What Is Sleep Apnea, and Should You Get Tested?
If you have the common condition, there are many treatment options available.
By Steven Y. Park, M.D. | Contributor | Jan. 24, 2017, at 6:00 a.m. | USNews.com
Obstructive sleep apnea causes people to stop breathing repeatedly at night, during sleep, due to throat muscle relaxation. It’s estimated that 18 million Americans have OSA, and of those, 80 percent remain undiagnosed.
Untreated, OSA has been found to significantly raise the risk of developing diabetes, high blood pressure, heart disease, heart attack and stroke. It often makes headlines, as many of the major industrial or transportation accidents in the past 50 years have been linked to sleep deprivation or OSA. Researchers from the University of California, San Diego, estimated that in 2000, an estimated 800,000 drivers were involved with collisions that could be attributed to OSA. In addition, the National Commission on Sleep Disorders Research estimates that nearly 40,000 deaths due to cardiovascular problems are connected to sleep apnea occur each year.
Fortunately, with the proper tools, OSA can be diagnosed – and, with proper treatment, risks for conditions associated with OSA can be significantly reduced.
Common Signs and Symptoms
Being Male, Overweight, Older, a Snorer and Excessively sleepy (MOOSE) are the typical risk factors for OSA. However, you can be female, thin, young, not snore and not be sleepy and still suffer from obstructive sleep apnea due to smaller jaw structures and smaller upper airways.
If you’re having any signs or symptoms of OSA, it’s important to get checked out by a medical professional.
The Sleep Lab
When being evaluated for OSA, it’s recommended you see a sleep physician. Most sleep physicians will be neurologists, pulmonologists, otorhinolaryngologists, pediatricians, anesthesiologists and family medicine doctors who undergo subspecialty training in sleep medicine.
Often, a sleep study will be suggested. However, for some, sleeping overnight in a strange place with wires hooked up can be a barrier to getting tested. Fortunately, there are other options. In some instances, simpler home tests can be ordered by physicians.
If you’re found to have sleep apnea, there are a number of different, effective treatment options, including conservative methods, medical devices and, in some cases, surgery.
5 Initial Conservative Steps for Treating OSA:
1. Lose weight. If you’re overweight, start by losing weight through a healthy diet and exercise regimen. While it’s been shown that lack of sleep can make it hard for someone to lose weight, losing even 5 to 10 pounds can help.
2. Don’t eat late. Eating close to bedtime will increase acid reflux in your throat every time you stop breathing; this is due to a suctioning effect. It’ll wake you up more often and lessen your sleep quality.
3. Breathe well nasally. Optimal nasal breathing is important so you don’t open your mouth, which causes your tongue to fall back more, leading to more obstructed breathing. Good nasal breathing also significantly improves your chances of doing well for more formal OSA treatment options. Chin straps or mouth taping can sometimes help.
4. Do tongue exercises. Researchers from Brazil found that a regimen of tongue exercises lowered the severity of OSA by about 50 percent.
5. Don’t sleep on your back. Most people with OSA won’t be able to sleep on their backs since the tongue falls back due to gravity. When in deeper levels of sleep, the tongue and throat muscles become even more relaxed. If you’re a side or tummy sleeper and are suddenly forced to sleep on your back (due to an injury or surgery), try to go back to your previous sleep position as soon as possible.
If these conservative steps don’t work, there are three formal options to consider:
1. Continuous Positive Airway Pressure, or CPAP. Gentle air pressure is passed through a mask over your nose (or nose and mouth), attached to a quiet and small bedside pump. This allows you to breathe properly at night. The best pressure is either measured in a second overnight sleep study (CPAP titration), or you’re given an automatic PAP machine (if you initially underwent a home test). With proper guidance from your sleep physician and equipment company, most people can sleep much better at night. The only way to know if you’ll benefit is if you try it.
2. Mandibular advancement device. Specialized dentists can make devices that pull your lower jaw forward, which results in pulling your tongue forward. These devices are recommended for people with mild to moderate OSA and can be considered as first-line therapy, in addition to CPAP.
3. Surgery. Before 1980, the only option available for OSA was a tracheotomy. Now, there are dozens of different surgical options for various areas and types of obstruction, from the tip of the nose to the voice box. However, surgery should be considered only after trying one or both the above formal options.
Since everyone has different levels and degrees of obstruction, there’s no one option that’s best. It’s important to work with your doctor to determine what’s most ideal for each individual situation. If you are at risk for OSA or exhibit any signs or symptoms, get tested. If you are found to have OSA, there are many treatment options available to help you improve your health and feel refreshed after a great night’s sleep.
