Medically reviewed by
Dacelin St Martin, MD
Triple board-certified in Sleep Medicine,
Internal Medicine, and Pediatrics.
What is OSA | Symptoms | What Happens When You Sleep? | Health Effects | Diagnosis | How to Manage OSA | Treatment
Overview
For some couples, snoring can be an issue. It’s a problem that can cause arguments and interferes with a good night’s sleep for the snorer and their partner.
Many people assume that snoring is one of those unpleasant things that you learn to accept, but it can be a sign of something far more severe, and in some cases, fatal.
Obstructive sleep apnea (OSA) is a common sleep disorder that affects more men than women but still has a large prevalence in both genders. Age and obesity are risk factors, but sleep apnea can affect anyone regardless of their waistline, gender, or age.[1]
Identifying symptoms and managing OSA is key to mitigating the deadly health effects of this potentially fatal sleep disorder.
What is OSA?
OSA occurs when your breathing pauses intermittently while you sleep. Each pause lasts for a few seconds at a time and can happen hundreds of times each night. Your brain naturally wakes you up when this happens, causing you to gasp for air or let out a loud snort or gasp.
It’s hard to definitively recognize if you have OSA without a partner to witness your pauses in breathing. If you’re down for the count, you won’t be aware that your breathing has intermittently paused.
Symptoms
- Periodic pauses in breathing while sleeping, followed by loud gasps or snorts
- Snoring, usually quite loudly
- Daytime fatigue
- Difficulty concentrating and focusing throughout the day
- Mood swings
- Morning headaches
What Happens When You Sleep?
Breathing may slow down or become shallower for those who don’t have OSA; however, someone who has this disorder has regular bouts of pauses in their breathing.
OSA is caused by the back of the throat relaxing during sleep, causing upper airways to become narrow or even close up entirely for a few seconds.
This physiological occurrence stops you from breathing, causing your brain to send a signal to your muscles, jerking you awake to resume your regular breathing pattern.
OSA causes you to have disrupted sleep, and over time, this leads to a range of problems.
Health Effects
- Anxiety and Depression
- Problems with Memory Recall
- Confusion
- Compromised Immunity
- Heart Disease
- High Blood Pressure
- Stroke
- Irregular Heart Rate [2]
Diagnosis
Diagnosis
OSA’s most notable symptoms include frequent awakenings at night, daytime drowsiness, and snoring; however, further physical examination and tests can help confirm a diagnosis.
During the physical check-up, the doctor will examine the mouth, back of the throat, nose for swelling, enlargement of tissues, or other abnormalities. The doctor might measure the waist and neck circumference and check blood pressure to ascertain OSA’s possible causes.
Diagnostic Tools
1. Polysomnography (sleep study at a sleep center)
2. Home sleep studies through MHSleepTesting.com
An AHI: Apnea hypopnea index of at least 5 in either polysomnography or home sleep study is required to be classified as OSA.
The Severity of Sleep Apnea Based on AHI:
1. AHI of 0-5: No Sleep Apnea
2. AHI: 5-15: Mild OSA
3. AHI: 15-30: Moderate OSA
4. AHI: >30 Severe OSA
How to Manage OSA
The good news is that you can take steps to manage your OSA; however, you need to know if your exhibiting symptoms. If you suspect that you have sleep apnea, ask a family member or partner to watch you while you sleep to see if you have pauses in breathing or snore.
If you live by yourself and suspect that you have OSA, schedule an appointment with your doctor for a check-up. There are resources available, like home-sleep tests, that can diagnose OSA, and will also give your doctor an idea of what is going on.
Alternatively, your doctor may refer you for a sleep study at a sleep clinic. When this happens, you stay overnight in a sleep clinic for monitoring. Monitors measure what happens to you during your sleep, including your heart rate, breathing rate, and oxygen levels.
Smoking and obesity are two main risk factors for sleep apnea, so you will probably be asked to stop smoking and reduce your weight if these are a problem for you. In some instances, OSA can be managed by simply losing 10% of your body weight.
You should also avoid drinking alcohol before you sleep, and try sleeping on your side. If you find that you continuously roll onto your back, you could try sewing a tennis ball into the back of your t-shirt, which will encourage you to remain on your side.
Treatment
OSA can be managed through continuous positive airway pressure (CPAP) or oral device:
- CPAP Machine: A CPAP machine is worn while you sleep and consists of a mask that you wear over your nose or mouth. The machine pumps oxygen through the mask, improving your sleep, and ensuring that your airways remain fully dilated and don’t become too narrow.
- Mandibular Advancement Device: This is a device shaped like a mouth guard, which helps to keep your airways open while you’re sleeping.
Also, OSA can be managed surgically through a number of procedures:
- Nasal procedures, such as septoplasty, rhinoplasty, or nasal valve surgery
- Upper pharyngeal procedures, such as UPP (uvulopalatopharyngoplasty), tonsillectomy, adenoidectomy
- Lower pharyngeal procedures, such as mandibular advancement, hyoid and tongue suspension, or genioglossus advancement
- Maxillomandibular advancement surgery
- Tracheostomy
- Upper airway stimulation through the placement of a device from a company called Inspire, which opens airways with a click of a button
Conclusion
If you think that you may have OSA, talk to your doctor about your diagnostic and therapeutic options.
References:
- Jean-Louis, G., Zizi, F., Clark, L. T., Brown, C. D., & McFarlane, S. I. (2008). Obstructive sleep apnea and cardiovascular disease: role of the metabolic syndrome and its components. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 4(3), 261–272.
- Franklin, K. A., & Lindberg, E. (2015). Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea. Journal of thoracic disease, 7(8), 1311–1322. https://doi.org/10.3978/j.issn.2072-1439.2015.06.11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561280
