Are there complaints that you snore, skip breaths, or gasp at night?
Do you wake up from a full night of sleep and still feel tired?
Does your bed partner complain of poor sleep due to your sleep habits?
If you answered yes to any of these questions, you may be suffering from obstructive sleep apnea syndrome (OSAS). Sleep apnea refers to a reduction or cessation of breathing during sleep and is caused by an anatomic blockage of the nose and/or throat. During sleep, a decrease occurs in the activity of muscles that keeps the airway open. This laxity leads to an increase in the collapsibility of the airway and can lead to significant airway obstruction. Patients who are overweight typically have thicker neck tissues and a smaller airway diameter that poses greater risk. In children, enlarged tonsils and adenoids are often responsible for the decreased airway caliber. This obstruction greatly affects gas exchange in the lungs and can lead to lower levels of oxygen in the blood (hypoxemia). This loss of oxygen places stress on the heart and lungs and leads to “arousals”—disruptions of the normal brain activity during sleep necessary to tighten the airway muscles and restart breathing. Due to these frequent arousals, patients with sleep apnea get fragmented sleep and, over time, complain of non-refreshing sleep and constant sleepiness. Chronic snoring is a major symptom of obstructive sleep apnea and is often the reason for referral to a sleep specialist. Loud and interrupted mouth breathing is usually seen in children with sleep apnea and is often due to enlarged adenoids and tonsils.
Obstructive sleep apnea has been clinically linked with obesity, hypertension, heart and lung disease, stroke, and unexplained sudden death. It also leads to chronic daytime sleepiness that greatly impairs memory, mood, and mental focus. In children, sleep apnea is associated with impaired learning and hyperactivity due to a decrease in concentration. In short, obstructive sleep apnea greatly impairs a patient’s quality of life and may pose a significant health threat.
SYMPTOMS OF OBSTRUCTIVE SLEEP APNEA
- Snoring, gasping, snorting in sleep (at all ages)
- Breathing cessation (apnea)
- Daytime fatigue
- Morning headaches
- Memory/concentration problems
- Difficulty in controlling high blood pressure or diabetes
Non-surgical treatments for sleep apnea include lifestyle changes, oral appliances and CPAP (Continuous Positive Airway Pressure). CPAP works by applying air pressure via a mask to the nasal and oral airways to “splint” the tissues open and prevent obstruction. It is the considered the gold standard for obstructive sleep apnea treatment. When CPAP and other conservative measures fail, surgery to widen the air passages in the nose and throat is often recommended (see Symptoms and Procedures portion of the website).
In normal weight children, tonsillectomy and adenoidectomy has a high rate of success in eliminating sleep apnea. Occasionally, nasal surgery to decrease the size of the turbinates will also be performed at the same time.
Dr. Gunnlaugsson is a Board Certified Sleep Specialist who manages all aspects of sleep apnea diagnosis and treatment. These areas include:
- Obtaining a thorough patient history and detailed anatomical exam of the airway and offending structures.
- Ordering diagnostic tests such as a Polysomnogram (Sleep Study), which Dr. Gunnlaugsson personally reviews and interprets.
- Initiating treatment with CPAP and verifying patient tolerance, compliance, and effectiveness.
- Recommending and performing surgical procedures to treat sleep apnea in patients who are intolerant to CPAP.
Sleep apnea in adults is often a chronic condition, and Dr. Gunnlaugsson will continue to evaluate patients throughout their treatment. With proper physician direction and patient encouragement, sleep apnea is a very treatable condition, and significant improvements can be made in a patient’s lifestyle.