Obstructive Sleep Apnea/Hypopnea Syndrome
What is obstructive sleep apnea/hypopnea syndrome?
Obstructive sleep apnea/hypopnea syndrome is a sleep disorder that affects people’s breathing for short periods of time during sleep. Obstructive sleep apnea (OSA) occurs when the tongue and the tissues at the back of the throat relax and completely block the airway to the lungs. It can happen 20 to 30 times or more an hour. Hypopnea syndrome is a partial reduction in air flow during breathing, ranging from 30 to 50 percent, caused by a partial closure of the airway.
Eighteen million American adults are estimated to suffer from OSA. However, an estimated 80 to 90 percent of moderate to severe cases remain undiagnosed. OSA occurs in all age groups but is most common in middle-aged adults. Twice as many men as women are affected. Risk factors for OSA include family history, weight gain, age, use of certain medications, and the use of alcohol prior to sleep. OSA is associated with an increased risk of death, diabetes, hypertension, congestive heart failure, stroke and depression.
What are the symptoms of OSA?
A cardinal symptom of OSA is excessive sleepiness. Loud snoring is another symptom, especially loud snoring accompanied by periods of silence followed by gasps for air. Additional symptoms can include restless sleep, morning headaches, trouble concentrating, irritability, forgetfulness, anxiety, and depression.
How is OSA diagnosed?
In addition to a thorough physical examination by a physician, tests to evaluate sleep patterns are the only way to diagnose OSA. These include the polysomnography (PSG) test, an overnight test performed in a sleep clinic or at home that measures disruptions in the sleep/wake patterns (electrical activity of the brain, heart rate) and respiratory effort (air flow, blood oxygen levels). The test measures the number of times breathing is impaired during the night to determine the severity of sleep apnea.
How is OSA treated?
Prompt and proper diagnosis of sleep apnea is an important first step in treating the disorder. Mild OSA can sometimes be overcome through weight loss or by preventing the patient from sleeping on his or her back. Surgery to remove excess tissue in the throat, nose or mouth in order to widen the airway is an option for some patients. Standard treatment is nasal continuous positive airway pressure (CPAP). Nasal CPAP uses a mask-like device and pump that work together to keep the airway open with air pressure. Even with treatment for the underlying obstruction, many patients still experience excessive sleepiness and a doctor may recommend additional therapies for patients who continue to experience excessive sleepiness.