Respiratory health

Obstructive Sleep Apnea - a Frequent Undiagnosed Condition

Written by
Dr. Sagar Ramesh Makode
and medically reviewed by Dr. Sneha Kannan

Published on Mar 06, 2017 and last reviewed on Feb 25, 2020   -  4 min read

Obstructive Sleep Apnea - a Frequent Undiagnosed Condition

Do you have any symptoms such as snoring, interrupted sleep, unrefreshed sleep, morning headaches, daytime sleepiness, etc.? Are you obese with a short and wide neck? If yes, then you may have obstructive sleep apnea, which is frequently an undiagnosed condition and has multiple adverse effects on our body.

What Is Obstructive Sleep Apnea?

Obstructive sleep apnea, otherwise called OSA, is a condition characterized by obstruction of the upper airway, especially during sleep due to lax airway and narrowing of the airway due to obesity. It is a potentially serious sleep disorder, as it causes your breathing to start and stop repeatedly when you sleep.

Snoring is the most important sign of sleep apnea. As air squeezes through the narrow airway, the person snores. If left untreated, sleep apnea can lead to severe health conditions, such as hypertension, stroke, heart problems, and diabetes. Diagnosing and treating this condition promptly is the key to prevent complications.

Treatment options like using a device that keeps your airway open during sleep or a mouthpiece to keep your jaw forward while sleeping are effective. Some cases can be treated with surgery.

What Are the Symptoms of Obstructive Sleep Apnea?

Obstruction of the upper airway leads to a temporary stoppage of respiration, increased sympathetic drive, and increased pulse rate and blood pressure. These episodes result in decreased oxygen supply to the brain and other parts, causing the following symptoms:

Daytime drowsiness increases the risk of road traffic accidents. As mentioned above, it also increases the risk of stroke, heart attack, and lung problems (pulmonary hypertension). In case your partner complains about your snoring or you get up in the middle of the night gasping or choking or feel tired and drowsy during the day, it is best to consult a doctor.

What Causes Obstructive Sleep Apnea?

In OSA, the muscles in the throat that support important structures, such as the soft palate, uvula, tonsils, and tongue relax too much. When these muscles relax, the airway constricts and prevents breathing for 10 seconds or longer. This lowers the level of oxygen in the blood and results in the buildup of carbon dioxide.

It can also deprive your brain of oxygen, which makes your brain to wake you up for a brief moment so that your airway gets reopened. Most people do not realize that they woke up during the night. Some people get up snorting, choking, or gasping for air.

It is necessary to adequately investigate through ENT examination if you have any symptoms of nasal stuffiness and recurrent tonsillitis to rule out nasal causes of obstruction. Sometimes, thyroid problems will cause obstruction. Altered lipid profile and sugar HbA1c that is, dyslipidemia and diabetes are the frequently associated problems. Vitamin D deficiency is also responsible.

Risk Factors:

The following factors might increase the risk of a person developing obstructive sleep apnea:

  1. Obesity - The majority of people who suffer from sleep apnea are overweight or obese. It is due to the fat deposits surrounding the upper airway.

  2. Hypertension - People with high blood pressure commonly have sleep apnea.

  3. Obstructed airway - Some people have naturally narrow airways, which when combined with tonsils or adenoids enlarged results in OSA.

  4. Nasal congestion - Chronic nasal congestion narrows the airway, which leads to OSA.

  5. Asthma - Some studies have shown that asthma increases the risk of sleep apnea.

  6. Diabetes - OSA is common in people with high blood sugar.

  7. Smoking - People who smoke are at risk.

  8. Sex - Men are more susceptible than premenopausal women, but the risk increases in women after menopause.

  9. Genetics - The risk increases if any of your family members has OSA.

  10. Other factors - Lower jaw shorter than the upper jaw (retrognathia), people with a large tongue or narrow palate.

What Are the Possible Complications of Obstructive Sleep Apnea?

The possible complications of OSA include:

  • Daytime sleepiness.

  • Difficulty concentrating.

  • Hypertension.

  • Abnormal heart rhythms.

  • General anesthetics can worsen sleep apnea.

  • Glaucoma.

  • Sleep deprivation.

How Is Obstructive Sleep Apnea Diagnosed?

The specialist might perform the following tests if he or she suspects obstructive sleep apnea:

Polysomnogram - This sleep study is performed by connecting you to various machines while you sleep. A polysomnogram measures the activity of various organ systems during sleep, which includes:

  1. Electroencephalogram (EEG) - measures brain waves.

  2. Electromyogram (EMG) - measures muscle activity.

  3. Electroculogram (EOM) - measures eye movement.

  4. Pulse oximetry test - measures the oxygen levels in the blood.

  5. Electrocardiogram (EKG or ECG) - measures heart rate or rhythm.

  6. Arterial blood gas analysis (ABG) - measures levels of oxygen and carbon dioxide.

How Is Obstructive Sleep Apnea Treated?

The treatment options include:

  1. Weight reduction - You need to have a low-fat and low-calorie diet to lose weight. A cure for this particular disease is weight reduction. So, a healthy lifestyle including both a healthy diet and regular exercise is the central goal in the management of OSA.

  2. CPAP (continuous positive airway pressure) - It is a mask device that provides pressure during inspiration and expiration during sleep in order to keep your airways patent and avoid OSA.

  3. Nasal decongestants - They help relieve snoring in mild cases.

  4. Bilevel positive airway pressure (BiPAP or BPAP) - In case CPAP therapy not being effective, BiPAP are used.

  5. Positional therapy - As sleeping on your back can worsen sleep apnea, patients are encouraged to sleep in other positions.

  6. Surgery - Uvulopalatopharyngoplasty (UPPP) is the most commonly done surgery for sleep apnea. It involves the removal of extra tissues from the back of the throat.

Also, regular exercise is vital. Chest physiotherapy and yoga will be helpful. For an in-person consultation, one needs to visit a sleep specialist or pulmonologist. Always talk to a doctor if you have daytime drowsiness or sleep problems. The symptoms can be effectively managed with the help of different treatment options. To know more about OSA, consult an obstructive sleep apnea specialist online.

 

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Last reviewed at:
25 Feb 2020  -  4 min read

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