Obstructive Sleep Apnea

Obstructive sleep apnea is a sleep disorder that is defined by the absence of breathing for at least ten seconds due to obstruction of the airway. This obstruction can be caused by the tongue, soft palate or uvula relaxing and blocking the airway. A person with OSA will have noticeable breathing efforts, such as chest rise, but will not be able to take are into the lungs. This causes the person to startle awake. Often times the person with the sleep disorder is not even aware that they have a problem, they wake only enough to start breathing again, and then fall back asleep. Often times, a person does not figure out they have sleep apnea until a loved one notices the signs. Some of these signs include loud and chronic snoring, gasping awake,
The diagnosis process begins with a patient making an appointment with either a family doctor or a sleep specialist. The sleep specialist will then, most-likely, recommend doing a sleep lab study or an at home study. There a pros and cons to both of these. The at home studies are becoming more common, and are cheaper to the patient. Also, with sleep studies done at home, the patient is likely more comfortable which can lead to different sleep habits/findings. With sleep lab studies the patient can be monitored more closely, and these studies are often split into half of a night of observation, and then half of a night of testing different treatments and the patient’s response to these
The most common treatment, and the usually the first one attempted is continuous positive airway pressure, or CPAP. CPAP is to be used only when the person with OSA is asleep. It is a machine that gives positive airway pressure through tubing that’s connected to a mask covering the patient’s mouth and nose, or through tubing connected to a mask that only covers the nose. CPAP with a mask that only covers the nose is known as NCPAP, and is the most commonly used form of CPAP. The positive pressure that comes from the machine helps to splint open the patient’s airway, and to keep it from collapsing upon inspiration. Using CPAP can be a little uncomfortable for the patient at first because positive pressure is anti-physiological. This form of treatment lowers blood pressure, decreases daytime sleepiness, and decreases the chances of heart problems in people with coronary arterial diseases. Some of the issues with CPAP include dry mouth/throat, runny nose or sneezing, possible abdominal bloating, irritation of the skin due to the mask, and nosebleeds. Some patients also reported having excessive and vivid dreams when first starting the use of CPAP. After beginning CPAP the patient will need to be observed with later sleep studies to determine if the treatment is working or not. Patients can either buy or rent a CPAP machine, but these machines can be expensive and