by Matthew Hinsley, MD
What is sleep apnea?
Obstructive sleep apnea syndrome (OSA) is characterized by repeated cessation or reduction of airflow while sleeping. This is caused by collapse of the upper airway structures, most commonly the tongue base, soft palate or upper throat. Symptoms of obstructive sleep apnea include daytime fatigue and sleepiness, poor concentration, morning headaches and many others. Sleep apnea can cause many health problems and may increase your risk of chronic cardiovascular and respiratory disease such as hypertension (high blood pressure), heart disease and stroke.
How common is obstructive sleep apnea?
Sleep disorders are on a spectrum, with snoring on one end and sleep apnea on the other. Partial airway obstruction causes snoring, which has no adverse health consequences. Snoring occurs in 40% of men and 20% of women in the US. Sleep apnea is complete airway obstruction and occurs in 2% of women 4% of men. Obesity (especially around abdomen) increases your risk of having sleep apnea.
How is obstructive sleep apnea diagnosed?
Sleep apnea is suspected based on abnormal sleep patterns like heroic and loud snoring, restless and disturbed sleep, observed gasping or apnea during sleep, and nighttime sweating.
Daytime signs and symptoms of sleep apnea include excessive daytime sleepiness, cognitive impairment and morning headaches. The Epworth Sleepiness Scale is useful tool to assess a patients at risk for sleep apnea.
Your doctor will perform a complete physical exam, including inspected of your head and neck. Those with a large neck size (men over 17 inches and women over 16 inches), narrow throat, large tongue or enlarged tonsils can be at risk.
A sleep study, also known as polysomography, is the gold standard for diagnosing obstructive sleep apnea. It can be performed overnight in a sleep lab or can be performed at home. Sleep studies provide detailed information regarding many aspects of sleep quality and architecture. It allows stratification of sleep apnea into mild, moderate or severe OSA.
Overnight oximetry can be used as a screening test. However, it is limited in usefulness and if OSA is suspected on this test, a formal overnight sleep study is required to confirm diagnosis and to assess severity.
What are treatment options for OSA?
Treatment must be individualized based on symptoms and OSA severity. Someone with mild OSA and no symptoms may not require treatment. However, those with moderate and severe obstructive sleep apnea are at increased risk of mortality or death. All patients with moderate or severe sleep apnea should be treated regardless of symptoms.
If you have concerns that you may be suffering from OSA, please call 505-982-4848 to make an appointment with one of our ENT specialists.