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Sleep Apnea

Sleep apnea is one of the most common sleep disorders affecting over 18 million Americans.  Eighteen percent of men and 8% of women between the ages of 30-70 have some form of sleep apnea.  Eighty percent of obstructive sleep apnea sufferers are undiagnosed.  Lack of sleep due to obstructive sleep apnea affects the quality of life, causing irritability, lack of energy and mood changes.  Left untreated, it can cause an increased risk of death and other complications such as high blood pressure, stroke, heart disease and diabetes.

What is Obstructive Sleep Apnea (OSA)?

When we sleep the muscles in the back of the throat relax.  Normally, the airway stays open.  However, with obstructive sleep apnea the muscles in the back of the throat relax and block the airway preventing airflow.  This blockage of airflow can be a partial blockage (30% or greater) causing a decrease in the oxygen saturation of at least 4% for 10 seconds (hypopnea) or a complete blockage of airflow for at least 10 seconds (apnea).  The amount of apneas and hypopneas per hour of sleep (apnea/hypopnea index- AHI) is used to diagnose and determine the severity of obstructive sleep apnea.   A person with an AHI of 5-15 has mild sleep apnea, an AHI of 16-30 moderate sleep apnea and an AHI greater than 30 severe obstructive sleep apnea.

What are the symptoms of obstructive sleep apnea?

The most common symptoms of obstructive sleep apnea are snoring, excessive daytime sleepiness and hypertension.  Other symptoms include acid reflux/GERD, morning headaches, diabetes, social problems, memory problems, and dental symptoms.  Obesity, menopause, mouth breathing and family history are contributing factors.

How is obstructive sleep apnea diagnosed?

A sleep study (polysomnography)  is used to diagnose obstructive sleep apnea. This can be done in a sleep lab or by using a home sleep test.

Why are excessive daytime sleepiness, lack of energy and fatigue symptoms of OSA?

Sleep is important for a healthy body.  During sleep, hormones are released, memory is consolidated and rest and recovery occurs.  Sleep is divided into REM and non REM sleep with 3-4 stages.  Your body cycles through the different stages of sleep throughout the night.  When your body undergoes an apneic event, you are pulled out of whatever sleep stage you are in.  You may not even wake up completely.  These microarousals occur many times during the night as your body fights to breathe.  This interrupted sleep results in poor sleep quality so that you do not feel rested in the morning no matter how long you sleep.  Lack of REM sleep makes you feel anxious and irritable.  Lack of non REM sleep makes you feel physically tired.

How is obstructive sleep apnea treated?

 There are several treatments available to treat obstructive sleep apnea each with their own pros and cons.  These include continuous positive air pressure (CPAP), oral devices fabricated by a dentist that pull the lower jaw forward opening the airway, surgery and lifestyle modifications.