What is Obstructive Sleep Apnea?

Obstructive Sleep Apnea (OSA) is a sleeping disorder related to breathing problems. Breathing is hindered during sleep as the upper airway collapses briefly. This affects the quality of sleep. Sleep Apnea refers to the periods when breathing pauses and restarts. Sleeping on a comfortable mattress at an elevated angle or on the side may help to control Obstructive sleep apnea. 

Definition and Causes of Obstructive Sleep Apnea

Obstructive Sleep Apnea occurs when the flow of oxygen from the nostrils to the lungs is hindered or blocked during sleep. The muscles of the chest and diaphragm need to work vigorously to expand the airway. The tongue and the soft inner palate relax briefly, and the air passage gets constricted. This causes narrowed breathing which repeatedly stops throughout the sleep duration. Breathing recurs with the body jerking or a noisy gasp. There are periods of silence, especially for those who snore loudly. Not all people who snore through the night suffer from OSA. OSA is mainly seen in older men and post-menopausal women. 

Symptoms of Obstructive Sleep Apnea

Persons suffering from OSA have a reduced sleep quality. Due to a reduced supply of oxygen to the brain, drowsiness during the day is a frequent complaint. The other symptoms are listed as follows. 

• Dry mouth
• Loud snoring
• Loud gasps
• Breathing pauses
• Insomnia
• Drowsiness during the day
• Headaches (especially in the morning)
• Irritability
• Decreased daytime attentiveness
• Reduced memory
• Episodes of staying awake at night

If left untreated, OSA can lead to more severe health conditions like Type 2 Diabetes, High blood pressure, Pulmonary hypertension, other heart diseases, stroke, and arterial fibrillation. Depression and decreased interest in having sex are also some mental problems faced. Lowered attention during driving is another common symptom that can lead to crashes and death. 

Diagnosis of Obstructive Sleep Apnea

The immediate family members of the person suffering from OSA are often questioned about the sleep pattern. Questionnaires about the sleep habits of the patient are to be answered in detail. Although drowsiness and snoring are the most common symptoms associated with OSA, the doctor will observe the patient overnight in the clinic or hospital using various types of monitors. Different parameters checked are 

• Heart rate
• Eye movement 
• Oxygen level in the blood
• Airflow during breathing
• The motion of the legs and arms
• Electric action within the brain

A Polysomnography or PSG is conducted to measure the activity levels of those organs connected to sleep. It includes the following tests.

• Pulse Oximetry Test: tests for any changes in the blood oxygen levels
• Electromyography: tests for levels of muscle action
• Electrocardiogram: tests for the rate of heartbeat and heart rhythms
• Electrooculogram: tests for movement in the eyes
• Electroencephalogram: tests for brain waves

A pulse oximeter detects how much oxygen is there in the blood with the help of infrared LEDs. The oximeter is attached to either the fingertips or lobes of the ear. Oxygen levels are found to be low in patients suffering from apnea during sleep. 

Treatment of Obstructive Sleep Apnea

There are some effective methods of treating OSA and are as follows.

1) Continuous Positive Airway Pressure (CPAP)

This is done with the use of a specialized face mask to be worn during sleep times. The mask opens the airway during breathing with a positive airflow. This can be a very efficient help during breathing at night for OSA patients.

2) Bilevel Positive Airway Pressure (BPAP)

This treatment makes use of BPAP machines which administer two different air pressures to the patient. Inhaled pressure and exhaled pressure are the two different airflows provided to help the patient breathe effectively. 

3) Losing weight

Most OSA patients are obese and are therefore advised to lose weight. The severity of OSA is seen to be below if there is weight loss. 

4) Practise sleeping on one side

Adopting a side position whilst sleeping reduces the extent of disturbed breathing in OSA patients.

5) Surgery

The last alternative after CPAP and BPAP for persons suffering from OSA is surgery. The patient has to have a breathing condition that can be corrected with surgery, like any uneven tissue. Examples of such conditions are swollen adenoids, deviated septum, tonsillitis, or a tiny lower jaw. Also, the other health aspects have to agree with the surgical procedure. The doctor first examines the anatomy of the upper respiratory tract. This is done with the help of a thin instrument during a ‘Laryngoscopy’ through the nose. The airway is lit up to make the procedure easy and magnified. The different types of correcting OSA are maxillary advancement surgery, nasal surgery, somnoplasty or Uvulopalatopharyngoplasty (UPPP). Surgery definitely is a big help to most patients for a long duration but may have to be repeated. 

Besides the above methods of treatment, using nasal sprays in case of ‘sinus’ issues also helps to clear the airway during breathing at night. Stopping the consumption of alcohol is also recommended for OSA patients. Oral ‘mandibular’ devices for preventing the tongue from slipping backwards and obstructing the throat are also helpful. They may also help in taking the lower jaw ahead and maintaining an open airway during sleeping durations. 

Conclusion

Obstructive Sleep Apnea is a highly dangerous disease as it involves repeated episodes of interrupted sleep at night. Using soft pillows for sleeping on a cotton bedsheet are some sleep add-ons that can be used. Specialized pillows for OSA patients are cervical pillows which may be used under the neck, or wedge pillows to be used below the back. One may also rest on a comfortable mattress for the best sleep. An inclined bed elevated upwards is also helpful for keeping the airways open at night. A memory foam mattress that can alleviate pressure on the head can also improve sleep quality in OSA patients. A hybrid mattress is another practical suggestion for sleep apnea patients. Diagnosing OSA early and finding the right treatment or practical methods to get good quality sleep is the best way of dealing with the illness. CPAP is currently considered the best way to treat OSA, as it provides a positive pressure airflow. Practical solutions like losing weight are preferred over using any devices. Heart diseases, diabetes, loss of balance, and the other symptoms associated with disturbed sleep in OSA have to be still dealt with despite the use of oral breathing devices. Therefore maintaining a healthy weight is one of the ideal solutions to OSA.