What is obstructive sleep apnea?

Condition can lead to, worsen variety of health woes

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photoDr. Britt Jura, The Vancouver Clinic

Obstructive sleep apnea refers to a disorder where airflow is limited or stopped while a person sleeps.

When we sleep, all of the muscles in the body relax. As the muscles surrounding the throat relax, this can lead to a narrowing or collapse of the airway. When this occurs, the amount of air reaching the lungs is reduced. The brain and body may become oxygen deprived, causing a person to wake up or have disrupted sleep.

Common symptoms of sleep apnea include snoring, pauses in breathing, fatigue and sleepiness during the daytime. Other possible symptoms include: morning headaches, waking up with a dry mouth, waking up gasping for air, memory problems, difficulty staying asleep, and waking frequently to urinate.

Risk factors for sleep apnea include excess weight, older age, male gender, large neck size, a smaller airway or mouth, and having family members with a history of sleep apnea. Certain medications or alcohol use can also lead to or worsen sleep apnea, by causing the muscles in the neck to relax too much during sleep. Enlarged tonsils are the most common cause of sleep apnea in children, but are a much less common cause in adults.

When airflow is restricted, it decreases oxygen in the bloodstream and causes frequent disruptions during sleep. Both effects are harmful to the body. Untreated sleep apnea can lead to or worsen high blood pressure, diabetes, congestive heart failure, abnormal heart rhythm, stroke, and heart attacks.

Sleep apnea is usually diagnosed by a sleep study. There are two ways to perform a sleep study: a patient may spend the night in bedroom inside a sleep lab to observe what happens while they sleep, or a patient may take home equipment for a portable

sleep study. Both methods of testing have their own benefits and drawbacks. If you feel a test is needed, you should talk to a sleep medicine specialist to decide which approach is best for you.

There are several possible treatments for sleep apnea:

CPAP (Continuous Positive Airway Pressure): Air is blown into a person's airway through a mask as they sleep. This extra air pressure keeps the airway open and prevents collapse or obstruction. This is the most common form of treatment for sleep apnea.

A dental device or oral appliance: A custom-molded mouthpiece that moves the lower jaw forward while a person sleeps. By moving the jaw and base of the tongue forward, the airway is supported and increased in size. This treatment is ideal for people with mild to moderate sleep apnea. This may also be used for the treatment of snoring in people without sleep apnea.

Surgery: Common surgical treatments aim to reposition or increase the size of the airway. Unfortunately, the common surgical procedures are not highly effective in adults. Surgery is often reserved for people who cannot tolerate noninvasive treatments for their sleep apnea.

Losing weight, avoiding alcohol or sedating medications before bedtime, and not sleeping on your back may also be helpful in the management of sleep apnea.

Additional information about sleep apnea and other sleep disorders is available at sleepeducation.com.

Dr. Britt Jura practices pulmonary and critical care medicine at The Vancouver Clinic at our 87th Avenue location and sleep medicine at the Clinic's Pacific Sleep Center NW at our Columbia Tech Center location.