Sleep Disorders: Obstructive Sleep Apnea (OSA)

Obstructive sleep apnea is a disorder which is extremely common in the USA today, affecting about 10% of the population over the age of 40. It occurs twice as common in men as it does in women, and is more common in women after menopause. However it can affect people of all ages, and even children.

The airway above the larynx (voice box) is held open only by muscle, which naturally goes slack when people fall asleep. Sometimes this causes the airway to collapse so much that a person can’t breathe. This then results in them waking up at night gasping for air, but then they go back to sleep so quickly that the person doesn’t usually remember doing it. This then happens over and over again, many times per hour. As a result, patients often wake up in the morning feeling just as tired as when they went to bed, and then feel tired and sleepy all day long. Sleep apnea can also affect a patient’s health later in life, as it can lead to higher risk of strokes, heart failure, heart attacks, abnormal heart rhythms (most commonly atrial fibrillation), as well as dementia.

What are the signs and symptoms?

Signs and symptoms of sleep apnea include waking up in the morning unrefreshed, falling asleep during the day, excessive fatigue, being irritable, weight gain, snoring, waking up at night gasping for air, waking up with a dry mouth or a headache, decreased sex drive, mood swings, forgetfulness, problems with concentrating.

What are the risk factors and triggers?

Risk factors for obstructive sleep apnea include being overweight or obese, drinking alcoholic beverages, smoking, male gender, or having a narrowed airway as a result of a large tongue, large tonsils, or a small or set-back lower jaw.

How is it diagnosed?

Sleep Apnea is very easily diagnosed by having either a home sleep study or an in lab sleep study. Which test a person has in based upon your current health conditions and decided upon by the patient and your provider.

What is the treatment?

The main treatment for obstructive sleep apnea is a device known as a CPAP machine. The patient wears a mask, which is attached via tubing to a device that sits at the bedside, and which is the size of a large clock radio. This device generates pressurized air, which it pushes into the airway and inflates it open. This takes away snoring and breath-holding spells, and as a result, patients sleep better at night and feel better during the daytime. Not only that, but CPAP can also decrease blood pressure, prevent abnormal heart rhythms, and cut down the risk of ending up in the hospital as a result of heart failure.

Some people can be treated with mouthpieces made by dentists, called oral appliances. These are less cumbersome than wearing CPAP, and work best for patients who are less overweight and have mild to moderate sleep apnea. They are not as effective for more severe cases.

In some people sleep apnea can be treated effectively with weight loss. However it can take a long time to lose weight, and then it is important to keep the weight off long-term. Most patients need to be treated initially with either CPAP or an oral appliance, and then after they lose weight a sleep study should be repeated to see if the sleep apnea is cured. Weight loss does not cure sleep apnea in everybody.

Also, some surgeries are effective in curing sleep apnea. Some people who can’t lose weight on their own can be treated with weight loss surgery. Others can be treated with a pacemaker device which is implanted in the chest, and which causes the tongue to move forward every time the patient takes a breath in while asleep. Not everyone is a candidate for this type of surgery, but if the patient is a good candidate then the cure rate is about 70%. Lastly there is a surgery called maxillomandibular advancement, where both the upper and lower jaws are moved forward about 1 cm. This is a fairly radical surgery and afterwards the jaws have to be wired in place for 10 weeks while the bone heals.

Piedmont App

Download the Piedmont Now app

  • Directions
  • Indoor Hospital Navigation
  • Find & Save Physicians
  • Online Scheduling

Download the app today!

Get the Piedmont Now on Google Play Get the Piedmont Now on iTunes App Store