Obstructive Sleep Apnea (OSA)

Obstructive sleep apnea (OSA) is a common sleep disorder characterized by repeated episodes of partial or complete upper airway obstruction during sleep, resulting in reduced or completely halted airflow despite ongoing breathing efforts.

Causes and Risk Factors

• Obstruction of the airway due to relaxation of the muscles in the throat
• Enlarged tonsils or adenoids
• Overweight or obesity, which can cause fat to accumulate in the throat and narrow the airway
• Family history of sleep apnea
• Narrow airway or other anatomical abnormalities
• Hypothyroidism (underactive thyroid gland)
• Asthma or chronic obstructive pulmonary disease (COPD)
• Smoking and exposure to secondhand smoke
• Certain medications, such as sedatives and tranquilizers

Symptoms

• Loud snoring, which can be intermittent or continuous
• Pauses in breathing during sleep, followed by gasping or choking sounds
• Morning headaches and dry mouth
• Daytime fatigue, sleepiness, and difficulty concentrating
• Irritability, mood swings, and depression
• High blood pressure and cardiovascular disease
• Nocturia (waking up to use the bathroom multiple times during the night)
• Erectile dysfunction or decreased libido

Diagnosis

Diagnosis of OSA typically involves a combination of the following:

• Medical history and physical examination
• Polysomnography (PSG), also known as a sleep study, which records brain waves, muscle activity, and breathing patterns during sleep
• Home sleep apnea testing (HSAT), which is a portable device that measures breathing patterns and oxygen levels during sleep
• Oximetry, which measures oxygen saturation in the blood

Treatment Options

Treatment for OSA depends on the severity of the condition and may include:

• Lifestyle modifications:
  • Weight loss through diet and exercise
  • Quitting smoking
  • Avoiding alcohol and sedatives before bedtime
  • Sleeping on one's side instead of back
• Continuous positive airway pressure (CPAP) therapy, which involves wearing a mask over the nose and mouth during sleep to deliver pressurized air into the airway
• Bilevel positive airway pressure (BiPAP) therapy, which provides two different levels of air pressure for inhalation and exhalation
• Oral appliances, such as mandibular advancement devices, which advance the lower jaw to keep the airway open
• Surgery, such as uvulopalatopharyngoplasty (UPPP) or maxillomandibular advancement, to remove excess tissue or reposition the jaw and facial bones

Complications

If left untreated, OSA can lead to:

• Cardiovascular disease, including high blood pressure, heart attacks, and strokes
• Type 2 diabetes
• Obesity and metabolic syndrome
• Cognitive impairment and memory problems
• Mood disorders, such as depression and anxiety
• Impaired motor function and increased risk of accidents

Prevention

To reduce the risk of developing OSA:

• Maintain a healthy weight through diet and exercise
• Avoid smoking and exposure to secondhand smoke
• Limit alcohol consumption and avoid sedatives before bedtime
• Sleep on one's side instead of back
• Get regular check-ups with a healthcare provider to monitor for signs of OSA