Sleep Apnea: Causes, Signs and Treatment

January 11, 2016

Obstructive Sleep Apnea (OSA) is a serious and very common condition that is characterized by repetitive collapse of the upper airway during sleep. It occurs when the soft tissue in the back of your throat relaxes during sleep and blocks the airway, often causing you to snore loudly.

Causes of Sleep Apnea

In the US, an estimated 18 million people have sleep apnea and only 80% are currently diagnosed. The risk factors that can cause sleep apnea include excess weight, large neck circumference, a narrowed airway, being male, having a family history, and smoking.

Signs of Sleep Apnea

Recurring obstructions and partial obstructions are called apneas or hypopneas, respectively. They cause an intermittent drop in oxygen and sleep fragmentation leading to sleep apnea symptoms. This includes daytime sleepiness, increased risk of cardiovascular diseases (heart attack and stroke), motor vehicle and occupational accidents, diabetes, hypertension and an overall reduction in quality of life.

Symptoms of sleep apnea are excessive daytime sleepiness, loud snoring, episodes of breathing cessation during sleep, abrupt awakening with a sensation of choking or shortness of breath, morning headaches, and dry mouth in the morning.

The diagnosis of sleep apnea is established by a sleep study and the severity is measured by the apnea-hypopnea index (AHI), which represents the average number of airway obstructions per hour that a person has during sleep. An AHI ≥ 5 events per hour with symptoms is generally considered to be clinically significant while an AHI ≥ 30 events per hour is considered severe.

Treatment of Sleep Apnea

Properly treated sleep apnea decreases the severity of the co-morbidities, leading to improved health. This includes significant improvement in controlling high blood pressure, decreasing the risk of cardiovascular diseases such as a heart attack and stroke, and improving glucose control in patients with diabetes.

Sleep apnea is treated with lifestyle changes, surgery, dental appliance, CPAP therapy and a new implantable neurostimulation technology called Inspire Therapy.

Continuous positive airway pressure (CPAP) is the main therapy for sleep apnea. CPAP works by blowing pressure into the airway. This causes the opening of the airway with pressure delivered via a face mask attached to a bedside flow generator. This prevents the repetitive collapse of the airway that occurs during sleep.

Lifestyle changes includes losing weight, changing the position you sleep in, and exercising regularly. These can help people with mild sleep apnea and those who have airway obstruction when sleeping on their back.

A dental appliance is another option of treatment for patients with mild or moderate sleep apnea, and those who cannot tolerate CPAP therapy. Patients are usually referred to a dentist who is specially trained on the treatment of sleep apnea. The dental appliance works by pushing the jaw forward and preventing the tongue from blocking the throat, thus preventing airway collapse.

Surgery works by altering the anatomy of the airway. The airway is made larger by removing certain soft tissues of the airway and sometimes realigning bony structures of the face or jaw to prevent airway collapse and obstruction during sleep.

Another treatment option for patients with moderate or severe sleep apnea who cannot tolerate CPAP is Inspire therapy. Inspire therapy works by surgically placing a small pacemaker in your body. This device delivers mild stimulation to key airway muscles, which keeps the airway open.

It is important for all of us to get good quality sleep preferably every night.  If you suspect that you, or a loved one, has Obstructive Sleep Apnea, or any other sleep disorders, make sure to obtain a diagnosis and treatment.  Obstructive Sleep Apnea doesn’t have to burden your life. With the help of a sleep physician your OSA can be managed and you can increase the quality of your life.

ABOUT THE AUTHOR Eskender Beyene, M.D. is the Bluepoint Medical Associates Sleep Director. He is a dedicated member of the sleep community with vast experience in the establishment and running of various health centers. Dr. Beyene strongly believes in patient education and awareness. He takes part in various talks to share knowledge of sleep and the processes of sleep disorder treatments. Read more articles from Eskender Beyene!

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