Obstructive Sleep Apnea

By German Iosif, MD
Board Certified Pulmonologist

What is obstructive sleep apnea?
Modern medicine has identified more than 80 different sleep disorders. The most serious among them is a syndrome called obstructive sleep apnea, or OSA. About 30 million Americans suffer from the disorder.

Productivity lost to sleep disorders costs our national economy millions of dollars each year. Sleepiness also causes more than 100,000 car accidents and 1500 highway fatalities in the
United States each year.

While they sleep, people suffering from OSA actually stop breathing for periods that can last 90 seconds and longer. People with severe OSA may stop breathing a hundred times or more during a single night. Each episode of the breathlessness ends with a person’s partial awakening. Although the person is unaware of these repeated partial awakenings, he or she is still deprived of the continuous, deep sleep the body needs to function normally. This leads, over time, to the development of chronic sleep deprivation.

What causes OSA?
Collapse of the throat causes the OSA sufferer to stop breathing during sleep. This throat closure occurs when the neck muscles that normally hold the throat open relax during sleep and allow the throat to narrow. When the throat narrows too much, airflow into the lungs stops and the sleeper has an apneic, or non-breathing episode. The episode ends only when the sleeper wakes, or partially wakes, to restore his or her own breathing.

What are the symptoms of OSA?
People suffering from severe OSA tend to feel extremely tired and sleepy during the day. This fatigue and sleepiness can lead to problems at work or school, and problems with relationships. It can also lead to car accidents and other potentially dangerous situations. Those suffering from severe OSA are also prone to having heart attacks or strokes during sleep. This is why doctors consider OSA the most serious of all sleep disorders.

OSA’s chief symptoms are daytime fatigue and sleepiness, and loud snoring. The snoring is often punctuated by periods of silence or by choking sounds. Obesity, high blood pressure, restless sleep, depression and impotence are other features that commonly occur with OSA.

How do doctors treat OSA?
Doctors have treated OSA with a wide variety of methods. For some people, a change in sleeping position can prevent sleep apnea. For others, weight loss can help as well as reducing the consumption of nicotine or alcohol, and avoiding sleeping pills and tranquilizers.

Continuous positive airflow pressure, or CPAP, has proved an effective treatment for many people. CPAP involves sleeping with a mask over one’s nose. The mask supplies the sleeper with a stream of pressurized air that keeps the nasal passages open and prevents sleep apnea.

Some patients can prevent sleep apnea by wearing certain dental appliances that hold the lower jaw forward during sleep, which helps to keep the throat open. Finally, there are various surgical procedures that have helped prevent sleep apnea.

If you’re exhibiting symptoms of obstructive sleep apnea, talk with your primary care doctor.