Obstructive Sleep Apnea

Obstructive Sleep Apnea (OSA) is marked by obstruction of the upper airway during sleep. This causes pauses or breaks in a person's breathing, preventing air from entering the lungs and forcing the person to wake briefly to start breathing again before falling back to sleep. The person with OSA is usually unaware of this. The interruption to breathing can happen hundreds of times a night, resulting in markedly fragmented sleep. As a result, people with OSA often feel excessively sleepy during the day.

More than 18 million Americans suffer from sleep apnea. It can affect anyone at any age, including children; however, those most at risk are middle-aged, overweight males. Some signs of sleep apnea include daytime sleepiness, loud snoring, morning headaches, lack of concentration, memory impairment, moodiness, and falling asleep at inappropriate times, such as sitting quietly at work or while driving. Sleep apnea also puts people at serious risk for automobile crashes.

Risk factors for obstructive sleep apnea include having a large tongue and/or tonsils, being overweight, recessed chin, small jaw or large overbite, having a large neck size (17 inches or greater in men or 16  inches or greater in women), smoking and alcohol use, being age 40 or older and ethnicity (African Americans, Pacific Islanders and Hispanics).  Also, OSA sometimes runs in families.

If left untreated, OSA may lead to medical conditions such as high blood pressure, cardiovascular disease, stroke, impotence, or personality changes.

Treatment For Adults

  1. Positive Airway Pressure (PAP Therapy) is the most effective and commonly used therapy for the treatment of OSA. The patient sleeps with a small, lightweight mask (various options exist) over the nose or mouth and nose, which is attached to a quiet air machine. This machine delivers the prescribed pressure that "splints" the airway open. 
  2. Oral appliances are devices that help to keep the airway open by pulling the jaw and/or tongue forward. These appliances appear to treat snoring fairly well. These are sometimes effective for treatment of mild or moderate OSA. However, this is usually not an option for the treatment of severe OSA.
  3. Surgery is considered if there is a physical problem that is interfering with the airway at night. Sometimes the tonsils, adenoids, nasal polyps, deviated septum or the shape of the jaw can interfere with breathing while asleep. A surgery called the UPPP (uvulopalatopharyngoplasty) removes the excess tissue in the back of the throat to help improve airflow at night. This surgery does not always completely correct the OSA but may improve it.
  4. Other measures such as weight loss, avoiding alcohol within 4 hours of bedtime, avoid sleeping pills unless prescribed by a physician, sleep on your side and relieve nasal stuffiness may also help to improve OSA.