Obstructive Sleep Apnea Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that involves a decrease or complete halt in airflow despite an ongoing effort to breathe. It occurs when the muscles relax during sleep, causing soft tissue in the back of the throat to collapse and block the upper airway. This leads to partial reductions (hypopneas) and complete pauses (apneas) in breathing that last at least 10 seconds during sleep. Most pauses last between 10 and 30 seconds, but some may persist for one minute or longer. This can lead to abrupt reductions in blood oxygen saturation, with oxygen levels falling as much as 40 percent or more in severe cases. The brain responds to the lack of oxygen by alerting the body, causing a brief arousal from sleep that restores normal breathing. This pattern can occur hundreds of times in one night.
The result is a fragmented quality of sleep that often produces an excessive level of daytime sleepiness. Most people with OSA snore loudly and frequently, with periods of silence when airflow is reduced or blocked. They then make choking, snorting or gasping sounds when their airway reopens. A common measurement of sleep apnea is the apnea-hypopnea index (AHI). This is an average that represents the combined number of apneas and hypopneas that occur per hour of sleep
Dr Vivek Gupta,Pulmonologist, Sleep Medicine and Critical Care Consultant,Criticare Hospital & Research Institute,Nagpur said that,OSA can occur in any ager group, but prevalence increases between middle and older age. About 24 percent of men and nine percent of women have the breathing symptoms of OSA with or without daytime sleepiness. About 80 percent to 90 percent of adults with OSA remain undiagnosed. OSA occurs in about two percent of children and is most common at preschool ages.
People who are overweight (Body Mass Index of 25 to 29.9) and obese (Body Mass Index of 30 and above) are more prone for OSA . Men and women with large neck sizes: 17 inches or more for men, 16 inches or more for women and Children with large tonsils and adenoids , often have OSA.
Dr Vivek Gupta,Pulmonologist, Sleep Medicine and Critical Care Consultant,Criticare Hospital & Research Institute,Nagpur further added,OSA can lead to Fluctuating oxygen levels, Increased heart rate , Chronic elevation in daytime blood pressure , Increased risk of stroke , Higher rate of death due to heart disease , Impaired glucose tolerance and insulin resistance , Impaired concentration and Mood changes and Increased risk of being involved in a deadly motor vehicle accident
Sleep apnea must first be diagnosed at a sleep center or lab during an overnight sleep study, or “polysomnogram.” The sleep study charts vital signs such as brain waves, heart beat and breathing.
Treatment options for OSA are
1. Continuous positive airway pressure (CPAP): CPAP is the standard treatment option for moderate to severe cases of OSA and a good option for mild sleep apnea. First introduced for the treatment of sleep apnea in 1981, CPAP provides a steady stream of pressurized air to patients through a mask that they wear during sleep. This airflow keeps the airway open, preventing pauses in breathing and restoring normal oxygen levels. Newer CPAP models are small, light and virtually silent. Patients can choose from numerous mask sizes and styles to achieve a good fit. Heated humidifiers that connect to CPAP units contribute to patient comfort.
2. Oral appliances: An oral appliance is an effective treatment option for people with mild to moderate OSA who either prefer it to CPAP or are unable to successfully comply with CPAP therapy. Oral appliances look much like sports mouth guards, and they help maintain an open and unobstructed airway by repositioning or stabilizing the lower jaw, tongue, soft palate or uvula
3. Surgery: Surgery is a treatment option for OSA when noninvasive treatments such as CPAP or oral appliances have been unsuccessful. It is most effective when there is an obvious anatomic deformity that can be corrected to alleviate the breathing problem.
4.Position Therapy: A treatment used for patients suffering from mild OSA. Patients are advised to stay off of the back while sleeping . This is called tennis ball therapy
