Obstructive sleep apnea (OSA) is a serious medical condition where breathing is interrupted or stopped for short periods of time during sleep. This occurs as a result of narrowed portions of the airways (usually the nose, tonsil region and throat) restricting air flow to the lungs. Untreated, OSA can lead to serious health issues such as heart disease, hypertension, stroke, diabetes, and obesity, which makes it critical to identify and fix.
In this article, we will detail some of the symptoms of OSA, find out how it’s diagnosed, and discuss the treatment options available to you.
How do I know whether I suffer from OSA?
Risk factors for sleep apnea include having large tonsils and adenoids, a large tongue, a neck circumference (collar size) of greater than 43cm in males, or greater than 40cm in females. Facial shape (small lower jaw) and nasal deformities (previous nasal fracture or difficulty breathing through the nose) can also be predisposing features.
While the condition identifies itself in a number of different ways, it’s important to note that no single symptom is proof of sleep apnea—if you suspect that you have the condition, you’ll need to consult with a specialist for an accurate diagnosis.
These are some common signs of OSA.
Gasping or choking
Gasping or choking in your sleep happens when your throat gets blocked (the airway collapses thus reducing airflow to the lungs); this is almost always a result of OSA.
Snoring is noisy breathing caused by air rushing through a narrowed or collapsed airway (in the nose and, or throat) and is a common symptom of OSA. Not all people who snore have OSA, but most people diagnosed with OSA are snorers.
Insomnia (poor sleep / daytime tiredness and fatigue)
Obstructive sleep apnea can cause insomnia, so if you’re struggling to fall asleep or lying awake for long periods of the night, or are feeling tired/fatigued during the day and have other symptoms of sleep apnea, you would benefit from a Specialist consultation.
Even moderate OSA can have a devastating effect on sleep quality, leaving you exhausted, irritable, and unable to focus throughout the day.
How is sleep apnea diagnosed?
To diagnose OSA, a complete physical examination and a sleep study (polysomnogram) are necessary. This investigation is performed after referral to a respiratory specialist. They will first ask about your medical history, and complete a physical examination that focuses on your head and neck to identify potential causes of OSA. You may also be asked to fill out a questionnaire that covers your sleep habits and drowsiness during the day.
Once the initial consultation is complete, the next step is to conduct a sleep study (polysomnogram) to assess your respiratory events and arousal during sleep, which is measured by your Respiratory Disturbance Index (RDI). This study usually requires you to stay overnight in the medical centre, and can measure a range of different activities in the body, including:
- EEG to monitor brain waves
- EOM to record eye movement
- EMG to measure electrical activity in the muscles
- EKG to monitor heart rate and rhythm
- Pulse oximetry to measure oxygen in the blood
The findings of the sleep study will diagnose the severity (mild, moderate, severe) of OSA. The respiratory specialist will recommend a treatment plan based on the severity of your condition.
What are the sleep apnea treatment options?
If a specialist confirms that you have OSA, they’ll create a personalised treatment plan for you, which can include any of the following common treatments.
Continuous Positive Airway Pressure (CPAP) therapy
CPAP therapy is a highly effective treatment that uses a special sleep apnea mask to deliver pressurised oxygen through the airways, helping to keep them open during sleep. It’s used to treat moderate to severe cases of obstructive sleep apnea.
For those who find the CPAP mask difficult to wear, an intra-oral appliance can be a good alternative. They work by moving the lower jaw forward slightly during sleep, which pulls the tongue forward and helps to reduce airway obstruction.
Extra tissue in the back of the throat can easily block airways, which is why OSA is more common in overweight individuals. Losing weight is an effective way to treat the condition, and comes with a huge list of health benefits.
If other sleep apnea treatments fail to work, surgery is considered, although this is usually only recommended with patients who have severe obstructive sleep apnea. Common procedures include: nasal surgery (septoplasty, rhinoplasty), removal of tonsils and adenoids, and repositioning the upper and lower jaws (maxillo-mandibular advancement). The final combination of procedures will be based on the severity of the patient’s OSA, and their facial shape.
Sleeping on your back can cause your tongue and soft tissues to obstruct your airway, and cause sleep apnea. To discourage back sleeping, positional therapy teaches a patient how to sleep in other positions.
Sinusitis or nasal congestion can create swollen airway passages and lead to sleep apnea. These conditions can be treated with a nasal decongestant.
Reduced alcohol consumption
Studies show that alcohol can cause episodes of sleep apnea, and by reducing your alcohol consumption, you can lessen the number of episodes throughout the night.
Smoking can inflame the float, and cause fluid retention in the upper airway. Smokers are three times more likely to have sleep apnea than non-smokers, so throwing away your cigarettes is a recommended treatment.
Avoiding sedative medications
Sedatives relax the muscles in your throat, which can aggravate sleep apnea. Avoiding sedatives can help to relieve the condition.
OSA can lead to a number of serious long term health issues, that can lead to permanent organ damage and chronic life shortening disease. If you snore, suffer from restless sleep, feel fatigued during the day or suspect that you have obstructive sleep apnea, talk to our Specialist Surgeon today. With sleep apnea averted, you’ll be healthier, happier, and sharper throughout the day.