Sleep Apnea: Understanding the Signs and Symptoms
Sunday, February 26, 2012
By Robert C. Robinson III, MD
Recently the wife of the late Reggie White, football legend and NFL Hall of Famer, has been bringing attention to the medical condition that plagued her husband, obstructive sleep apnea.  As the obesity epidemic proves to be more of an issue in our community, so
too does sleep apnea.  Here are a few points that you and your loved ones need to know about sleep apnea, its symptoms, side effects and treatment.
What is sleep apnea?
Obstructive sleep apnea (OSA) is a condition in which affected individuals have periods during their sleep when their breathing decreases or stops (apnea) due to collapse of the airway.  These periods of decreased breathing result in decreased oxygen flow to vital tissues and organs in the body.  As the body tries to compensate, there are often multiple awakenings throughout the night.  This causes the characteristic excessive daytime sleepiness so often found in sleep apnea.
Who is affected by sleep apnea?
Most often sleep apnea affects obese individuals however it is important to recognize that anyone can be affected by sleep apnea.  The major factor contributing to the development of sleep apnea is excessive soft tissue compressing the airway.  This is often seen in the obese.  However, other risk factors such as smoking, chronic nasal congestion, upper airway abnormalities (enlarged tonsils or adenoids), diabetes, and family history may also contribute to developing sleep apnea.
How do I know if I have sleep apnea?
A definitive diagnosis of sleep apnea is typically established by way of a sleep study known as polysomnography.  During this test a neurologist or pulmonologist will have you spend the night in a “sleep lab” where they will monitor your activity during sleep.  The purpose of this monitoring is to observe if and how many periods of apnea an individual experiences.  Below is a list of symptoms that an individual with sleep apnea may notice:
Loud snoring and snorting sounds during sleep (often recognized more by the spouse or significant other rather than the affected individual him or herself)
Daytime sleepiness
Morning headaches upon awakening
Falling asleep at inappropriate times during the day
Not feeling rested after a full night’s sleep
Chest Pain
High blood pressure
What are the risks of sleep apnea?
Untreated sleep apnea can lead to a number of serious medical complications.  In addition to increased risks of accidents and injuries due to excessive fatigue and the inability to concentrate, sleep apnea may also contribute to heart disease, stroke, and sudden death.  High blood pressure, heart failure, irregular heart rhythms, and pulmonary hypertension (elevated blood pressure in the lungs) can also be caused by sleep apnea.
How is sleep apnea treated?
Depending on the cause and severity of sleep apnea, various treatment options exist.  Your physician will determine if lifestyle modifications, surgery, nighttime oxygen therapy, or a combination of these treatments are appropriate for you.  
Weight Loss
For those individuals in whom weight is the major contributor to their sleep apnea, weight loss may prove curative.  However, significant weight loss to the point of cure of sleep apnea may take time.  Therefore it is likely that one of the following therapies will be used even if only temporarily.
The most common form of treatment is use of a CPAP (continuous positive airway pressure) machine which blows a continuous stream of air into the patient’s airway to prevent the airway from collapsing.  Your doctor will need to fit you for your CPAP mask.  This is to ensure it is delivering the air to you appropriately.  It will also be necessary to titrate or adjust the flow of air from your device to meet your specific airway needs.
In those individuals who have an anatomic defect contributing to their sleep apnea, surgery may be a viable option.  These individuals include those who have very large adenoids, tonsils, or other soft tissue structures that are compressing their airway and contributing to their sleep apnea.  Surgery is not appropriate for everyone.   Therefore it is important that you speak with your physician to see what treatment option is best for you.
What do I need to do if I suspect sleep apnea?
The best thing to do if experiencing any of the symptoms of sleep apnea is to visit your doctor.  Often times the effects of sleep apnea can be treated or reversed if caught early enough.  Sleep apnea affects 1 out of every 5 people in this country and many are undiagnosed.  Prevent the long-term complications of sleep apnea by seeking treatment today.
This was printed in the February 26, 2012 - March 10, 2012 Edition

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