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Diagnosing Sleep Apnea

Do you wish you could sleep like a baby? If you suffer from depression, headaches, tiredness, or have problems concentrating, you might be suffering from sleep apnea!

What is sleep apnea?

Sleep disorders are syndromes which cause a chronic disturbance in normal sleep patterns. They are increasingly common these days. Apneas are the most common type of sleep disorders and can be divided into three types: Central sleep apnea (CSA), obstructive sleep apnea (OSA), and mixed apnea (both OSA and CSA). Apnea is described as a period of time when breathing stops or becomes shallow. If an individual experiences recurrent episodes of apnea during sleep, this means they have sleep apnea.

Of the three types, OSA is the most common sleep apnea and is believed to be linked to the increased prevalence of obesity. OSA affects approximately 2-4% of adults and 1-4% of children. It is caused by the obstruction or collapse of the pharynx. The pharynx is a funnel-shaped passage that is located in your neck. Starting behind your nose and ending at the top of your windpipe and esophagus, the pharynx is approximately 5 cm long and used for both air and food.

During sleep apnea, your blood oxygen level drops, triggering your brain to arouse you to breathe harder to reopen your airway. Arousal could mean that you don’t completely wake up but rather drift back and forth between deep sleep and shallow sleep. Alternatively, arousal may mean that you repeatedly wake up gasping for air. Arousal can occur once per hour or more than 30 times per hour. CSA is much less common in adults and occurs when the brain does not send signals to prompt muscular effort to breathe.

What are the risk factors for OSA?

Some common risk factors for OSA include:

  • Obesity resulting in increased amounts of fat surrounding your neck
  • Large tonsils or adenoids
  • An enlarged tongue
  • Abnormal positioning of your jaw relative to your facial structure
  • A history of trauma to your upper airway
  • Age greater than 40
  • Family history of sleep apnea
  • The use of alcohol, tranquilizers, or sedatives, (since these relax muscles in your throat)
  • Nasal congestion and nasal septum deviation
  • Menopause

What are the symptoms of OSA?

Some common symptoms of OSA in both adults and children include:

  • Increased daytime naps, sleepiness, or fatigue
  • Difficulty waking up
  • Difficulty concentrating
  • Poor short-term memory/academic problems
  • Depression
  • Loud snoring, choking/gasping during sleep

If you or your child suffers from one or a combination of these symptoms, it might be time to see your doctor. If left untreated, OSA can result in excessive daytime sleepiness, increased risk of car accidents, high blood pressure, stroke, diabetes, and some forms of heart failure.

How is OSA diagnosed?

Diagnosing OSA is done using a polysomnography (or overnight sleep study), which is most commonly administered in a sleep lab. There are also portable monitors available which can be used for a home sleep study. Portable monitors are primarily used for diagnosing adults. However, they are also increasingly being used successfully in cooperative children.

During a home sleep study, multiple physiological signals — such as, heart rhythm, airflow, blood oxygenation, and abdominal movements — are monitored. The number of episodes of apneas, decreases in blood oxygen, abdominal movements, and sleep positions are recorded in a formal report. This information will help your doctor determine your diagnosis and treatment options.

What are the treatment options for OSA?

Treatment for OSA can be surgical or non-surgical, depending on its cause(s) and your overall medical profile. For some people, treatment may require simple weight loss while for others treatment may require surgical correction of upper airway abnormalities. The most common non-surgical treatment, after weight loss, is continuous positive airway pressure (CPAP). CPAP is a noninvasive device that you wear while you sleep. As you breathe through the device it ensures there is enough air pressure to keep your pharynx from collapsing or being obstructed.

Your physician will determine the best treatment plan for you based on the results of the sleep study and in consideration of your medical profile. The good news is, early diagnosis and treatment of OSA may prevent future complications. If you think you may have a sleep disorder, visit your doctor as soon as possible.