Understanding Obstructive Sleep Apnea
Who Gets Obstructive Sleep Apnea? continued...
Sleep apnea is more common among people with thick or large necks. The condition is also more common among people who have smaller airways in their noses, throats, or mouths. The small airway could be related to the actual size and shape of the airway, or to obstructions or other medical conditions that are causing obstructions.
Babies and small children may have sleep apnea that is caused by swollen tonsils. Adults may also have enlarged tonsils causing obstruction. More commonly, their obstruction is caused by too much tissue at the back of the throat -- the uvula and soft palate -- that hangs down and blocks the windpipe. A larger than average tongue can also block the airway in many people as well as a deviated septum in the nose.
What Are the Risk Factors for Obstructive Sleep Apnea?
In addition to being overweight and getting older, other risk factors for obstructive sleep apnea include:
- High blood pressure
- Having risk factors for heart failure or stroke
How Is Obstructive Sleep Apnea Diagnosed?
To diagnose obstructive sleep apnea, your doctor will perform a physical exam and take a medical and sleep history. The doctor may also ask people who live with you about your sleeping habits.
You might also be asked to take a sleep test called a polysomnogram, or PSG. Sleep testing is performed in a sleep lab and is supervised by a trained technologist. The test will measure various body functions, including:
- Air flow
- Blood oxygen levels
- Breathing patterns
- Electrical activity of the brain
- Eye movements
- Heart rate
- Muscle activity
After the study is completed, the technologist will tally the number of times your breathing was impaired during sleep and grade the severity of sleep apnea. In some cases, a multiple sleep latency test is performed on the day after the overnight test. This measures how quickly you fall asleep. In this test, patients are given several opportunities to fall asleep during the course of a day when they normally would be awake.
How Is Obstructive Sleep Apnea Treated?
The treatment for obstructive sleep apnea will depend on the factors causing the obstruction. There are several possible treatments for obstructive sleep apnea. They range from a change in behavior to facial surgery. The aim of treatment is to open the airway and restore normal breathing during sleep and to alleviate the bothersome symptoms, such as daytime fatigue and snoring. Treatment may also help lower blood pressure and decrease risks for stroke, diabetes, and heart disease.
Conservative treatments -- In mild cases of sleep apnea, conservative therapy may be all that is needed. These treatments include the following:
- Overweight individuals can benefit from losing weight. Even a 10% weight loss can reduce the number of sleep apnea events for most patients.
- Individuals with sleep apnea should avoid the use of alcohol and sleeping pills, which make the airway more likely to collapse during sleep and prolong the apneic periods.
- In some patients who have mild sleep apnea, breathing pauses occur only when they sleep on their backs. In such cases, using pillows and other devices that help them sleep in a side position may be helpful.
- People with sinus problems or nasal congestion, who are more likely to experience sleep apnea, can try nasal sprays to reduce snoring and improve airflow for more comfortable nighttime breathing.
- Avoiding sleep deprivation is important for all patients with sleep disorders.