Introduction
Obstructive sleep apnea (OSA) is a common sleep disorder characterized by repeated episodes of upper airway obstruction during sleep. These obstructions lead to pauses in breathing or shallow breaths, resulting in disrupted sleep and reduced oxygen levels in the blood. OSA can affect people of all ages, but it is more prevalent in adults, particularly those who are overweight or obese.
Causes
OSA occurs when the muscles in the back of the throat relax during sleep, causing the soft tissues, such as the tongue and soft palate, to collapse and block the airway. Risk factors for OSA include obesity, a large neck circumference, a narrow airway, a recessed chin, nasal congestion, and a family history of sleep apnea. Alcohol and sedative use can also worsen OSA by further relaxing the throat muscles. In children, enlarged tonsils and adenoids are a common cause of OSA.
Symptoms
The symptoms of OSA can vary among individuals. Common symptoms include loud snoring, witnessed pauses in breathing during sleep, gasping or choking during sleep, and frequent awakenings. Daytime symptoms include excessive daytime sleepiness, fatigue, difficulty concentrating, morning headaches, irritability, and mood changes. OSA can also lead to nocturia (frequent nighttime urination) and decreased libido.
Diagnosis
Diagnosing OSA typically involves a comprehensive sleep evaluation. A sleep study, or polysomnography (PSG), is conducted in a sleep laboratory to monitor brain waves, eye movements, muscle activity, heart rate, and breathing patterns during sleep. Home sleep apnea testing (HSAT) may also be used in some cases. The apnea-hypopnea index (AHI), which measures the number of apneas and hypopneas per hour of sleep, is used to determine the severity of OSA.
Treatment Options
Treatment for OSA aims to alleviate symptoms and prevent complications. Continuous positive airway pressure (CPAP) therapy is the most common and effective treatment. CPAP involves wearing a mask that delivers pressurized air to keep the airway open during sleep. Oral appliances, such as mandibular advancement devices, can also be used to reposition the jaw and tongue. Lifestyle modifications, such as weight loss, avoiding alcohol and sedatives before bed, and sleeping on the side, can help reduce symptoms. In some cases, surgery to remove enlarged tonsils or adenoids or to correct structural abnormalities may be necessary.
Prevention
Preventing OSA involves addressing modifiable risk factors. Maintaining a healthy weight, avoiding alcohol and sedatives before bed, and sleeping on the side can help reduce the risk of developing OSA. Regular exercise and a balanced diet are also important. For children, early evaluation and treatment of enlarged tonsils and adenoids can help prevent OSA.
Takeaway
Obstructive sleep apnea is a common and treatable sleep disorder that can have significant impacts on health and quality of life. Early diagnosis and appropriate treatment are essential to alleviate symptoms, prevent complications, and improve overall well-being. Individuals with symptoms of OSA should seek medical evaluation and follow their healthcare provider’s recommendations for management.