If you are overweight, snore heavily, awaken several times during the evening, get morning headaches and daytime fatigue, you are likely to have sleep apnea.
Obstructive sleep apnea is the most common form of sleep apnea. Anything that can block your airway from the nose, mouth, jaw or throat can cause a decreased amount of air to get to your lungs. Your airway can become blocked when the muscles in your tongue and throat relax while you are sleeping. In some cases, especially in children, it can be the tonsils or adenoids.
It is estimated that 3 to 7 percent of males and 2 to 5 percent of females in the United States have been diagnosed with Obstructive Sleep Apnea. These rates are even higher for people over the age of 65. It is also believed that an additional 5 percent of the general United States population has undiagnosed sleep apnea.
Besides the nighttime arousals, morning headaches and daytime tiredness, obstructive sleep apnea can increase the risk of heart arrhythmias, heart attacks, stroke and death. Symptoms may also include irritability, difficulty concentrating and frequent nighttime urination. Obstructive sleep apnea is more likely to occur if you are overweight, drink alcohol before sleeping, use certain medications or sleep on your back. Sometimes, patients come to their family doctor after their family members become concerned because of loud snoring, gasping, choking, temporary breathing stoppages or restless sleeping.
Obstructive sleep apnea is diagnosed based on a patient’s history and physical condition, in addition to a sleep study that is usually done in an overnight sleep lab. For patients who are unwilling or unable to undergo an overnight sleep study in a sleep lab, portable home monitoring is an alternative. This process, however, will not supply as much information as the more comprehensive sleep lab study.
Once the diagnosis of obstructive sleep apnea is made, the treatment usually consists of a device that delivers a continuous positive pressure air flow to the patient while he or she sleeps. The unit is known as a CPAP. In some cases, surgery is used to relieve the obstruction to the airway.
Lifestyle modifications are important. Weight loss is one of the most important of these lifestyle modifications, as it can reduce the symptoms of the obstructive sleep apnea and also reduce the risk of forming other disease states. A regular exercise program should be initiated, especially early in the day. Alcohol should be avoided as well as medications that can be sedating. A number of medications have been studied in multiple medical drug trials, but at the present time there is insufficient evidence to recommend drug therapy for obstructive sleep apnea.
If a patient has any of the above signs or symptoms of sleep apnea, he or she should visit their primary care physician so that a correct diagnosis can be made and treatment initiated. Delaying treatment can have long-term negative consequences to one’s health with possible damage to the heart as well as other organs. ••
Joseph Pongonis, M.D., practices family medicine with EPIC Physician Group, 8019 Frankford Ave.