Obstructive Sleep Apnea (OSA)

Sometimes snoring is just snoring, but when paired with other symptoms, obstructive sleep apnea may be to blame. Some of the most common obstructive sleep apnea symptoms are:

• Excessive daytime fatigue & sleepiness: if you can’t seem to feel rested despite the number of hours you sleep a night, sleep apnea might be to blame.

• Loud snoring: sawing logs, upsetting your partner, scaring the cats, waking the neighbors? If your snoring is disrupting your sleep or the sleep of others, getting tested for obstructive sleep apnea may be a good idea.

• Difficulty concentrating: if your brain seems foggy for no reason, OSA might be the reason.

• High blood pressure: there are many reasons blood pressure can spike, but we recommend getting tested for obstructive sleep apnea if your blood pressure is consistently high—especially if you’re exhibiting other symptoms of sleep apnea.

• Nighttime sweating: waking up covered in sweat is a common symptom of obstructive sleep apnea. Why? If you are struggling to breathe during sleep, your body will work harder—which can cause you to sweat, just like when you work out. Each sleep apnea can also produce a burst of cortisol (the stress hormone).

• Wakings that are abrupt, accompanied by gasping/choking: if you wake frequently gasping for air (and you’re not having a nightmare!), obstructive sleep apnea might be the reason why.

• Decreased libido: not feeling as… frisky lately? Sleep apnea can cause a decrease in libido.

• Morning headaches: frequent headaches that seem to occur primarily in the morning are a sign of obstructive sleep apnea.

• Mood swings: we all have our moody moments, but if your moods seem to fluctuate from high to low without a solid reason why, getting tested for obstructive sleep apnea might be a good idea.

• Episodes of interrupted breathing during sleep: many people with sleep apnea actually stop breathing for short periods of time during sleep. If your partner has noticed this happening, it can be scary—and it’s usually a sign that sleep apnea is the culprit.

Obstructive sleep apnea is a potentially serious condition that, over time, can have the following health consequences if not properly treated:

• High blood pressure

• Heart disease

• Stroke

• Diabetes

If you’re exhibiting one or more of the symptoms listed above, check with your doctor to get tested for obstructive sleep apnea. Keep in mind that many of these symptoms can be signs of other health conditions, so having a thorough physician exam is always wise to ensure you receive the best care for your situation.

Obstructive sleep apnea appears more frequently in people who:

• Sleep on their back

• Are middle-aged

• Are overweight (fat deposits around your upper airway can obstruct your breathing)

• Are male

• Smoke

• Have a family history of sleep apnea

While people who fit the criteria above are at a higher risk of developing obstructive sleep apnea, it can affect people of all ages, sexes, and levels of health and fitness

Your physician will perform a physical examination. They will look at the back of your throat, nose, and mouth for abnormalities or excess tissue. They might measure your waist/neck circumference and check your blood pressure. You may also get a referral to an ear, nose, and throat doctor (commonly referred to as and ENT) to rule out anatomic blockages in the nose and throat. If obstructive sleep apnea is suspected, your doctor may refer you to a sleep specialist for further observation and evaluation in a sleep center.

If referred to a sleep specialist, they may perform the following tests:

• Polysomnography: a sleep study where you are hooked up to equipment that monitors your heart, brain, and lung activity, leg/arm movements, breathing patterns, and blood oxygen levels during sleep. These tests may be performed in one night, or in a split-night study.

• Home sleep apnea testing: your doctor may provide you with an at-home version of the polysomnography test

There are several treatment options for obstructive sleep apnea, including:

• Lifestyle Changes If your sleep apnea is mild, your doctor may recommend lifestyle changes such as:

  • Weight loss

  • Smoking cessation

  • Regular exercise

  • Alcohol in moderation (or not at all)

  • Use of allergy medications and/or nasal decongestants

  • No longer sleeping on your back

• Therapies If your obstructive sleep apnea is more severe, or if lifestyle changes aren’t enough to bring relief, your doctor may suggest the following sleep apnea therapies:

  • Positive Airway Pressure This treatment involves a machine that delivers air pressure through a fitted piece that is placed over your nose/mouth while you sleep. The machine delivers air pressure through the fitted piece, which reduces the number of respiratory events that happen while you sleep—resulting in a reduction of daytime fatigue and an increase in quality of life.

    • The most common type is called continuous positive airway pressure (CPAP). During CPAP, the pressure of air you breathe in is continuous and a little greater than the surrounding air. This is just enough air to keep your upper airways open. Some people worry that their mask will be too loud or uncomfortable, but CPAP therapy is the most consistently successful and common type of obstructive sleep apnea treatment. With time and practice, almost all patients find that they become used to their CPAP mask

    • Another type of positive airway pressure therapy is bilevel positive airway pressure (BiPAP). Unlike CPAP, this airway pressure therapy delivers a preset amount of pressure when you breathe in, and a different amount when you breathe out.

    • It’s important to not stop using your CPAP if you experience problems or discomfort—your doctor can work with you to make adjustments to improve your comfort.

  • A Mouthpiece Oral appliances like mouthpieces are a good alternative for those with mild to moderate obstructive sleep apnea. Mouthpieces work by keeping your throat open. Some oral devices bring your jaw forward, keeping your airway open. This can help relieve snoring and sleep apnea symptoms. Other oral appliances work by holding your tongue in a different position.

  • Surgery/Other Procedures In cases where lifestyle changes and therapies aren’t effective, surgical options to relieve obstructive sleep apnea might be considered. These surgical options include:

    • Surgical removal of tissue

    • Jaw surgery

    • Upper airway stimulation

    • A surgical neck opening

    • Palate implants

    • Nasal surgery

    • Removal of tonsils or adenoids