What is Obstructive Sleep Apnea?
Obstructive sleep apnea is a potentially serious condition that is characterized by periods of breathing pauses, gasping, or choking during sleep that are often accompanied by decreased oxygenation of the blood. These breathing pauses or gasping or choking are due to obstruction of the upper airway. People with sleep apnea have obstructed upper airways due a variety of anatomical problems including large tongues, long palates, tonsils, adenoids, and/or small lower jaws.
In addition to small airways, the muscles that surround and support the upper airway relax excessively during sleep leading to collapse. The combination of these factors results in various degrees of obstruction of the airway and increased resistance to airflow during sleep. Minor obstruction results only in snoring, while more significant obstruction results in partial (hypopnea) or complete (apnea) breathing impairment.
The brain senses the impairment in breathing and declining blood oxygen, and responds by causing arousals or partial awakenings that allow breathing to resume. If these arousals are frequent, the result is inadequate sleep and poor quality sleep with excessive sleepiness during the daytime. Obstructive sleep apnea should be diagnosed by a physician who is a sleep specialist, who will then determine the best treatment option. The definitive diagnosis of sleep apnea is made by conducting an overnight sleep study called a polysomnogram.
The severity of sleep apnea is expressed by the apnea-hypopnea index (AHI). It is essentially the number of times per hour of sleep that a person either stops breathing and/or has a significant impairment in breathing. These episodes are often accompanied by a drop in the oxygen content in the blood (blood oxygen saturation). An AHI of less than 5 times per hour is considered normal, 5-15 per hour is mild, 15-30 per hour is moderate, and more than 30 times an hour is considered severe. A blood oxygen saturation of less than 95% is considered abnormal.
Depending on the severity of the diagnosis, sleep apnea is treated by one or more of several options including 1) behavior modification, especially weight loss, 2) positive airway pressure [CPAP], 3) oral appliances, or 4) surgery. CPAP is the gold standard of treatment.
Sleep apnea increases your risk for:
- High Blood Pressure
- Heart Attack
- Daytime sleepiness
- Mental confusion, irritability
- Fatigue-related car crashes
- Dying of cancer
Warning Signs of Sleep Apnea
- Loud snoring with breathing pauses, gasping, or choking during sleep
- Excessive sleepiness during the day
Factors That Increase the Risk for Sleep Apnea
- Collar size 17" or greater for men and 16" or greater for women
- Large tongue, long soft palate, receding chin
- Presence of tonsils and/or adenoids