the surgery
  • Explain all the possible risks and side effects.

The results of a surgery may not be permanent. You will need to follow up with a health care provider after the surgery. An operation can be an effective treatment for some people, but it is not the right choice for everyone.