Obstructive sleep apnea

Overview – Obstructive sleep apnea is the most common type of apnea that causes breathing to repeatedly stop and start during sleep. Obstructive sleep apnea occurs when your throat muscles intermittently relax and block the airway during sleep.

The risk factors for obstructive sleep apnea are obesity, male gender, craniofacial (face or head) and upper airway abnormalities, nasal congestion, smoking.

 

Symptoms

  • Daytime sleepiness, fatigue, tiredness, low energy, or poor focus
  • Loud snoring, choking, gasping, snorting, or interruptions in breathing while sleeping
  • Morning headaches
  • Mood changes such as depression, anxiety
  • Nighttime sweating
  • Decreased libido

 

Complications

  • Heart disease and arrhythmias – The sudden drops in blood oxygen levels can increase the blood pressure and put a strain on the heart.
  • Sleep-deprived partners – Loud snoring can disrupt the relationship with your partner.
  • Memory problems, headaches, anxiety, depression.

 

Diagnosis

  • Your doctor will do a thorough physical examination and examine the back of your throat, mouth, and nose for abnormalities.
  • Your doctor may refer you to sleep specialist who may do additional tests such as polysomnography, home sleep apnea testing.

 

Lifestyle management

  • Follow the diet and exercise regimen as recommended by your doctor. Maintain healthy body weight.
  • Do not drink alcohol.
  • Quit smoking.
  • Don’t sleep on your back.
  • Use a saline nasal spray to help keep your nasal passages open, if you have nasal congestion.
  • Talk to your doctor about devices that can help open up a blocked airway. Mandibular advancement devices, tongue retaining devices are some of the devices used in the treatment of obstructive sleep apnea.
  • Your doctor may not prescribe certain medications when you have obstructive sleep apnea as these may exacerbate obstructive sleep apnea and theoretically worsen daytime sleepiness. These include benzodiazepines, antiepileptic drugs, sedating antidepressants, antihistamines, and opiates.

 

Medical management

  • Positive airway pressure is the mainstay of therapy for adults with obstructive sleep apnea. The modes of positive airway pressure administration include continuous positive airway pressure (CPAP), bilevel positive airway pressure (BPAP), and auto-titrating positive airway pressure (APAP). CPAP is the most common one. CPAP machine that is placed over your nose and mouth while you sleep delivers air pressure that is continuous, constant and somewhat greater than that of the surrounding air, which keeps your upper airway passages open.
  • Upper airway surgery is generally considered when positive airway pressure or an oral appliance is declined or ineffective.

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