Obstructive Sleep Apnea


Sleep apnea is a serious sleep disorder that affects over twelve million Americans. Affected people actually stop breathing while they sleep, often for a minute or longer, and sometimes this happens more than one hundred times per night.


There are three types of sleep apnea: central, obstructive, and mixed. With central sleep apnea, breathing stops because the body is making no effort to breathe. In obstructive sleep apnea (OSA), the body tries to breathe but the airflow is blocked. Mixed apnea is a combination of these two types.


Untreated, sleep apnea leads to daytime sleepiness and the associated job impairment and driving risks. More serious complications are possible as the apnea continues, including serious cardiovascular problems such as congestive heart failure.


Diagnosis of OSA


A study published in the Journal of the American Medical Association showed that approximately 1 in 5 American adults has OSA, making it much more common than the central type. The most common symptoms of obstructive sleep apnea are snoring, morning headaches, and daytime sleepiness.


The highest risk populations are people with low muscle tone and overweight individuals who are carrying some of the excess weight in their necks and chests. Men are substantially more at risk than women.


OSA can be diagnosed one of two ways. The patient can spend the night in a sleep lab and having a polysomnogram. This device measures 11 characteristics of the patient, including brain activity, blood oxygen, and movements of the chest and abdominal walls. Another test called pulse oximetry provides less information but may be adequate to diagnose OSA and can be done in the patient’s home.


Treatment of OSA


There are several options for OSA patients depending on their medical histories and specific symptoms.


Pharmaceutical treatments have proven ineffective. Drugs such as theophylline may reduce the number of apneas, but can lead to insomnia and heart palpitations. Other drug therapies seek to treat the daytime sleepiness with stimulants, but that doesn’t fix the underlying apneas or the potential health risks.


There are a number of surgical treatments such as removal of part of the soft palate or tongue base. Although these surgeries help a few people, in many cases they do nothing and the patient has undergone the risk of surgery for no benefit.


Patients can undertake a series of lifestyle changes that can reduce or eliminate their OSA. The best thing a person suffering from OSA can do is to lose weight, plus the weight loss will have other health benefits as well. Other changes can include avoiding alcohol and cigarettes or using special pillows that prevent people from sleeping on their backs.


The most successful treatment for obstructive sleep apnea is the use of a CPAP machine. The CPAP (Continuous Positive Airway Pressure) generates a steady stream of air at a constant pressure through a CPAP mask. The pressure, set by a sleep physician after a polysomnogram, keeps the airway open and prevents breathing from being obstructed. This device has shown great success in helping OSA sufferers get a good night’s sleep and avoid the dangerous consequences of sleep apnea.