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What is Obstructive Sleep Apnea?
According to the Mayo Clinic, “Obstructive sleep apnea is a potentially serious sleep disorder. It causes breathing to repeatedly stop and start during sleep.” While there are different types of sleep apnea, obstructive sleep apnea is the most common form.
Obstructive sleep apnea is caused by the relaxing of your throat muscles, which could block the airway while you’re sleeping. Symptoms include snoring, excessive daytime tiredness, loud snoring, observed episodes of breathing cessation during sleep, abrupt awakenings accompanied by gasping or choking, awakening with a dry mouth or sore throat, morning headache, difficulty concentrating during the day, mood changes (depression, irritability), high blood pressure, nighttime sweating, or decreased libido.
Treatment Options
Because obstructive sleep apnea happens while we’re asleep, it may be difficult to know that one experiences it. Keep in mind that just because you snore, it does not mean you experience obstructive sleep apnea. If you have a partner who has complained of loud snoring that is disturbing or that you wake up gasping or choking, then it might be time to see a medical professional for a sleep assessment and seek treatment.
A polysomnography, or a sleep assessment, requires an overnight observation made by a qualified sleep physician or a sleep lab. This involves being hooked up to equipment that monitors your heart, lung, and brain activity, as well as your breathing patterns, leg and arm movements, and blood oxygen levels. A sleep assessment will provide information on whether or not you experience sleep apnea. If you do experience it, the sleep physician will be able to tell you the degree of the apnea (mild, moderate, or severe obstructive).
If sleep apnea is found, you may be subjected to a split-night sleep study in which your sleep is monitored and sleep lab researchers will wake you up part-way through the night and give you continuous airway pressure (see below) for the second half of the sleep study.
Current Treatment Options
There are a number of obstructive sleep apnea treatment options available. Again, it is important to seek a professional sleep study before moving forward on any treatment.
1. Continuous Positive Airway Pressure (CPAP)
With obstructive sleep apnea, the muscles in the back of the throat relax too much to facilitate normal breathing. As a result, your airway narrows or closes during breathing, which could lead to a lower level of oxygen and a higher level of carbon dioxide in your blood. The brain can sense this impairment in breathing and therefore rouses you – allowing you to reopen your airway. As a result, this can lead to disruption in one’s sleep patterns, leading to feeling tired during the day.
Continuous airway pressure (CPAP) is a machine that provides airflow and is the first line of treatment for obstructive sleep apnea. CPAP delivers air pressure through a nose/mouth mask piece, thus reducing the occurrence of the throat muscles narrowing. By providing constant pressure, CPAP keeps your upper airway passages open, which prevents sleep apnea and snoring.
CPAP is the first choice for treating severe obstructive sleep apnea. CPAP treatment systems are diverse and customizable depending on the person and their sleep apnea. There are different amounts of pressure available, as well as the option for continuous or varied pressure throughout the night. For people who experience milder cases, there are other options as well.
2. Oral Appliance Therapy
Oral appliance therapy is one of the best CPAP alternatives available. This particular option resembles an orthodontic appliance or mouth guard used by athletes. Oral appliance therapy pieces are worn during sleep and act as scaffolding for the internal structures of the mouth, preventing the collapse of the tongue and soft tissues in the back of the throat. In doing so, oral appliance therapy ensures continuous air intake.
3. Surgery
If CPAP treatments do not appear to be effective, surgery is an option. Uvulopalatopharyngoplasty (UPPP) is the surgery used to remove soft tissues at the back of your mouth and the top of your throat. UPPP might also involve the removal of tonsils and adenoids. UPPP surgery does not guarantee that it will be cured, and in some cases, people still continue to use CPAP or oral appliance options post-surgery.
4. Lifestyle Changes
Aside from the medical treatments available, milder cases could be addressed simply by making lifestyle changes. These include losing weight (if you are overweight), exercising regularly, drinking alcohol moderately (and not drinking several hours before bedtime), quitting smoking, using a nasal decongestant or allergy medication, and not sleeping on your back.
