Obstructive Sleep Apnea
WHAT IS OBSTRUCTIVE SLEEP APNEA (OSA)?
Obstructive sleep apnea is a very common medical condition in which breathing is disrupted during sleep . Signs and symptoms of sleep apnea are loud snoring, suddenly awakening with a gasp, and sometimes daytime sleepiness. It may present as high blood pressure, atrial fibrillation, a heart attack or stroke, memory loss, or lack of interest in sex. Obstructive sleep apnea can be a hidden disorder-and it is estimated that 90% of the cases have not yet been diagnosed. Often it is the bed partner who notices the person is having difficulty breathing. Until March of 2009, an all night study, called a polysomnogram, was required to diagnose it. Since that time, after much review, Medicare and other insurances have seen the utility of home sleep studies. These studies record fewer variables (for instance not EEG changes of sleep stages) but can document breathing pauses and correlate well with overnight Polysomnography sleep study at about one tenth of the cost.
WHAT ARE THE CAUSES AND HEALTH EFFECTS OF OBSTRUCTIVE SLEEP APNEA (OSA)?
The incidence of OSA increases with age and with increased weight, and the prevalence of these two phenomenon is part of the reason it is becoming more commonly diagnosed. It is also correlated with upper airway anatomy. Overbite and nasal obstruction, such as that caused by allergy, may be a factor. There is also a definite correlation between OSA and acid reflux, diabetes, and vascular inflammation. Reggie White died young, thought to be with undiagnosed ODA. Likely John Candy, Jerry Garcia, and John Bellucci had it also. In some people, OSA seems to have a more negative effect than others. The incidence of sleep disorders in women increases to 25% post-menopausally, and this may be part of the reason for increased yet often undiagnosed heart disease in this population.
All but very mild OSA is treated with Continuous Positive Airway Pressure (CPAP). CPAP therapy is positive air pressure applied through a mask that works to stop the airway from collapsing. Many different types of equipment have become available. Wearing the CPAP device can completely normalize the patient’s nighttime breathing. It can have benefits including regaining normal sleep patterns, greater alertness and less daytime sleepiness, less anxiety and depression, and improved mood, increased work productivity, and improved concentration and memory.
If the patient’s anatomy does not allow them to use CPAP, or if it is directly causing their OSA, surgery may be an option.
New Treatment for Sleep Apnea - PROVENT® Sleep Apnea Therapy
For more information, see NIH, AASM