Sleep apnea is a disorder in which breathing is interrupted periodically throughout the night. These pauses, or gaps, in breathing may be accompanied by choking or gasping but rarely awaken the sleeping individual. An estimated 18 million Americans suffer from sleep apnea, many of them unaware of their condition.
Are you experiencing symptoms of sleep disorders?
Take self test here
What Causes Sleep Apnea?
There are two main types of sleep apnea: obstructive and central. Obstructive sleep apnea occurs when the throat muscles relax and droop during sleep, blocking the airway and causing breathing difficulty. It is by far the most common form of the disorder. Central sleep apnea is the result of the brain failing to properly control breathing during sleep; this is rare.
The main sign of sleep apnea is chronic, loud snoring. Symptoms include daytime drowsiness, lack of concentration, memory loss, irritability and depression. You may experience frequent morning headaches and sore throats and wake up with a dry mouth.
Those who are male, overweight and older than the age of 40 are most at risk, though sleep apnea can – and does – affect people of both sexes and all ages. Other factors that can contribute to sleep apnea include natural aging, excessive or bulky throat tissue, large soft palate or uvula, small jaw, large neck and oversized tonsils or adenoids.
Allergies, sinus infections, tobacco use and alcohol all may play a role as well.
How Is Sleep Apnea Treated?
Sleep apnea is more than just a nuisance that robs you of sleep. Left untreated, it can lead to serious health issues such as congestive heart failure, stroke, heart attack, high blood pressure and cardiac arrhythmia. If you suspect you are suffering from sleep apnea, schedule a visit with your physician who will perform a thorough physical examination and may set up a sleep study test.
You may be able to reduce the severity of your symptoms by implementing certain lifestyle changes. Try losing weight, cutting back or eliminating alcohol (especially before bedtime) and quitting smoking. Sleeping on your side instead of your back and elevating your head may also help.
The preferred method of treatment for sleep apnea is continuous positive airway pressure (CPAP). This involves controlled bursts of air pumped into your throat while you sleep, delivered through a mask that is worn over the nose and mouth and attached to a machine. Other options for treatment include oral mouth guards that reposition the lower jaw and tongue, nasal breathing strips and surgery.
Continuous Positive Airway Pressure (CPAP)
The most popular type of treatment for obstructive sleep apnea is the CPAP (continuous positive airway pressure) device. This machine utilizes a face or nasal mask connected to a pump, which provides a positive flow of air powerful enough to keep your airway passage open. The device must be worn every night to be effective.
While some find it inconvenient and uncomfortable, the results are typically instantaneous and worth the discomfort. Both machines and masks are available in a variety of styles and sizes, which can be geared toward your individual needs. Some people benefit from a nasal mask that covers the nose, while others require a full-face mask that covers both the nose and mouth.
Nasal pillows, consisting of soft silicone tubes that are placed directly in the nostrils, are another popular option. An optional humidifier can help prevent nasal irritation and drainage by providing a steady flow of heated and moisturized air.
A number of alternative PAP devices are available. Autotitrating positive airway pressure (APAP) automatically increases or decreases air pressure throughout the night as needed. Bi-level positive airway pressure (BPAP) devices increase the pressure level when the people breathe in, and decrease it when they breathe out. These machines often help individuals who have trouble with the basic CPAP device.
Oral Appliances
While continuous positive airway pressure (CPAP) therapy is the preferred method of treatment, not everybody is able to tolerate sleeping with a mask. Oral appliances are an alternative for these patients. They work by either moving the lower jaw forward to keep the airway passages open or holding the tongue in place to prevent it from falling backward and blocking the airway.
Oral appliances may be either fixed or adjustable and are available in many different styles. Some are custom designed to fit the individual’s mouth after impressions are made and must be prescribed by a dentist, oral surgeon or ENT physician with sleep medicine experience.
They are easy to use, may be inexpensive and are effective for treating a number of sleep disorders including snoring, upper airway resistance syndrome and obstructive sleep apnea. They are easy to insert and remove and tend to have higher compliance rates than CPAP. Younger patients who have to moderate sleep apnea, lower BMI and smaller neck sizes are most likely to see positive results from oral appliances.
UPPP
Uvulopalatopharyngoplasty, or UPPP, is a surgical procedure designed to treat obstructive sleep apnea that involves the removal of excess tissue in the throat to widen the airway, making it easier to breathe.
UPPP includes the removal of tissues that may include the uvula, tonsils, soft palate, adenoids, pharynx and, in some instances, small portions of the tongue. The procedure takes place under general anesthesia and may require a brief hospital stay for close monitoring post-surgery.
This treatment may be appropriate for those who experience sleep apnea due to excessive tissue and cannot use or are unwilling to use CPAP, or continuous positive airway pressure. However, it is not a viable solution for every patient. Results may vary, ranging from a possible drastic reduction in snoring episodes to additional treatment being required.
Your doctor can help you understand the risks associated with UPPP and determine what treatment is best for you.
Learn more how UPPP can help with sleep apnea
Inspire
Inspire is an implantable device, like a pacemaker, that monitors your breathing patterns while you sleep. It delivers mild stimulation to the nerve that controls movement of the tongue and airway muscles, keeping the airway open and preventing OSA.
The device contains three parts: a small generator, a breathing sensor lead and a stimulation lead. Patients use a small handheld remote to control the device, turning it on or off and pausing it during the night if needed. The stimulation is typically painless, and its strength can always be adjusted using the remote if needed.
Your specialist implants the Inspire device during an outpatient surgical procedure using general anesthesia. It is placed beneath the skin of the neck and chest via two small incisions. Most patients recover fully from surgery within a couple of weeks.
Learn More About How Inspire Can Help
Somnoplasty
Somnoplasty is a surgical procedure for treating snoring and obstructive sleep apnea. It works by shrinking tissue in the upper airway. Typically the inferior turbinate tissue is treated. This improves nasal airflow, allowing for unobstructed breathing.
This minimally invasive treatment method causes less pain than similar procedures used for upper airway obstruction.
Somnoplasty is an outpatient procedure that relies on low levels of radiofrequency heat energy to shrink tissue. The patient is given a local anesthetic, and the entire procedure takes only 30 to 45 minutes.
Side effects such as swelling and discomfort are common but short-lived, typically lasting no more than a few days. More serious complications such as uncontrolled pain, infection, and bleeding are rare.
More than one treatment may be needed for best results.
Call Carolina Ear Nose & Throat – Sinus and Allergy Center at (828) 322-2183 for more information or to schedule an appointment.