Obstructive Sleep Apnea - a Frequent Undiagnosed Condition

Introduction:

Obstructive sleep apnea, otherwise called OSA, is a condition characterized by obstruction of the upper airway, especially during sleep due to lax airway and narrowing of the airway due to obesity. It is a potentially serious sleep disorder, as it causes breathing to start and stop repeatedly when one sleeps. Snoring is the most important sign of sleep apnea. As air squeezes through the narrow airway, the person snores. If left untreated, sleep apnea can lead to severe health conditions, such as hypertension, stroke, heart problems, and diabetes. Diagnosing and treating this condition promptly is the key to preventing complications.

What Are the Symptoms of Obstructive Sleep Apnea?

Obstruction of the upper airway leads to a temporary stoppage of respiration, increased sympathetic drive, and increased pulse rate and blood pressure. These episodes result in decreased oxygen supply to the brain and other parts, causing the following symptoms:

• Loud snoring.

• Poor sleep quality.

• Daytime drowsiness.

• Feeling tired in the morning.

• Frequent headaches.

• Feeling grumpy.

• Forgetfulness.

• Gasping or choking at night.

• Drowsiness.

• Night sweats.

• Hyperactivity (in children).

• Depression.

• Poor performance at work or school.

• Poor sex drive.

• In severe cases, leg edema.

Daytime drowsiness increases the risk of road traffic accidents. As mentioned above, it also increases the risk of stroke, heart attack, and lung problems (pulmonary hypertension). In case one's partner complains about them snoring or getting up in the middle of the night gasping or choking or feeling tired and drowsy during the day, it is best to consult a doctor.

What Causes Obstructive Sleep Apnea?

In OSA, the muscles in the throat that support important structures, such as the soft palate, uvula, tonsils, and tongue, relax too much. When these muscles relax, the airway constricts, preventing breathing for 10 seconds or longer. This lowers the level of oxygen in the blood and results in the buildup of carbon dioxide.

It can also deprive the brain of oxygen, which makes the brain awaken a person for a brief moment so that the airway gets reopened. Most people do not realize that they wake up during the night. Some people get up snorting, choking, or gasping for air.

It is necessary to adequately investigate through ENT examination if one has any symptoms of nasal stuffiness and recurrent tonsillitis to rule out nasal causes of obstruction. Sometimes, thyroid problems will cause obstruction. Altered lipid profile and HbA1c sugar, that is, dyslipidemia and diabetes, are frequently associated problems. Vitamin D deficiency is also responsible.

What Are the Risk Factors of Obstructive Sleep Apnea?

The following factors might increase the risk of a person developing obstructive sleep apnea:

1. Obesity - The majority of people who suffer from sleep apnea are overweight or obese. It is due to the fat deposits surrounding the upper airway.

2. Hypertension - People with high blood pressure commonly have sleep apnea.

3. Obstructed Airway - Some people have naturally narrow airways, which, when combined with tonsils or adenoids, results in OSA.

4. Nasal Congestion - Chronic nasal congestion narrows the airway, which leads to OSA.

5. Asthma - Some studies have shown that asthma increases the risk of sleep apnea.

6. Diabetes - OSA is common in people with high blood sugar.

7. Smoking - People who smoke are at risk.

8. Sex - Men are more susceptible than premenopausal women, but the risk increases in women after menopause.

9. Genetics - The risk increases if any of the family members have OSA.

10. Other factors include a lower jaw shorter than the upper jaw (retrognathia) and people with a large tongue or narrow palate.

Who Is at Risk of Obstructive Sleep Apnea?

• Family members with obstructive sleep apnea.

• Continuous nasal congestion.

• Post menopause.

• Larger and thick neck.

• Thyroid conditions.

• Overweight.

• Problems in the tissues that support the head and neck.

• Smoking.

• Down syndrome.

What Are the Possible Complications of Obstructive Sleep Apnea?

The possible complications of OSA include:

• Daytime sleepiness.

• Difficulty concentrating.

• Hypertension.

• Abnormal heart rhythms.

• General anesthetics can worsen sleep apnea.

• Glaucoma.

• Sleep deprivation.

How Is Obstructive Sleep Apnea Diagnosed?

The specialist might perform the following tests if obstructive sleep apnea is suspected.

• Polysomnogram - This sleep study is performed by connecting one to various machines while sleeping. A polysomnogram measures the activity of various organ systems during sleep, which includes:

1. Electroencephalogram (EEG) - Measures brain waves.

2. Electromyogram (EMG) - Measures muscle activity.

3. Electrooculogram (EOM) - Measures eye movement.

4. Pulse Oximetry Test - Measures the oxygen levels in the blood.

5. Electrocardiogram (EKG or ECG) - Measures heart rate or rhythm.

6. Arterial Blood Gas Analysis (ABG)- Measures oxygen and carbon dioxide levels.

How Is Obstructive Sleep Apnea Treated?

The treatment options include:

1. Weight Reduction - One needs to have a low-fat and low-calorie diet to lose weight. A cure for this particular disease is weight reduction. So, a healthy lifestyle, including a healthy diet and regular exercise, is the central goal in managing OSA.

2. CPAP (Continuous Positive Airway Pressure) - It is a mask device that provides pressure during inspiration and expiration during sleep in order to keep the airways patent and avoid OSA.

3. Nasal Decongestants - They help relieve snoring in mild cases.

4. Bilevel Positive Airway Pressure (BiPAP or BPAP) - In case CPAP therapy is ineffective, BiPAP is used.

5. Positional Therapy - As sleeping on one’s back can worsen sleep apnea, patients are encouraged to sleep in other positions.

6. Surgery - Uvulopalatopharyngoplasty (UPPP) is the most common surgery for sleep apnea. It involves the removal of extra tissues from the back of the throat.

Also, regular exercise is vital. Chest physiotherapy and yoga will be helpful.

When Should a Person Consult the Healthcare Provider?

An individual should consult a doctor in case:

• If the person finds any symptoms of apnea or if snoring becomes problematic.

• When the person feels sleepy or drowsy throughout the day.

• If the person has a risk of other health conditions due to sleep apnea.

• If lack of sleep impacts the life of the person.

Conclusion:

Having symptoms such as snoring, interrupted sleep, unrefreshed sleep, morning headaches, daytime sleepiness, and so on, accompanied with being obese with a short and wide neck, could indicate that one is suffering from obstructive sleep apnea, which is frequently an undiagnosed condition and has multiple adverse effects on one's body. For an in-person consultation, one needs to visit a sleep specialist or pulmonologist. Always talk to a doctor if one has daytime drowsiness or sleep problems. The symptoms can be effectively managed with the help of different treatment options. Treatment options like using a device that keeps the airway open during sleep or a mouthpiece to keep the jaw forward while sleeping can be effective. Some cases can be treated with surgery. To know more about OSA, one can consult an obstructive sleep apnea specialist online.