Obstructive Sleep Apnea-Hypopnea Syndrome

The following discussion is for general informational purposes only and is not meant to provide the reader with specific medical advice. Please consult with your personal physician, or with a neurologist, for specific advice, guidance and information regarding your particular circumstances.

Description: 

Sleep related breathing disorders such as obstructive sleep apnea-hypopnea (OSAHS) syndrome are common, affecting up to 5 percent of the adult population.  It is caused by partial to complete collapse of the airway while sleeping.  Snoring is a common complaint associated with sleep related  breathing disorders and is brought up by the bed partner.   A sensation of gasping or choking in sleep, and recurrent dreams of suffocating or drowning may also be associated with sleep related breathing disorders.   Frequently, a bed partner may witness periods of apnea, defined as complete cessation of breathing for 10 seconds or longer while sleeping.   An overnight polysomnogram, or sleep study, is the most commonly used test diagnose the problem.  Sleep apnea is associated with obesity as well as certain craniofacial features including deviated nasal septum, high arched narrow palate, mandibular hypoplasia, and a large neck circumference.

Symptoms: 

Sleep related breathing disorders can cause both nighttime and daytime symptoms.  Common nighttime symptoms include snoring, witnessed breathing abnormalities, frequent awakenings, sensations of choking and gasping, frequent urination after sleep, and dry mouth with the need to keep a glass of water at the bedside.  Common daytime symptoms include excessive sleepiness, clumsiness,  loss of dexterity, irritability, personality changes, memory impairment, decreased libido, impotence, and headaches.  Undiagnosed and untreated sleep apnea can increase the risk of hypertension, cardiac disease, stroke, as well as accidents due to excessive daytime sleepiness.

Treatment: 

Treatment depends on the kind of sleep apnea you have:

A machine may be used to help you get more air during sleep, with a mask that may be placed over your nose and mouth, or just your nose. 

  • A continuous positive airway pressure (CPAP) machine is used to keep your airway open during sleep. The machine blows a gentle stream of air into the mask when you breathe. This helps keep your airway open so you can breathe more regularly. Extra oxygen may be given through the machine.
  • A bilevel positive airway pressure (BiPAP) machine gives air but lowers the pressure when you breathe out.
  • An adaptive servo-ventilator is a machine that only gives air when it senses you are not breathing.

 

A mouth device that looks like a mouth guard stops your tongue and other tissues from blocking airflow.

Surgery may be needed to remove extra tissues that block your mouth, throat, or nose.

Manage or prevent sleep apnea:

  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
  • Do not drink alcohol or take sedative medicine before you go to sleep. Alcohol and sedatives can relax the muscles and tissues around your throat. This can block the airflow to your lungs.
  • Maintain a healthy weight. Your healthcare provider can tell you what weight is healthy for you. He or she can help you create a weight loss plan, if needed. The plan will include healthy foods and regular exercise to help you reach your healthy weight. Exercise can also help you sleep and may reduce stress.
  • Sleep on your side or use pillows designed to prevent sleep apnea. This prevents your tongue or other tissues from blocking your throat. You can also raise the head of your bed.

Follow up with your doctor as directed: You may need to have blood tests during your follow-up visits. You will need to work with your healthcare provider to find the right breathing support equipment and settings for you. Write down your questions so you remember to ask them during your visits.