Are you more tired than you would like to be? Does your partner complain about your snoring and restless sleep? Or even worse, does your partner sleep in another part of the house because of that commotion? If so, chances are that you suffer from obstructive sleep apnea (OSA), a condition during sleep in which frequent gasping and pauses in breathing occur. OSA can create debilitating symptoms and increases the risk for many other diseases, even death.
Obstructive Sleep Apnea
OSA is a common condition with more than 30 million cases estimated in the US. Symptoms can include excessive daytime sleepiness, morning headaches, fatigue, and restless and non-restorative sleep. Although loud snoring is often seen (and heard!), some patients gasp and choke in relative silence as they snooze. Family and friends typically observe the troubled breathing long before the OSA patient may be aware of the problem.
OSA occurs because of obstruction (blockage and resistance) in the upper airway from the nose to the windpipe. Repeated blockages of breathing in the upper airway is the hallmark of OSA.
To confirm the diagnosis, a sleep study is performed to measure the sleep pattern, airflow, blood oxygen saturation, and other factors during a night of sleep. Sleep studies can be performed in a sleep laboratory or at home with portable testing devices.
There are two critical breathing failures that are measured to confirm OSA. Apnea is a pause in breathing lasting 10 seconds or longer. Hypopnea is a partial reduction in airflow together with a 4% or greater drop in blood oxygen saturation. Together, apnea and hypopnea are totaled then divided by the time spent asleep during the sleep study to calculate the Apnea Hypopnea Index (AHI). The AHI defines the severity of OSA for a patient, ranging from mild (6 to 15 events per hour), moderate (> 15 up to 30 events per hour), to severe (> 30 events per hour).
The severity of OSA tends to correlate both with symptoms as well as overall health risk. The list of health problems associated with OSA is extensive, reading like an A-list of serious diseases. Chronic health conditions such as high blood pressure, diabetes, depression, and obesity are more common and challenging to treat in patients with OSA. Even worse, untreated moderate to severe OSA can double to triple the risk for the top 5 leading causes of adult mortality in the US: cancer, sudden cardiac arrest, stroke, heart attack, and driving accidents.
Fortunately, effective treatment is available that can both improve the quality of life and reduce the health risk for people with OSA. The first line treatment for symptomatic mild OSA and all moderate to severe OSA is continuous positive airway pressure (CPAP). CPAP devices provide a constant push of air that keeps the upper airway open, preventing the mechanical blockage of air in the nose and throat. Modern CPAP is often “automatic,” constantly measuring breathing resistance and adjusting the pressure delivered in realtime to keep airway open.
A variety of other treatments can be offered to help a patient unable or unwilling to use CPAP. Weight loss can lead to a significant drop in the severity of OSA by reducing the size of the neck and the tongue that together can collapse the throat. Oral appliances that are worn on the upper and lower jaws can keep the throat from collapsing to control OSA. Surgery of the nose and sinuses in patients with nasal obstruction and/or chronic sinusitis have been shown to increase the use of CPAP and even improve the degree of OSA in many patients. Throat surgery of the tonsils, soft palate, tongue, and the neck can also lead to improvement and control of OSA. In the last 5 years, pacemaker technology that stimulates the tongue to contract during inspiration through mild electrical stimulation has been used to help many patients who are unable to use CPAP effectively.
Although many physicians have an understanding of OSA, an otolaryngologist (ear, nose, and throat surgeon) with specialty training in sleep medicine at South Florida ENT can provide patients with comprehensive care. The combination of diagnostic and surgical skills enables our otolaryngologists with sleep medicine expertise to offer the full range of diagnostic and treatment options.
South Florida ENT Associates are dedicated to the medical and surgical treatment of adult sleep, sinus and nose disorders. State of the art diagnostic protocols such as Home Sleep Studies, Laboratory Sleep Studies, Nasal Endoscopy, Video Flexible Laryngoscopy, Video Stroboscopy, Sleep Endoscopy, and CT Scan Imaging help us analyze our patient’s condition.
Our mission is the optimization of Sleep and Sinus health for our patients using a comprehensive and individualized plan designed for long-term success. To discuss your condition, please contact us online or call 561-624-5311.