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Fact Sheet OBSTRUCTIVE SLEEP APNEA (OSA)
What is OSA? Obstructive sleep apnea (OSA) occurs when air cannot flow into or out of the person's nose or mouth, although efforts to breathe continue. In a given night, the number of involuntary breathing pauses -or "apneic events" -may be as high as 20 to 60 or more per hour. Snoring and choking between apneic events is common, although not everyone who snores has OSA. The frequent interruptions of deep, restorative sleep often lead to excessive daytime sleepiness and may be associated with early morning headache. Normally during sleep, the muscles, which control the tongue and soft palate, hold the airway open. If these muscles relax, the airway becomes narrower which causes snoring and breathing difficulties. If these muscles relax too much, the airway can become completely blocked and prevent breathing. After a period of time, which can be from 10 seconds to 2 minutes, the brain realizes there is a lack of oxygen and alerts the body to wake up. Though the sufferer is not often aware of it, this cycle can happen several hundred times during the night, severely disrupting sleep OSA affects approximately 10% of the population. It occurs in all age groups (from newborn babies to adults) and both sexes, but it is more common in men (it may be under diagnosed in women) and possibly young African Americans.
Signs & Symptoms: It is often easy to tell if someone has OSA. If you listen while they sleep, you will hear snoring followed by a period of silence. There may be a loud snort or gasp as the patient starts breathing againMany people with OSA experience tiredness during the day. They may fall asleep at work, while driving a car, in the middle of a conversation, and/or while reading or watching television. Due to lack of recuperative sleep that results from OSA, combined with the stress of trying to conduct a normal life, people who suffer from OSA are often irritable. More serious consequences associated with OSA include: depression, high-blood pressure, serious heart conditions, sexual problems, weight gain, memory lapses, intellectual ) deterioration and morning headaches Diagnosing OSA: OSA is diagnosed by polysomnography (i.e., an overnight sleep study). During polysomnography, activities that occur during sleep -brain waves, muscle movements, eye movements, ECG, leg movements are monitored by applying electrodes to the head and skin. Belts around the chest and abdomen are also used to measure the patient's breathing efforts; a thermo-couple is applied to pick up nasal /oral airflow. Blood oxygen level and heart rate are monitored by a clip on the patient's index finger. Treatment Options: In addition to weight loss, sleep position change and improvements in sleep hygiene, the most common treatments for OSA are: · NASAL CPAP (Continuous Positive Airway Pressure; A Nasal CPAP unit delivers lightly pressurized air through a hose to a small nose mask. The flow of the air acts like an "air splint" to keep the upper away open and prevent apneic events. · ORAL APPLIANCE THERAPY: Similar to an orthodontic retainer, a custom-made oral appliance may be worn in the mouth during sleep to prevent the soft-throat tissues from collapsing and obstructing the airway. These devices advance the patient's jaw forward to allow vertical and lateral movement, dilating the airway to permit normal breathing to occur during sleep. Oral appliances are endorsed by the American Academy of Sleep Medicine and the Academy of Dental Sleep Medicine. Note: Sleep patients fitted with oral devices should be thoroughly evaluated before and after a device is fitted to determine whether it is not only reducing snoring and improving sleep as perceived by the patient, but also maintaining blood oxygen at appropriate levels. Additional treatment options include: medications, removal of tonsils and adenoids, and nasal operations (e.g, LAUP & UPPP).
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