What is Obstructive Sleep Apnea (OSA)?

Obstructive sleep apnea (OSA) is a common sleep disorder characterized by breathing that repeatedly stops and starts during sleep. Although there are 3 distinct types of sleep apnea, OSA is the most common. This type of sleep apnea occurs when the muscles in the back of your throat relax causing a partial or complete obstruction of the airway. People with OSA may experience hundreds of apneic episodes per night lasting up to a minute at a time.[1]

Risk Factors for OSA

OSA can occur at any age, but there are certain risk factors that increase your chances of getting it. They are as follows:1OSA, What is Obstructive Sleep Apnea, Obstructive Sleep Apnea, sleep apnea

  • Being male – men are twice as likely as women to have OSA. But, women who are overweight and/or post-menopausal are also at risk.
  • Being overweight or obese – approximately 50% of all people with OSA are overweight. Fat deposits around the neck and upper airway may obstruct breathing. But it’s important to note that even thin people get OSA.
  • Smoking – smokers are three times more likely to have OSA.
  • Having a larger than average neck circumference – 17 inches or greater in men and 16 inches or greater in women puts you at higher risk for OSA.
  • Diabetes – OSA may be more common in people with diabetes.
  • Hypertension – OSA is common in people with high blood pressure.
  • Family history – people who have a family member with OSA are at increased risk.
  • Chronic nasal congestion – people with ongoing, persistent nasal congestion are twice as likely to have OSA.
  • Narrowed airways or enlarged tonsils/adenoids – having naturally narrow airways or enlarged tonsils and/or adenoids that block the airway increases your risk for OSA.
  • Asthma – recent studies have revealed an association between asthma and OSA.
  • Having a large tongue or deviated septum – having a larger than normal tongue may obstruct your airway increasing your risk of OSA, as well as having a deviated septum in the nose.

Symptoms of OSA

Because symptoms of OSA occur during sleep, it’s often the partner of the person with the condition who notices them. The most common symptoms of OSA are listed below:[2]

  • Daytime sleepiness or fatigue
  • Extremely loud snoring
  • Morning headaches, sore throat and/or dry mouth
  • Trouble with concentration, forgetfulness, depression and irritability
  • Abrupt awakenings accompanied by gasping or choking
  • Decreased libido
  • Night sweats
  • Restlessness during sleep
  • Trouble waking up in morning

Diagnosis of OSA

To make a diagnosis of OSA, your doctor will evaluate your symptoms, physical examination results and tests. You may need to undergo an overnight sleep study in your home or a sleep laboratory. Among other things, your sleep study will reveal how many times your breathing was interrupted during sleep and help support a diagnosis of OSA.2

Treatment of OSA

Milder cases of OSA may respond favorably to the following lifestyle changes:1

  • Quitting smoking, if you’re a smoker.
  • Getting regular physical exercise.
  • Sleeping on your side instead of your back.
  • Moderate alcohol consumption, if at all; don’t drink several hours before bedtime.
  • Using an allergy medication or nasal decongestant to keep your airways clear.
  • Weight loss, if you’re overweight or obese. Losing even 10% of your body weight can prove beneficial to OSA symptoms.

If the lifestyle changes above do little to improve your OSA symptoms, further treatment may be necessary including:

  • Positive airway pressure (PAP) – including CPAP and BiPaP – helps keep the airway open and is endorsed by the American Academy of Sleep Medicine. Both types of PAP therapy use a breathing mask that fits snugly over the nose, or sometimes over the nose and mouth, depending upon the patient. The PAP machine forces a constant flow of air through the mouth or nose to keep the airways open during sleep. Studies show that people with OSA who consistently use PAP therapy have fewer apneic episodes and encounter fewer complications. They also report feeling better.2
  • Oral appliances – in mild to moderate cases of OSA, dental appliances or oral mandibular advancement devices can be used to keep the tongue from blocking the airway. These treatments have been found to reduce daytime sleepiness and improve quality of life.2
  • Surgery – there are a number of surgeries available to treat severe cases of OSA. They include: nasal surgery, uvulopalatopharyngoplasty (a surgical procedure that removes excess soft tissue from the back of your throat and palate thus increasing the width of the airway), jaw surgery (including mandibular/maxillary advancement surgery), tracheostomy (a surgical opening in the neck through which air will freely pass for life-threatening OSA) and somnoplasty (uses radio frequency to tighten the tissue of the soft palate).2

For more information about sleep apnea, talk to your primary health care provider. 

[1] Mayo Clinic. Obstructive Sleep Apnea. Last Update August 2, 2017.

[2] WebMD. Obstructive Sleep Apnea Explained. Last reviewed February 27, 2016.

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