Obstructive Sleep Apnea (OSA) is a problem for adults and children in which the breathing pauses during sleep. This occurs because of narrowed or blocked airways. When sleeping, all of the muscles in the body become more relaxed, including the muscles that help keep the throat open so air can flow into the lungs. Normally, your throat remains open enough during sleep to let air pass by. Some people have a narrow throat. When the muscles in their upper throat relax during sleep, the tissues close in and block the airway. This stop in breathing is called apnea. It is the recommendation of the AAO-HNS that patients presenting with symptoms of OSA require a face-to-face evaluation conducted by a qualified physician trained in Otolaryngology-Head and Neck Surgery or Sleep Medicine (one who maintains certification from the American Board of Sleep Medicine or one of the sponsoring sleep medicine boards of the American Board of Medical Specialties, including the American Board of Otolaryngology). Sleep-disordered breathing (SDB) is a general term for breathing difficulties occurring during sleep. SDB can range from frequent loud snoring to Obstructive Sleep Apnea (OSA). When a child’s breathing is disrupted during sleep, the body perceives this as a choking phenomenon. The heart rate slows, blood pressure rises, the brain is aroused, and sleep is disrupted. Oxygen levels in the blood can also drop.
Loud snoring is a telltale symptom of OSA. Snoring is caused by air squeezing through the narrowed or blocked airway. Not everyone who snores has sleep apnea though. Factors that may be the reason why you are experiencing Obstructive Sleep Apnea include a lower jaw that is short compared to the upper jaw, certain shapes of the roof of the mouth (palate) or airway that cause it to collapse more easily, large neck or collar size, 17 inches (43 centimeters) or more in men and 16 inches (41 centimeters) or more in women, large tongue, which may fall back and block the airway, obesity, large tonsils and adenoids that block the airway and sleeping on your back can also cause your airway to become blocked or narrowed.
For children, the most obvious symptom of sleep disordered breathing is loud snoring that is present on most nights. The snoring can be interrupted by complete blockage of breathing with gasping and snorting noises and associated with awakenings from sleep. Due to a lack of good quality sleep, a child with sleep disordered breathing may be irritable, sleepy during the day and have difficulty concentrating in school. Busy or hyperactive behavior may also be observed as well as bed-wetting, which is frequently seen in children with sleep apnea.
If you have OSA, you usually begin snoring heavily soon after falling asleep. The snoring often becomes very loud. Snoring is interrupted by a long silent period while breathing stops and the silence is followed by a loud snort and gasp, as you attempt to breathe. This pattern repeats throughout the night and most people with OSA do not know their breathing starts and stops during the night. Usually, a sleep partner or other family members hear the loud snoring, gasping and snorting. Snoring can be loud enough to hear through walls. People with sleep apnea may wake up unrefreshed in the morning; feel sleepy or drowsy throughout the day; act grumpy, impatient, or irritable; be forgetful; fall asleep while working, reading or watching TV; feel sleepy while driving or even fall asleep while driving; have headaches; experience depression; children may experience hyperactive behavior; high blood pressure; leg swelling.
The physicians at OKLAHOMA OTOLARYNGOLOGY ASSOCIATES are committed to the highest standards of care and ensuring patients receive quality care for obstructive sleep apnea, so, during your initial office visit, they will discuss your medical history, list all prescribed and over the counter medications, vitamins and herbs that you take and do a very thorough physical exam, checking your entire head and neck region, including your mouth, neck, ears and throat. You may be asked about daytime sleepiness, how well you sleep and bedtime habits.
You and the physician will schedule a sleep study which will document if you do have OSA. Other tests that may be performed include Arterial blood gases, Electrocardiogram, Echocardiogram and Thyroid function studies.
To keep your airway open while you sleep so your breathing does not stop, there are some lifestyle changes which may help relieve symptoms in people with mild sleep apnea. Avoid alcohol or medicines that make you sleepy before bedtime. They can make symptoms worse. Avoid sleeping on your back. Lose excess weight. Continuous positive airway pressure (CPAP) devices work to treat obstructive sleep apnea in most people. The CPAP machine pumps air under pressure through the hose and mask and into your airway while you sleep. This helps keep your airway open. For some people, there are dental devices, worn in your mouth while you sleep to keep your jaw forward and the airway open. Oral appliances are a treatment of the upper airway. An oral appliance device for the medical treatment of Obstructive Sleep Apnea may be fit, adjusted and medically assessed by the physicians at Oklahoma Otolaryngology Associates. Other treatments may be available, but there is less evidence that they work. It is best to talk with the physicians at OKLAHOMA OTOLARYNGOLOGY ASSOCIATES, who specializes in sleep problems before trying them. Surgery may be an option for some people with physical problems which are causing the obstruction. The physician may be able to remove extra tissue at the back of the throat, correct problems with the structures in the face, create an opening in the windpipe to bypass the blocked airway if there are physical problems, remove tonsils and adenoids.
If not treated, sleep apnea may cause anxiety and depression, loss of interest in sex, slow growth rate in children, cardiovascular problems, poor performance at work or school and daytime sleepiness and behavior problems. Because of a lack of quality sleep, there is a chance of motor vehicle accidents from driving while sleepy, industrial accidents from falling asleep on the job, poor performance at school due to an inability to concentrate and pay attention. Untreated obstructive sleep apnea may lead to or worsen heart disease, heart arrhythmias, heart failure, heart attack, high blood pressure or stroke.
Sources: medlineplus.gov; entnet.org