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  • Obstructive Sleep Apnea: What You Need to Know

    Many of you have probably heard of the condition Obstructive Sleep Apnea or OSA.

    Even if you’re not familiar with the condition, chances are you know someone who suffers from the disease as recent studies estimate that about 1 in 4 adults have OSA; and the condition has been found to affect 3 to 5% of children.

    Many know of the condition as one that causes your partner or someone else you know to snore loudly at night.

    What might not be as well known is that OSA is more than just loud and annoying snoring. It’s a very serious condition that can lead to many negative health outcomes and even increase a person’s risk of sudden death.

    With the prevalence of OSA on the rise and the many potential negative consequences of this condition, it’s important that we are aware of what to look out for and how to treat it.

    So keep reading to learn more about how to identify and treat OSA and the dangers of not doing so.

    Don’t Ignore the Snore

    Snoring is an all too prevalent occurrence in today’s society.

    Many of us view it as a trivial annoyance however, snoring is never normal!

    Simply put, snoring occurs due to turbulent flow in the airway while breathing.

    It often happens secondary to some form of airway obstruction and if that obstruction is severe enough, it can lead to OSA.

    While snoring can be a sign of OSA, not all that snores is obstructive sleep apnea. However, if snoring occurs consistently more than 3 nights a week, it is something that should be investigated further by your or your child’s physician.

    When Does A Snore Become More?

    As I mentioned above, once snoring occurs consistently on most nights of the week, it may be a sign of something more.

    Besides just the consistency of the snoring, it’s important to be aware of any apneic episodes that occur while sleeping.

    Apnea is defined as a temporary cessation of breathing and can present itself as gasping or choking episodes that occur while asleep.

    This occurs because the obstruction in the airway is so significant that it progresses from causing just turbulence of airflow to a complete block of airflow, starving your body of oxygen that is needed to supply all of your vital organs for several seconds at a time throughout the night.

    What Causes Obstructive Sleep Apnea

    There are several potential causes of obstructive sleep apnea that all boil down to some form of airway obstruction that inhibits airflow while sleeping.

    In children, the most common causes of OSA are enlarged tonsils and adenoids.

    The tone of the airway muscles is naturally at its lowest while sleeping, making you more vulnerable to anything that causes additional airflow blockage.

    Tonsils and adenoids are lymphatic tissues that, if enlarged, will lead to blockage of airflow and obstruction of breathing.

    In adults, the most common cause of OSA is obesity. Which plays a large role in the ever-increasing prevalence of the disease.

    Obesity leads to excess fat and soft tissue of the mouth, throat, and neck that increases pressure on the upper airways and contributes to collapse and obstruction.

    There are also some anatomical issues that can put you at risk for OSA including a small airway, small jaw, large tongue or uvula, or large-sized neck.

    OSA tends to run in families reflecting a likely genetic component to the condition as well.

    What Are the Dangers of Untreated OSA?

    Because of the many disruptions and fragmentation of sleep that occurs due to OSA, people who suffer from the disease often report poor sleep quality no matter how much time they actually spend sleeping.

    And we all know from my post Why Sleep is Important for the Brain that poor sleep quality affects your cognitive abilities, mood and ability to concentrate.

    Untreated OSA can lead to more than just poor sleep quality. Along with daytime tiredness, fatigue and frequent headaches, OSA can lead to significant health consequences down the line.

    In fact, untreated OSA can lead to uncontrollable hypertension, coronary heart disease, heart failure and even sudden cardiac death.

    In Children, OSA can lead to poor growth, cognitive impairment, ADHD, and behavioral problems in addition to some of the cardiovascular effects mentioned above.

    How is OSA Diagnosed?

    Many physicians routinely screen for OSA at well visits. They may do so by asking about snoring, morning headaches or other side effects of OSA.

    Once the suspicion of OSA arises, the diagnosis is confirmed via a sleep study.

    A sleep study is a test that is performed overnight in a sleep lab. It monitors the patient’s breathing while asleep and determines the number of apneas (complete blocks in breathing) and hypopneas (partial blocks in breathing) that occur each hour.

    The test is then scored and a diagnosis is made along with the severity of the condition.

    How Is OSA Treated?

    In children, a positive screening by the primary care physician is generally referred to an otolaryngologist (ENT) or a sleep medicine physician.

    If your child is found to have enlarged tonsils, then it is generally assumed that they are the cause of your child’s OSA and the tonsils and adenoids may be removed by an otolaryngologist without requiring confirmatory diagnosis with a sleep study.

    Alternatively, your child may be sent directly to have a sleep study performed to confirm the diagnosis prior to initiating treatment.

    Unless the child has very little adenotonsillar tissue, the first step in treatment will generally be the removal of the adenoids and tonsils or watchful waiting while using things like intranasal corticosteroids to reduce inflammation and hopefully relieve the obstruction non-surgically.

    In adults however, the number 1 treatment modality for confirmed OSA is positive pressure through the use of a CPAP machine.

    This machine is worn at night and provides continuous positive pressure to keep the airway open and prevent obstruction.

    Given that obesity is a significant contributor to OSA in most adults, weight loss can be helpful in treatment as well.

    Correcting impaired airflow via surgical correction or the use of a CPAP machine significantly reduces the downstream health consequences of OSA.

    I hope you find this information helpful and please share with anyone you know who may be suffering from OSA or would just like to learn more.

    And as always, happy sleeping!