If your significant other refuses to sleep in the same room with you because you snore all night, you may have a problem called obstructive sleep apnea (OSA). Snoring and daytime somnolence are the cardinal signs of this disorder.
What is OSA?
When we sleep, our brainstem controls all of the respiratory efforts in the body--diaphragm movement, breathing, and muscle contractions. This is all done in a cyclic pattern. Apnea occurs when the effort given by the respiratory center is not enough to overcome obstructions in the airway. Snoring is a result of the body trying to force air through a partially obstructed path. Eventually, the brain is deprived of oxygen and forces the body to "wake up" and take a deep breath or gasp. Hypopnea is defined as decreased oxygen levels in the body due to apnea.
What are the risk factors?
The biggest risk factor for this disorder is being overweight or obese, and having a large neck circumference also complicates things. Other risks include family history of this disorder, craniofacial abnormalities, smoking, diabetes, and nasal congestion. If you are a current smoker, your risk for OSA is three times that of a nonsmoker! Twice as many men than women suffer from OSA and are diagnosed each year.
Can children get OSA?
Typically when someone under the age of 18 has this disorder, it is characterized by snoring and daytime sleepiness. It may be noticed when a child has a decline in school performance and difficulty staying awake at school and home. When children have problems with this, it is usually due to enlarged tonsils and/or adenoids which cause the obstruction. If you are concerned, bring your child to your physician for a further workup.
Who should be tested?
If you are concerned that you may have OSA, make an appointment with your physician to discuss the issue. If you have a few risk factors and mild symptoms, weight loss may be the treatment of choice and no further testing is warranted. Your physician can use the Epworth Sleepiness Scale (ESS) to determine your severity of daytime sleepiness. If you drive long distances for work or have any job that would cause harm to others or yourself if you fell asleep, you may need to undergo further testing.
How is OSA diagnosed and treated?
Prior to testing, neck circumference and abdominal girth are measured, as well as blood pressures and BMI (Body Mass Index). Testing for sleep apnea includes a "sleep study" in which you are attached to machines to monitor brain function and oxygen saturations while sleeping. During the study, apneic and hyponic episodes are monitored and if you have a certain amount in a set time frame, you are diagnosed with OSA. The second half of the test involves fitting you with a CPAP (Continuous Positive Airway Pressure) device and finalizing the settings on it for each specific person.
CPAP is the treatment of choice for OSA and is most often used. It is a device that uses continuous pressure to keep the airway open so apnea and hypopnea do not occur. These devices are typically worn whenever the patient is sleeping to keep airways open, even during naps. A variety of styles of masks are available for use. Often, patients see an improvement in sleepiness after the first night.
Obstructive sleep apnea is a medical problem that often goes undiagnosed due to its common, vague symptoms. If you are concerned about yourself or a loved one, visit your doctor today and discuss your risk factors.