What is sleep apnea and how do you treat it?

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.

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