Obstructive Sleep Apnea Overview, Symptoms, Treatments

Sleeping well is essential for the proper functioning of the body. Sleep is responsible for resting the mind, muscles, breathing, and heart. It is during sleep that hormones that affect the body’s metabolism are released, such as growth hormone and satiety hormone. Poor sleep quality has several implications for health: it increases daytime sleepiness; reduces memory, attention, and reasoning; increases the risk of car accidents; reduces bone cartilage growth and muscle mass production; increases the chance of weight gain and depression, thus reducing quality of life. The two main diseases responsible for poor sleep quality are insomnia and obstructive sleep apnea (sleep apnea).

What is obstructive sleep apnea?

Sleep apnea is a clinical condition in which repetitive throat obstructions occur during sleep, generating recurrent apneas (breathing pauses of at least 10 seconds) and/or hypopneas (near-apneas). Our throat is narrow, and when we sleep, the muscles relax, causing the tongue to fall back and the jaw to move backward, thus obstructing the throat and preventing the passage of air (apnea). For the individual to emerge from apnea, they need to wake up, and this allows the throat muscles to regain the strength that keeps the throat open until sleep returns and the throat closes again. This cycle repeats dozens to hundreds of times throughout the night. For each apnea, there is an awakening; deep and restorative sleep does not occur, sleep is of poor quality, and daytime sleepiness is significant, leading to serious health implications as described above.

How is sleep apnea diagnosed?

The diagnosis of sleep apnea is based on medical history, physical examination, and a sleep recording test (polysomnography).

The most common signs and symptoms of sleep apnea are snoring, witnessed apneas, and excessive daytime sleepiness. In individuals with heart disease and hypertension, active screening for symptoms should be performed. Some risk factors for sleep apnea include obesity, large tongue, large tonsils and uvula, redundant palate, small chin, large neck circumference, male sex, and genetic syndromes with evident craniofacial deformities.

Individuals with symptoms characteristic of the disease and risk factors should undergo a sleep recording test (polysomnography) for a definitive diagnosis of the disease.

Full-night polysomnography, performed in a sleep laboratory under the supervision of a qualified technician, is the standard diagnostic method for sleep apnea.

How to treat sleep apnea?

The goal of sleep apnea treatment is to maintain throat opening and therefore prevent apnea, decreased blood oxygenation, increased blood pressure, and increased adrenaline release, as well as promote improvement in daytime sleepiness and quality of life. Sleep apnea treatment is selected based on several factors, such as AHI (Apnea-Hypopnea Index) defined by polysomnography, degree of decreased blood oxygenation, and the presence of other associated diseases, especially heart disease.

Modifications to risk factors should be adopted by all individuals with sleep apnea, although they are not, in most cases, the only treatment modality: Avoiding alcohol and sedatives, losing weight, sleeping on your side (sleeping on your back increases the chance of apnea), and elevating your head. These may be the only treatment modality in cases of mild apnea. The use of intraoral devices to increase airflow through the throat and speech therapy to strengthen the muscles that keep the throat open can also be used to treat mild apnea and, in selected cases of moderate apnea.

For moderate to severe sleep apnea, the use of a continuous positive airway pressure (CPAP) generator during sleep is the treatment of choice. CPAP promotes air pumping that prevents the throat from closing, thus preventing apnea and its previously described deleterious consequences. Surgery for the treatment of sleep apnea is an exceptional procedure, only indicated in selected cases.

Sleep apnea can seriously affect your health, energy, and quality of life, but the good news is that effective diagnosis and treatment are available. If you snore, feel tired during the day, or suspect you may have sleep apnea, do not ignore the signs. Call us today to schedule an appointment and take the first step toward better sleep and better health.

Related Article: What are Warning Signs of Sleep Apnea?