Sleep Apnea

Obstructive sleep apnea is a common and potentially dangerous sleep disorder characterized by pauses in breathing that occur repeatedly throughout the night. It can lead to sleepiness and fatigue during the day and create serious health problems.

Symptoms of Sleep Apnea

Chronic, loud snoring is the most common sign of obstructive sleep apnea. This is accompanied by pauses in breathing and occasional gasping and snorting. Other symptoms include daytime drowsiness, morning headache, dry mouth, and sore throat. Lack of sleep can lead to difficulty concentrating, confusion, and loss of memory.

Many people with sleep apnea aren’t even aware of the condition unless alerted by a partner. Their pauses in breathing often go completely unnoticed. If your partner complains of loud snoring, especially if it includes pauses in breathing, and if you suffer from chronic fatigue or irritability, make an appointment with your doctor. Sleep apnea can rob you of quality sleep and can lead to heart attacks, strokes, high blood pressure, diabetes, and other serious health problems.

Why should I get treated for obstructive sleep apnea?
There are three potential reasons to treat obstructive sleep apnea:
  • Snoring. Some patients (and bed partners) are more concerned with snoring than with the other two consequences of obstructive sleep apnea. Although the primary purpose of treating obstructive sleep apnea is not to improve snoring, it is often very important to patients and bed partners.
  • Health impacts. When blockage in breathing occurs, patients often have drops in oxygen levels and wake themselves up with a response like an adrenaline rush. This places stress on the cardiovascular (heart), pulmonary (lung), and endocrine (metabolism) systems. Obstructive sleep apnea is strongly associated with the risks of developing hypertension, stroke, heart attack, and early death. These risks are greatest in those with more severe sleep apnea.
  • Sleep disruption, fatigue, memory problems, and decreased quality of life. Sleep apnea can prevent patients from getting refreshing sleep because the blockage in breathing is often worse during deep sleep. Interestingly, the degree of sleepiness or other symptoms is not related to sleep study results, so that some patients with what is called mild obstructive sleep apnea can experience significant symptoms, and vice versa. The bottom line is that if patients are not getting good sleep, they need treatment to function well during the day.

Treatment

Conservative treatments include weight loss, sleeping while lying on one’s side or stomach, and avoiding alcohol or other sedating medications. Weight loss can improve sleep apnea, especially in men, and the benefits often depends on the amount of weight loss. Although results vary, one large study estimated that a 10% weight loss was associated with a 25% reduction in the severity of sleep apnea. A bed partner often knows whether body position during sleep affects snoring (and the pattern of stoppage in breathing), and a sleep study may determine how body position affects breathing patterns in sleep apnea. Finally, individuals with snoring or sleep apnea should avoid alcohol and other sedating medications within 3 hours of bed time because they produce muscle relaxation and other effects to worsen snoring, sleep apnea, and sleep quality.

Positive airway pressure (CPAP, BiPAP, or AutoPAP) is a non-surgical therapy that works by delivering air pressure to prevent blockage of breathing in the throat. It is recognized as the first-line treatment for obstructive sleep apnea because it works well in the ideal situation where patients can wear it and sleep comfortably through the night, every night. Unfortunately, many patients do not tolerate it well, and it is important that these patients undergo evaluation to improve compliance or seek alternative treatment.

Surgical treatment must be directed at the areas that are responsible for snoring and airway narrowing or complete obstruction. There is a wide range of procedures available to stop snoring and to enlarge and/or stabilize the airway to prevent blockage of breathing in the three major areas where it can occur: the nose, palate, and tongue regions. Our research and that of other experts in the field has shown that often more than one of these areas is responsible and that accurate identification and treatment of the involved areas is critical. Oral appliances represent an alternative non-surgical therapy for certain patients with snoring or obstructive sleep apnea. We work closely with dentists who have expertise and experience in sleep dentistry to identify patients who might benefit most from these devices.

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Department of Otolaryngology - Head & Neck Surgery
University of Southern California
1520 San Pablo Suite 4600
Los Angeles, CA 90033
(323) 442-5790​


@USCENT


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