OSA is the most common type of sleep apnea. Around 15-20% of adults experience OSA and it is associated with being overweight, older age groups, smokers, rhinitis, pharyngeal reflux and in males. During sleep, our muscle tone relaxes and the airway lumen diminishes which requires more respiratory effort. This increase in respiratory effort results in negative airway pressure causing the airway soft tissue to flop back and obstruct the airway.
Source: science based medicine.org
Symptoms of OSA
Most common symptoms include snoring and restless sleep with periods of silence (apnea) followed by sudden gasping and even arousal from sleep. This causes poor quality sleep which results in early morning headache, unexplained daytime sleepiness, trouble concentrating, mood changes such as irritability and poor work performance.
There are also heath implications as they are more likely to get hypertension, heart disease, stroke, diabetes and involved in accidents.
Important to have a complete examination by an ENT doctor to check BMI, neck circumference, nose and oral cavity to look for any anatomical obstruction by any polyp, septum deviation, tongue or lymphoid tissue.
Sleep study (PolySomnoGram or PSG) is the ‘gold standard’ to diagnose OSA and can be done at home by sleep coordinators who will do a home visit. Some other parameters which can be measured include heart rate, oxygen saturation, airflow and sleeping position. The Apnoea:Hyponoea Index (AHI) is used to grade the severity of the sleep apnea depending on the number of ‘events’ detected per hour of sleep.
An ‘apnea event’ is defined as complete cessation of airflow for at least 10 seconds while ‘hyponoea event’ is defined as 50% decrease in airflow for at least 10 seconds or 30% decrease in airflow with associated decrease in oxygen saturation or an arousal from sleep.
- Lifestyle modification such as losing weight and gentle regular exercise (read “How much exercise should we need daily?”)
- Avoid stimulants such as caffeine, alcohol or light emitting devices before sleep and observe good sleep habits (read “Sleep Disorders”)
- Treat any nasal symptoms such as allergic rhinitis
- Surgery such as Adenotonsillectomy or Cautery Assisted Palatal Stiffening Operation (CAPSO) or mandibular advancement procedure may be helpful
- Continuous Positive Airway Pressure (CPAP) device