​Obstructive Sleep Apnea

Obstructive sleep apnea is a serious medical disorder seen primarily in men. Unfortunately, this is frequent overlooked as “normal” snoring. This condition occurs when obstructions in the nose and throat block the ability to breathe.

This can cause several symptoms including:

1. Gasping for air during sleep
2. Witnessed apnea (stopping of breathing for at least 10 seconds)
3. Waking up tired, even after a full night’s sleep
4. Feeling sleepy during the day (at work or while driving)
5. Irritability or short temper
6. Problems with concentration or memory
7. Medical conditions such as high blood pressure and heart disease

Breathing During Sleep

Snoring is caused when there is narrowing of the normal airway. Because of a phenomenon known as the “Bernoulli Effect”, air flows faster through a narrowed passage similar to how water sprays faster and farther when you put your finger on the tip of a garden hose.

This faster flow of air causes high frequency vibrations of the soft tissue of the airway resulting in the characteristic sounds of snoring.

Different patterns and sounds of snoring can occur if the obstruction is located in the nose or in the back of the throat.

Obstructive sleep apnea occurs when there is an actual obstruction of airflow and no air enters the lungs. This usually occurs during deep sleep due to relaxation of the muscles of the throat that keep the airway open during the day. The body sense the inability to breathe and tries to open the airway by bringing the brain out of deep sleep to restore muscle tone and the airway (gasping and frequent arousals at night). Given the choice between deep, restful sleep and oxygen, the body chooses oxygen. The resultant disruption and lack of deep, restful sleep results in the brain craving sleep during the day (feeling tired or even falling asleep during quite periods)

If left untreated, obstructive sleep apnea can lead to serious health and safety consequences. There is an increased risk of automobile accidents because of the impaired concentration and attention deficit that is caused by the apnea. In fact, the risk is the same as if one had three drinks before driving every time one gets behind the wheel! Long term risks include high blood pressure, heart disease, heart attack, stroke and sudden death. This is not a small risk. One study show that over 50% (!) of men with untreated obstructive sleep apnea suffer a serious health condition or even death within 10 years.

The doctor will perform a detailed history and physical examination including an endoscopic examination of the upper airway. He will also recommend a sleep study (overnight polysomnography) to objectively quantitate the severity of the disease. Based on his finding, he will recommend one of several treatment options.