Obstructive Sleep Apnea

What is Obstructive Sleep Apnea?

Obstructive sleep apnea describes a sleep disorder characterized by frequent pauses in breathing due to collapse or obstruction of the airway. It is quite a common disorder and affects around 4% of the population.

Symptoms of Obstructive Sleep Apnea

The main symptom of obstructive sleep apnea is pauses in breathing during sleep. You may also experience:

  • Snoring
  • Insomnia
  • Sweating
  • Sleep awakenings due to gasping or choking
  • Dry mouth or sore throat

Symptoms during the day may include:

  • Sleepiness
  • Fatigue
  • Memory loss
  • Poor productivity
  • Headaches
  • Heartburn
  • Depression

Causes of Obstructive Sleep Apnea

Sleep apneas are caused when the muscles in your soft palate, uvula (extension of the soft palate which hangs from the roof of the mouth down towards your tongue), tongue and tonsils become overly relaxed during sleep, narrowing your airways so that they close.

This stops your breathing for a few seconds. As a result, your brain is triggered, briefly wakes you up, re-opens your airways and re-starts your breathing. This can occur many times in a night, disturbing your sleep, often without you realizing it. Obstructive sleep apnea can result in low blood oxygen levels and accumulation of carbon dioxide.

Who is at Risk of Developing Obstructive Sleep Apnea?

Obstructive sleep apnea is more common in men than women. You are more likely to develop obstructive sleep apnea if you have:

  • Narrow airways due to hereditary causes, enlarged tonsils or adenoids
  • Chronic nasal congestion
  • Excessive weight
  • High blood pressure
  • Diabetes
  • Asthma
  • A history of smoking
  • A family history of sleep apnea

How is Obstructive Sleep Apnea Diagnosed?

To diagnose obstructive sleep apnea your doctor will review your symptoms and medical history, and perform a physical examination.

A polysomnography (method of recording body measurements during sleep) is performed. This is usually carried out in a sleep laboratory and provides details on factors such as length and quality of sleep, breathing, position of the body and heart rate.

What if Obstructive Sleep Apnea Remains Untreated?

Hypertension increasing the risk of heart disease and stroke, accidents resulting from daytime sleepiness and diabetes

Treatment of Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is commonly treated by making lifestyle changes and using a specialized breathing apparatus while sleeping. Long-term treatment is usually necessary.

Lifestyle changes include:

  • Losing weight if you are overweight or obese
  • Stopping smoking if you smoke
  • Limiting your alcohol consumption, particularly before going to bed
  • Avoiding sedative medications and sleeping tablets

Sleeping on your side, rather than on your back, may also help relieve the symptoms of OSA.

Continuous Positive Airway Pressure (CPAP) for Obstructive Sleep Apnea

A CPAP breathing apparatus is recommended if you have moderate-to-severe OSA. You will wear a mask that either covers your nose, or your nose and mouth while you are sleeping. The mask is connected to a small pump that delivers a continuous supply of compressed air to keep your airway patent.

It may take a little while for you to get used to the CPAP device, but it is a highly effective treatment for obstructive sleep apnea and can be adjusted or modified to improve comfort.

Mandibular Advancement Device for Obstructive Sleep Apnea

Mild symptoms of OSA can be treated by a dental appliance called a mandibular advancement device (MAD). The device is worn over your teeth while sleeping and holds your jaw and tongue in a forward position to increase the opening of your airway. This device can also prevent snoring.

Surgery to Treat Obstructive Sleep Apnea

Surgery for certain conditions such as enlarged tonsils and adenoids, or obesity can improve symptoms of OSA.

Apart from these, a soft tissue implant may be placed within your soft palate to prevent obstruction and snoring. If you have severe difficulty breathing due to OSA, rarely, a tracheostomy may be performed.