As a result of obstructive sleep apnea (OSA), you stop breathing during sleep. As your airway becomes blocked repeatedly during sleep, your lungs may not receive enough air. The brain and body become oxygen deprived and you may wake up. When this happens, you may snore loudly or make choking noises as you try to breathe. It can happen a few times a night, or several hundred times a night in more severe cases.
As a result of too much relaxation of the throat muscles, OSA occurs. When these muscles relax, they collapse and block the airway. They support structures such as the soft palate, the tonsils, and the tongue. OSA is more severe if your airway is narrowed.
OSA is associated with the following factors:
Obesity or overweight
Large necks (17 inches or more for men, 16 inches or more for women)
A narrow throat, enlarged tonsils, or adenoids
Family history of OSA
Older age (OSA is more common in people over 40)
Men are more likely to suffer from OSA than women.
Using sedatives, smoking, or drinking alcohol
A deviated septum, nasal congestion, or allergies
A medical condition such as diabetes, heart disease, or hypothyroidism
Snoring is the most common symptom of OSA. However, not everyone who snores has OSA. Other symptoms include:
Sleeping with gasping, choking, or coughing
Breathing pauses followed by loud snorts or body jerks
After waking up, feeling tired, groggy, or unrefreshed
Having trouble concentrating, memory problems, or mood swings
Morning headaches, dry mouth, or sore throat
Frequently urinating or nocturia (waking up at night to use the bathroom)
Impotence or reduced libido
It is important to see your doctor for a medical history and physical examination if you suspect you have OSA. In addition to asking about your symptoms, your sleep habits, lifestyle, and family history, your doctor may also measure your neck circumference, your blood pressure, and your body mass index (BMI).
You may be referred to a sleep specialist for a sleep study by your doctor to confirm OSA. During sleep, your brain activity, eye movements, heart rate, blood oxygen levels, breathing patterns, and muscle activity are recorded. A sleep study can be done at home or in a sleep center, depending on your condition.
Polysomnography (PSG) is the most common type of sleep study. It involves having sensors attached to your head, chest, limbs, and finger, and sleeping overnight at a sleep center.
During sleep, a portable device is used to measure your breathing, blood oxygen levels, and heart rate using home sleep apnea testing (HSAT). You may use the device at home or in another comfortable setting. It is less comprehensive than PSG, but some people may find it sufficient.
A sleep study will show how often you stop breathing or have reduced airflow during sleep, as well as how low your blood oxygen levels fall during sleep. These events are called apneas and hypopneas, respectively. The severity of your OSA can be determined by the apnea-hypopnea index (AHI), which measures the number of apneas and hypopneas that occur per hour of sleep. In general, an AHI of 5 to 15 is considered mild OSA, 15 to 30 is considered moderate OSA, and more than 30 is considered severe OSA.
The main goal of OSA treatment is to restore normal breathing during sleep and prevent complications such as low blood oxygen, high blood pressure, heart problems, and daytime sleepiness. There are a variety of treatment options available depending on the severity of your OSA, your medical history, and your preferences.
An effective and widely used treatment for OSA is continuous positive airway pressure (CPAP). It involves wearing a mask over your nose and mouth, which keeps your airway open during sleep by delivering a steady stream of air pressure. Snoring, apneas, and hypopneas can be reduced or eliminated with CPAP, as well as improved sleep quality and alertness during the day. Some people, however, may find CPAP uncomfortable, noisy, or inconvenient, and may find it difficult to comply with it. The most common side effects of CPAP are nasal congestion, dry mouth, skin irritation, and claustrophobia. You may need to try different masks, adjust the pressure settings, or use humidifiers or nasal sprays to improve your comfort.
You can use oral appliances to prevent your lower jaw or tongue from collapsing and blocking your airway by fitting them in your mouth. Although oral appliances are less effective than CPAP, they may be more comfortable, convenient, and portable. For people with mild to moderate OSA who cannot tolerate CPAP or prefer an alternative, they may be suitable. The best way to ensure your oral appliance fits properly and functions properly is to have regular follow-ups and adjustments with an orthodontist or dentist with experience treating OSA. Some possible side effects of oral appliances include jaw pain, tooth movement, or bite changes.
When other treatment options have failed or are not suitable for OSA, surgery is generally considered a last resort. As part of surgery, tonsils, adenoids, uvulas, soft palate, tongue, or other structures that cause airway obstruction are removed or reduced. Jaw, nose, or palate shape or position can also be corrected with surgery. It is possible that surgery can have some risks, such as bleeding, infection, pain, or scarring, and it may not be effective or permanent in some cases. You may still have to use CPAP or oral appliances after surgery in order to maintain results.
The following lifestyle changes may improve your OSA symptoms and your overall health.
Overweight or obese people losing weight
Smokers should quit smoking
Before bedtime, avoid alcohol, sedatives, and caffeine
Using a wedge pillow to elevate your head or sleeping on your side
Maintaining a regular sleep schedule and practicing good sleep hygiene
Your breathing may be affected by nasal congestion, allergies, or other medical conditions
While OSA is not always preventable, you can reduce your risk by making some of the lifestyle changes mentioned above. In addition, you should see your doctor if you have any symptoms of OSA, such as snoring, gasping, or choking during sleep, or daytime sleepiness. By diagnosing and treating OSA early, complications such as high blood pressure, heart disease, stroke, diabetes, or depression can be prevented or delayed. As an OSA sufferer, you need to follow up with your doctor and sleep specialist to find the best treatment option for you and stick to it as prescribed. You should also have regular check-ups and sleep studies to monitor your condition and adjust your treatment as needed. By taking these steps, you can improve your sleep quality, your health, and your quality of life.
