Obstructive Sleep Apnea, commonly known as OSA, is a life-threatening breathing disorder that occurs during sleep. Apnea refers to a period of 10 seconds or more of not breathing; during an apnea, the upper airway collapses, obstructing the flow of air (a partial obstruction or shallow breathing is referred to as a hypopnea). Apneas may result in a decrease in blood oxygen, an increase in heart rate and an arousal, possibly occurring many times in an hour, which causes excessive daytime sleepiness, or EDS.

There are three types of sleep apnea:

Central sleep apnea (CSA) refers to a lack of effort to breathe rather than an obstruction. It occurs when the brain does not send the signal to the muscles to take a breath, and there is no muscular effort to take a breath.

Obstructive sleep apnea (OSA) occurs when the brain sends the signal to the muscles, and the muscles make an effort to take a breath, but they are unsuccessful because the airway becomes obstructed and prevents an adequate flow of air.

Mixed sleep apnea occurs when there is both central sleep apnea and obstructive sleep apnea.

While sleeping, the brain instructs the muscles for breathing to take a breath. When an apnea occurs, sleep usually is disrupted due to inadequate breathing and poor oxygen levels in the blood. Sometimes this means the individual wakes up completely, but sometimes this can mean the person comes out of a deep level of sleep and into a more shallow level of sleep.

Some risk factors of OSA include, but are not limited to a decreased quality of life, hypertension and cardiac.

Some signs and symptoms of OSA include snoring; obesity; hypertension; depression; excessive daytime somnolence; morning headaches; gasping or choking during sleep; large neck; frequent urination; poor memory; and restless sleep. Usually if patients have two or more symptoms, the physician will refer them to a sleep lab for a nocturnal polysomnogram.

Treatment of sleep apnea may be either surgical or nonsurgical 

The most commonly prescribed therapy for the OSA syndrome is nonsurgical, continuous positive airway pressure – better known as CPAP therapy – and for the most part, the most effective therapy if the patient is compliant. CPAP applies a continuous pressure to the airway acting as a “pneumatic splint”; eliminating respiratory events, snoring, arousals, blood oxygen desaturations; and increasing sleep efficiency. CPAP complications can be nasal dryness and congestion (heated humidification and/or nasal spray can help with this), pressure sores, Rhinitis, skin rashes and central apneas but this is the preferred treatment. However, there are surgical therapies, such as a procedure called Uvulopalatopharyngoplasty, but this procedure only has a 4 percent success rate and is considered quite painful. Tracheotomy is a procedure used to bypass the point of obstruction and is 100 percent effective, but requires a considerable life change and is generally reserved for those patients with life-threatening sleep apnea who are unresponsive to CPAP or reconstructive surgery on the upper airway.

Noticeable symptoms of sleep related issues:

• Night terrors, or erratic behavior in the middle of sleeps
• Feeling of suffocation
• Restlessness, tossing and turning frequently
• Bed wetting (primarily in adolescence)
• Restless Leg Syndrome
• Insomnia
• Snoring

Though common, these symptoms may detect a treatable, yet, life-threatening sleep disorder. A good night’s rest might be the answer to many of problems.

For more information please call the Texas Christian Care Sleep Center.

Donna J. Miranda, RPSGT