The term “apnea” means “without breath,” and can also be referred to as instances when an individual stops breathing. Obstructive sleep apnea (OSA) typically occurs at night because an individual has a physical obstruction, either in the roof of mouth, tongue, throat, or nose. OSA is characterized by significant and prolonged interruptions of breathing and airway obstructions at night.
Signs of Obstructive Sleep Apnea
Individuals with OSA may experience the following symptoms:
- Persistent “tired” feeling
- Inability to achieve feeling of being fully rested
- Taking frequent daytime naps
- Difficulty staying awake during the day
- Difficulty staying awake while driving
- Headaches
- Low energy
- Mood swings
- Low sex drive
- Memory loss
Left untreated, sleep apnea may lead to stroke, heart attack, high blood pressure and even premature death.
How Obstructive Sleep Apnea is Diagnosed
Patients who experience symptoms of OSA and snore loudly should undergo a sleep study (polysomnogram). This is an overnight test that can be performed in the patient’s own home or in a sleep laboratory where the patient is monitored while they sleep. During the study, sensors keep track of a number of important processes, including the heart rhythm (EKG), sleep state, blood oxygen levels, and the number and duration of spells of interrupted breathing. The collected data is analyzed and used to determine whether the patient has a snoring problem or obstructive sleep apnea.
How is OSA Treated?
A physician will typically recommend a conservative, or non-surgical treatment, such as weight loss, adjustments to sleep position, and the use of a positive airway pressure device.
Positive Airway Pressure (CPAP or BiPAP) Therapy is the primary treatment for sleep apnea. A CPAP mask is worn during sleep and helps deliver pressurized air. Air pressure is adjusted to alleviate airway obstruction and eliminate airway closure episodes. Many patients experience significant improvements in their sleep pattern. Some patients, however, have difficulty with the CPAP device and find it cumbersome and difficult to use.
A Mandibular Advancement Appliance is a device worn at night to increase space in the airway. The device uses the upper teeth as the focal point to move the lower teeth and jaw forward. This brings the tongue forward and opens the airway. Most devices are adjustable and can be customized to a patient’s needs. Some patients may experience movement of the teeth or discomfort of the jaw joint (TMJ) as a result of prolonged pressure on the teeth. However, most patients without pre-existing problems with TMJ don’t experience any negative side effects.
Drug-induced Sleep Endoscopy, or DISE, is a procedure that involves examining a sleeping patient’s throat with the goal of gaining additional information about how it collapses. In a controlled environment, such as the operating room, patients are given medication that will put them in light sleep. Once they begin to snore, a flexible, very thin video camera is placed through the nose and the physician examines the airway to identify the precise location of the site(s) of obstruction, such as the palate, tongue, tonsils, sides of the throat, or epiglottis. Patients can typically return to normal activities the following day.